Two leading doctors in gerontological care have described undercover footage to be revealed in an RTÉ documentary tonight as shocking and disturbing.
It examines standards of care in several residential facilities owned by Ireland's leading provider of private nursing homes.
The company at the centre of the allegations, Emeis Ireland - previously known as Orpea - has apologised to residents and their families for the distress caused by the failings identified in the RTÉ report, saying it has launched an in-depth review to immediately address all issues identified.
The investigation which focuses on two nursing homes - The Residence Portlaoise and Beneavin Manor in Glasnevin in north Dublin - uncovered multiple examples of care failings and neglect of vulnerable older residents.
"This is going to shorten people’s lives and the lives that they have will be more miserable because of the situation that they’re in," said Consultant Geriatrician Professor David Robinson.
"It’s abuse - there’s no other word for it."
Following detailed concerns raised by several whistleblowers, RTÉ Investigates had two undercover researchers simultaneously apply for and secure healthcare assistant roles at the Emeis homes.
They both had all the required qualifications and were garda vetted by RTÉ.
At The Residence Portlaoise, where up to 101 residents can be accommodated at a weekly cost of approximately €1,200 per week under the Fair Deal scheme, RTÉ witnessed some staff provide good care but more often saw repeated instances of staff shortages impacting daily resident care.
The Fair Deal scheme is a State support system that helps cover the cost of nursing home care in Ireland, based on a person's income and assets.
This included large groups of residents being congregated together in day rooms, vulnerable older people being left unsupervised resulting in resident falls and day-to-day requests going unattended to for lengthy periods of time, such as pleas to be put to bed or use the toilet.
"What we’re looking at is largely institutional abuse and this is neglect in a setting which is supposed to be caring," Prof Robinson added.
RTÉ's undercover carer also witnessed multiple examples of poor manual handling with older residents frequently lifted under the arms and without the required use of proper handling equipment, contrary to best practice.
On some occasions, staff were hampered by a lack of available equipment, while in one instance, management also instructed healthcare assistants not to use hoisting equipment in public areas for fear their poor technique would be seen by visitors.
"The shocking disappointing thing to me is that someone who clearly has an identified need in order to assist his transfers and mobility is not provided with the means by which that can occur," Consultant Geriatrician Rónán Collins told RTÉ Investigates.
"This patient needs this piece of equipment to be able to stand up safely and the equipment is not in his room - it should be in his room."
In Dublin’s Beneavin Manor, which can provide care for up to 115 adults for approximately €1,400 per week with Fair Deal funding, another RTÉ researcher saw similar patterns of staff under pressure.
Here, despite regulations stating nursing homes must provide opportunities for residents to engage in activities, this rarely happened on the floor where RTÉ’s carer worked.
Staff also faced constant challenges when it came to the supply of essential resources with recurring shortages of basic items such as towels, bedsheets, sanitary wipes and gloves.
"It's pretty shocking to be honest with you," Prof Collins said.
"Really one would have to ask in terms of supply chains why staff don’t have access to the equipment to do their job appropriately?"
"In healthcare, what causes burnout is people who go to work and come home day after day feeling frustrated because they're unable to provide the level of care they knew they should be providing or wanted to provide," Prof Collins added.
At Beneavin Manor, RTÉ also witnessed the inappropriate handling of vulnerable residents with frail older people sometimes moved by their clothing instead of using the correct handling equipment mandated in their care plans.
"There's no regard for the person," Prof Robinson said on seeing RTÉ’s footage.
"It’s prioritising expediency and expediency of care over the person's dignity and it's just not appropriate," he added.
Having witnessed repeated poor practices, RTÉ Investigates had both researchers hand in their notice and report all their concerns to management at the nursing homes and to the regulatory body, the Health Information and Quality Authority (HIQA).
HIQA told RTÉ both The Residence Portlaoise and Beneavin Manor have set out compliance plans to address issues at their homes with reports from recent inspections of both centres currently being finalised.
In a statement, Emeis Ireland said the evidence of poor care delivery, improper moving and handling of residents, and a lack of dignity and breaches of residents' rights are deeply distressing, adding that it does not tolerate any individual or systemic neglect or practices.
Offering its sincere apologies, the company said this is not the standard of care it expects and not what residents and their families deserve.
Emeis added it is fully committed to doing everything in its power to ensure the failings do not recur.
This will include, according to the statement, a thorough examination of the management and oversight of medical supplies, housekeeping products and continence supplies across all its nursing homes.
It is also to review staffing allocations at both The Residence Portlaoise and Beneavin Manor.