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BBC News
3 days ago
- Health
- BBC News
Covid Inquiry: Care homes had 'fragile' workforce at start of pandemic
Northern Ireland's care home sector had a fragile workforce compounded by tight budgets as it entered the pandemic, the UK Covid-19 Inquiry has were evident pressures in social care at the start of 2020, with an estimated 1,400 care home workers needed each year to maintain staffing levels, Professor Sean Holland was chief social work officer with the Department of Health at the time of the inquiry is currently examining adult and residential care as part of its scrutiny of the response to the pandemic. Prof Holland said social care had been characterised as low-wage, with workers often on zero-hours contracts and a high turnover of had been made to make the sector more appealing as a long-term career option, he about the state of the sector as it entered the pandemic, he said: "There would have been a fragility in the workforce and there would have been pressure on budgets, because the relationship is that the budget buys the service, which drives the workforce." Struggles with isolation policies The inquiry heard that many care homes in Northern Ireland had struggled to ensure they had proper isolation policies in place for elderly patients who were being discharged from hospitals into their care.A report from the Regulation and Quality Improvement Authority (RQIA) had suggested that only about 80 care homes out of the 480 across Northern Ireland had isolation Holland said this had been "a desktop exercise" review and had not been done in person, and he estimated the number of homes with isolation availability had been higher. Prof Holland said mechanisms for isolating patients should be thought about in planning for future pandemics."That then takes you to looking at the actual configuration of care homes," he said."Building of care homes over the years has always been subject to standards, but those may benefit from being revisited to consider how the infrastructure would support a positive response to a future pandemic."The inquiry referenced one study which suggested patients discharged from hospitals to care homes were not substantial causes of Covid outbreaks. NI's care home deaths Prof Holland said Northern Ireland's lower number of care home deaths during the pandemic should be used as a learning tool to deal with future global outbreaks."When I say this, this is not in any way to minimise the experience of people who died in care homes in Northern Ireland, and it is not to suggest anything positive about the system... we know you were least likely to die in a care home in Northern Ireland compared to England, Scotland and Wales," he said."Compared to England, by quite a margin. Many European countries did better than Northern Ireland."He added: "One thing for future learning is that we have to understand that better, because currently we don't really know why."Prof Holland said at one stage during the pandemic, there was a suggestion of creating "a ring of steel" around care homes, with staff remaining there and sleeping there had been no take-up when an expression of interest for the so-called Safe At Home model had been had also been concerns raised by trade unions over the supply of PPE, staff feeling compelled to stay in the care homes and adequate payment for workers, the inquiry Holland told the inquiry about difficulties in obtaining enough supplies of personal protection equipment (PPE).He said he had personally told all the Northern Ireland health trusts that there should be "no boundaries" in the distribution of PPE between the public and independent sectors."I remember someone saying: 'Are you saying we have to share our PPE?'."And I said: 'It is not your PPE, this is a resource for Northern Ireland'."
Belfast Telegraph
15-07-2025
- Health
- Belfast Telegraph
‘We've had more than enough': Bereaved NI families demand action on mental health services
Colleen Bell (39) and Mary Gould (58) were among the group of campaigners who have been backed by Melanie Leahy. Ms Leahy led a 10-year campaign for a public inquiry into more than 2,000 mental health-related deaths in Essex between 2000 and 2023. Professor Phil Scraton also backed the families during the meeting hosted by New Script for Mental Health, a grassroots mental health rights movement. The Queen's University professor led the Hillsborough Independent Panel's research, and played a key role in uncovering the truth behind the 1989 disaster that killed 97 football fans. His book, Hillsborough: The Truth, is widely seen as the definitive account of the disaster. Ms Leahy, whose son Matthew (20) died in 2012 while a patient at a mental health facility, described more than a decade of 'fighting for the truth'. She said she has been in contact with the Northern Ireland families for several months after coming across their campaign on social media. She said: 'I hope my determination serves as a powerful reminder that truth will find its way, no matter what the obstacles.' Ms Gould, whose 21-year-old son Conall died in 2017 following a struggle with mental health, said the current situation was a 'scandal'. She described the standards of care within mental health as 'atrocious', and said she feels that those who speak out 'have our voices silenced by a system unwilling to acknowledge the breadth of this crisis'. As a gesture of solidarity, Ms Leahy and the Essex campaigners have included a photo of Conall in a montage displayed at the inquiry. Ms Gould, a midwife from Ballymena, said that over two years after a High Court order, the RQIA has failed to meet its obligation to regulate community mental health services. 'Despite promises and briefings, the protocol it claimed to be developing remains unpublished and unproven,' she added. The establishment of a procedure for regulating community mental health services was ordered as part of a landmark judicial review ruling in May 2023, following a case taken by the family of Belfast man Gareth Waterworth. It also required the establishing of a protocol for further investigations. An RQIA spokesperson said the policy is at 'development stage and being utilised to set out the approach to undertaking an inquiry into any case where it appears that there may be deficiency in care or treatment'. They added: 'The policy is currently subject to equality screening and RQIA are working closely with the equality unit in Business Services Organisation to support the equality screening of this key policy. On completion of equality screening and final internal quality assurance checks RQIA intend to publish the policy.' Ms Bell, from Coalisland, lost her uncle Stephen in July 2016, less than two months after he suffered an adverse reaction to an antidepressant. 'We just had absolute blind faith in doctors. So when Stephen was telling us it was the medication, we were saying 'how could medication do that', we didn't dare to delve into it,' Ms Bell said. She has since campaigned for greater transparency around medication risks. Sara Boyce, New Script for Mental Health campaign organiser, said: 'Families involved in New Script are united in their desire to ensure that the harm and loss they experienced because of health service failures should never happen to other families.' She said that in Northern Ireland we 'need to start doing things differently'. 'Over the 15 to 17 years of the campaign, one of the biggest lessons for families has been that trying to fix bits of the mental health service isn't working,' she added. 'As a starting point, we must start listening to families, because families know, because they have lived it.' News Catch Up - Tuesday 15th July Ms Boyce said Health Minister Mike Nesbitt needs to 'get a grip', adding that there are failures across the board. 'Families have had more than enough, because lessons are not being learnt,' she said. Ms Boyce also called for greater transparency, saying data on the number of people accessing mental health services and those who have died while under their care must be made public. Ms Gould pointed to Essex as evidence that the scale of the crisis may be greater than it is believed, noting that more than 2,000 cases were identified there.
BBC News
07-07-2025
- Health
- BBC News
UK Covid-19 Inquiry: NI health watchdog governance was 'missing'
The head of Northern Ireland's health watchdog has said its regular governance processes were "missing" at the height of the Covid-19 Donaghy, chief executive of the Regulation and Quality Improvement Authority (RQIA), was speaking at the UK Covid-19 2020, several senior RQIA staff were redeployed and its entire board resigned after a row over the handling of the coronavirus Donaghy said there was "anxiety" within the watchdog and Stormont's Department of Health to ensure what happened would "never recur". The inquiry in London is examining the impact of the pandemic on the social care aims to consider government decision-making, steps taken to prevent the spread of Covid in care homes, and their capacity to respond to the June 2020 the entire RQIA board quit, claiming they were not consulted on several decisions taken by the health included reducing care home inspections and redeploying senior RQIA staff some months earlier to other health independent review in 2021 found several issues led to the mass resignations, including breakdowns in working relationships. 'Particularly difficult' Ms Donaghy joined the RQIA in July 2021 as chief told the inquiry that a lot of senior experience "was gone" when several senior staff were redeployed during the pandemic."The regular processes of governance were missing, and the challenge and oversight of decision-making was not what it should have been," she Donaghy, who previously worked in a senior role in the Northern Health and Social Care Trust, said it was "shocking" when the RQIA board resigned."In the height of a pandemic, to be facing into such organisational issues, I mean, it would not be welcome at any time but it was particularly difficult at that time," she said it meant significant decisions were being made "without the effective scrutiny and oversight".Ms Donaghy said the RQIA last week signed off a "partnership agreement" with the Department of Health following the independent review by David Nicholl."It has taken us a considerable time to get to this point," she added."I think it demonstrates the level of anxiety on both the Department of Health, and us in RQIA, to ensure what occurred and reported under the Nicholl report will never recur."The inquiry was launched in 2022 by former Prime Minister Boris Johnson, who said the government's actions would be put "under the microscope".
Belfast Telegraph
03-06-2025
- Health
- Belfast Telegraph
Department of Health bypassed own regulator over report into the Royal's cardiac unit
A leaked report made headlines last week after it found an 'intolerable working environment and a pattern of consistently poor behaviour within the unit'. It indicated operations had been cancelled due to 'personal grievances' between staff and that four consultants had been working from home, citing 'safety and wellbeing' concerns. Chair of the health committee, Sinn Féin's Philip McGuigan, has called on the department to publish the report 'in the interest of transparency', adding that he had not yet seen it. Northern Ireland's health watchdog, the Regulation and Quality Improvement Authority (RQIA), has confirmed it was not approached to carry out a review into the issues at the cardiac surgery unit. A spokesperson said: 'RQIA has not been asked to produce any such report recently.' The body had previously inspected the unit in December 2021. It came a year after a Royal College of Surgeons invited service review report which found a 'breakdown of communication and working relationships within the service'. The invited service review was completed in March 2020, just weeks before the Covid-19 pandemic took hold, and made 37 recommendations relating to interpersonal and behavioural issues within the service. RQIA's review found some improvements had been made. 'RQIA were pleased to see early signs of change and improvement whilst cognisant that it takes time to make cultural changes and embed these fully within a service; it is a journey that requires strong and resilient leadership to embed the vision, align behaviours accordingly and instil robust systems of monitoring and accountability,' concluded the regulator. It recommended that the Trust should 'ensure the cardiothoracic management team involves and actively engages with all staff disciplines and groups'. 'Meetings should be structured to promote constructive discussion and collaboration to address the recommendations of the invited service review,' added the review team. It is understood the leaked review was commissioned by the Public Health Agency (PHA) working alongside the department. A Department of Health spokesperson said 'expert input' from other parts of the UK was required to complete the report. 'Cardiac surgery is a highly specialised service and the Royal Victoria Hospital is the only unit in Northern Ireland to deliver this service,' they said. 'For this reason, securing expertise from people experienced in the area means going outside Northern Ireland. 'An earlier external review had been undertaken in the Royal Victoria Hospital by the Royal College of Surgeons. That review confirmed the cardiac service was safe, but highlighted areas for improvement. Whilst Belfast Trust subsequently undertook work to address issues raised, the department and PHA obtained further external expertise to help support the team with a focus on two metrics — patient safety and team working. 'It was agreed to engage an experienced team with specific expertise involving senior clinicians who had completed similar work in the UK, including in other cardiac surgery units.' Mr McGuigan told the BBC Sunday Politics programme that the report had led to 'very many public trust issues'. 'We are told there are recommendations and an action plan contained within the report. 'I think for proper scrutiny and to restore public trust, what we need to see is the report in the first instance published so we can interrogate the recommendations for restoring public trust in this issue,' he said. Health Minister Mike Nesbitt has said he wants to place the report in the library of the Assembly, but is currently receiving legal advice. 'People need to have confidence when they go to a hospital or whatever health setting that they are going to be looked after properly,' added Mr McGuigan. 'One of the things in the report was that the behaviour of the staff was posing a risk to patient safety, so that in itself is very concerning.'
BBC News
15-05-2025
- Health
- BBC News
Belfast: RQIA watchdog's 'serious concerns' at supported living facility
"Serious concerns" have been identified by Northern Ireland's health watchdog regarding the delivery of care at a supported living facility in west same facility – The Mews - was previously criticised by the parents of one of its service users in an interview with BBC News NI. The Cedar Foundation, which runs the service, said it acknowledged there were "areas" where compliance had not been "fully met".It comes after the Regulation and Quality Improvement Authority (RQIA) found a series of failings which, it said, compromised service users' quality of life. Cedar said it was now working to implement a "comprehensive action plan" to address the issues it also argued that the standards applied by the RQIA in regulating supported living services were outdated and not necessarily relevant to people with complex this year, Mark and Marjorie Sharp said Cedar had threatened to evict their daughter after they made multiple complaints regarding her 39, has a severe learning disability and has been living at The Mews for seven and Mrs Sharp have now welcomed the RQIA's decision to take enforcement action against the facility. The RQIA carried out an unannounced inspection at The Mews over the course of three days in February and March. It said this was in response to receiving information at the start of concluded that the service was "failing to consistently and meaningfully implement a supported living model of care" that focuses on promoting service users' "independence" and "choice", and the "delivery of person-centred care".It said these "deficits" undermined the core principles of supported living and therefore "compromise service users' quality of life".The watchdog issued the facility with two "failure-to-comply" notices - giving it until June to ensure its concerns have been is also seeking to impose a condition on The Mews that would prevent it from admitting any new service users without prior and Mrs Sharp said they recognised some of the failings identified by the RQIA in their daughter's said Laura had "no quality of life" at The Mews and they believed she had been "neglected".They said she was "more like a detained patient" than someone being supported to live as independently as possible. 'Not fit for purpose' In a statement to BBC News NI, Cedar said "many" of those within its supported living service had "positive experiences", but added there were "instances where individual needs may go beyond the scope of supported living".Among the RQIA's findings were a "limited structure" to service users' daily routines, as well as staff not having the required knowledge or skills to effectively manage or avert behavioural incidents, resulting in service users being "contained in a restrictive environment".It described as "concerning" the use of "restrictive practices", including the locking of some service users' doors and limiting their ability to access the garden and watchdog identified an "inflexible and indiscriminate" approach to the use of key fobs to control access to internal doors and gates, regardless of whether service users had said it was not assured that such practices promoted the "rights, dignity and choice" of those living at the told BBC News NI that the restrictive practices identified by the RQIA were in place specifically to keep some service users safe depending on the complexity of their needs and that they were formally assessed by the Belfast Health and Social Care Trust, which commissions the service. Following the RQIA's findings, Mr Sharp said the facility was "not fit for purpose".Mrs Sharp said her daughter was "suffering" in the facility – that her wellbeing had declined sharply over the past year to the point where she now sleeps during much of the day."When she first went in she was out every day either going shopping, or going for a walk, going for a coffee," she said."Laura has no quality of life. She's like a detained patient – or a detained resident in supported living. Laura has nothing to look forward to. She has no structure."Mrs Sharp added that she believed the system had "let Laura down". What has been the response? Cedar Foundation said it remained committed to doing its best "to ensure that disabled people get the support most appropriate to their needs".The Belfast Trust, which commissioned Cedar to provide Laura's care, said it was "very sorry" that the current situation concerning Laura's placement was "causing considerable stress and anxiety to her and her family"."Laura's wellbeing is of vital importance to us and we will continue to work with her family regarding the next steps in finding the best outcome for her," it trust added that it was working with Cedar on an agreed action plan to address the RQIA's this year, Cedar gave Mr and Mrs Sharp notice of what they described as their daughter's main reason for its decision, it said in a letter to the couple, was that it was "unable to provide the care and support that Laura needs".It added that relationships had "broken down" between Mr and Mrs Sharp and Cedar staff, citing "ongoing incidents of verbal aggression, disparaging comments, and intimidation" by Mr and Mrs Sharp towards and Mrs Sharp told BBC News NI they had never been abusive and had only ever acted in the best interests of their daughter.
