The family of a showband musician who died after the fall of a retirement home criticizes Hiqa

The last thing Regina Nolan did for her father Noel O’Sullivan was carry his casket.

A few days before, the last thing she had asked him was, “Could he watch over her from heaven?”

Regina becomes emotional when she remembers her 92-year-old father’s response.

“He looked at me and he was puzzled,” she recalls between two anguished sobs.

“And as I held his hand in mine, he asked me, ‘Why are you saying that?’ He really had no idea. He just wasn’t ready to die.

“I replied to him, joking with him, ‘you had an old fall, devil’. He said nothing. He just stared at me in silence.

“I don’t even really know where that question came from, asking him to watch over me from heaven. I guess something inside of me knew I wouldn’t have the chance to talk to him again and it just came out of my mouth.

Noel O’Sullivan had been a resident of Bon Secours Care Village.

Cork City Coroner Philip Comyn entered a verdict of accidental death at the inquest for the former Skyliners Showband musician last Thursday.

He was a resident of Bon Secours Care Village when he fell in the early hours of October 12, 2020.

The nursing staff who put him back in bed soon after did so after a very brief telephone consultation with a GP from SouthDoc.

Mr Comyn was told Mr O’Sullivan was finally physically examined six hours later by a doctor who immediately ordered his transfer to Cork University Hospital.

It took seven hours at home to inform Regina that he had fallen and that in addition to sustaining a head injury, he had also broken his left hip and left wrist.

And this despite the fact that the home had been expressly asked to contact the family immediately in the event of an accident.

The fall Mr O’Sullivan suffered before his death was one of ten he endured during the short time he was at home from March to October 2020.

Two of them, including his latest fall, had forced the pensioner – who suffered from dementia, various mobility issues and was at high risk of falling – into hospital.

A new post-fall home protocol has been developed for residents who have suffered serious or serious injuries since the death of Mr O’Sullivan, of Old Blackrock Rd, Cork.

Mr Comyn recommended that the Lee Road care home review protocols for communicating with families and with the out-of-hours GP service, SouthDoc, to ensure there is no of “information gaps” in the future.

Mr O’Sullivan’s death certificate says he died of ‘head trauma[…]due to a fall.

Regina Nolan with a plow made from her late father's pajamas.
Regina Nolan with a plow made from her late father’s pajamas.

The day after her father fell, Regina called the Health Information and Quality Authority (Hiqa) and asked the health watchdog to investigate.

She says she was told no because Hiqa did not investigate individual complaints.

She was so shocked that she hired Marian Fogarty of Cantillons Solicitors to take her case instead.

“What good is Hiqa if it cannot investigate individual complaints? she asked.

“I couldn’t believe it when they said they wouldn’t investigate.

How serious must a case be before Hiqa investigates a nursing home complaint?

Regina has since discovered that just weeks before her father’s death, Hiqa said the house was fully compliant with nearly every regulation it was inspected for.

At the time of the May 28, 2020 inspection, Mr. O’Sullivan had suffered four falls and all but one had gone unwitnessed.

The one we witnessed was seen by a cleaner and not by nursing staff.

His lawyer, Ms Fogarty, said: “In my view, Hiqa’s inspection methods leave open the possibility of missing serious security issues.

“By the time Hiqa inspected the Bon Secours home, Mr O’Sullivan had already suffered four falls, but his subsequent inspection report found that ‘good quality care had been provided to the residents’.

“The report also found evidence that staff had received training appropriate to their roles, which enabled them to provide evidence-based care to residents.”

She said the findings contradicted the facts and evidence heard during Mr O’Sullivan’s investigation, adding that she found it “surprising” that Hiqa did not investigate individual complaints.

“This contradicts the Health Act which states that Hiqa can investigate if they believe there is a serious risk to the health and well-being of a resident of a care home,” she said. declared.

Just weeks before Noel O'Sullivan's death, Hiqa said the nursing home was fully compliant with nearly every regulation it had been inspected for.
Just weeks before Noel O’Sullivan’s death, Hiqa said the nursing home was fully compliant with nearly every regulation it had been inspected for.

Majella Beattie, of advocacy group Care Champions, welcomed the coroner’s recommendations on communications between care homes and family members.

“The concerns about communications between home and family and the medical profession in the tragic case of Noel O’Sullivan mirror those we always hear from families,” she said, adding that the refusal to Hiqa to investigate Mr O’Sullivan’s case was “deeply disturbing”. .

“Hiqa’s refusal to investigate individual complaints is an issue hundreds of families have reported to us.”

A Hiqa spokesperson said regulations require a registered provider to notify them of any serious injury to a resident that requires immediate medical treatment.

“It is important to note that not all falls result in serious injury,” they said, adding that providers are not required to notify the agency of every fall that occurs.

“Inspectors are constantly focusing on key risks in nursing homes, such as falls,” the spokesperson said.

“Even in the absence of any notifications regarding falls, inspectors will look at care planning, healthcare, staffing levels, risk management, complaint handling during the majority of inspections.”

They added that a statutory investigation by the body “results in no enforceable sanction” and as such may mean no improvement in a resident’s care.

Regina becomes emotional as she reflects on the last months of her beloved father’s life.

“I was my father’s primary carer for many years before he finally had to go to the nursing home.

“I bitterly regret that the one time I was not responsible for my father’s care, he ended up suffering the most.

I also regret the day my father crossed the threshold of this place.

Her voice fighting back tears, she added, “There’s never a good time to lose a parent, but I think losing them in these circumstances is so heartbreaking.

“We could have had him for another month, maybe even a year if he hadn’t suffered so much at the end.”

Mr O’Sullivan had been a painter and decorator and worked in the family business, run by his father Jeremiah O’Sullivan.

Clients included Christ the King Church at Turner’s Cross, where his wife Eileen was organist, and Kent Railway Station in Cork City.

The father-of-five also worked for a time as a maintenance worker at St Finbarr’s Hospital.

A Lotto fan, he once won €3,500 but gave it to charity rather than keeping it.

An avid snooker player and fan of the game, he got to meet many of his heroes in Cork when they played testimonials there, including Steve Davis, Alex Higgins and Dennis Taylor.

One of the first things he did after retirement was to restore the Stations of the Cross on display in the South Parish Church in Dunbar Street.

Until the age of around 90, Mr O’Sullivan performed with his accordion at various venues in Cork City, including the Brother Jerome Kelly day care center at the back of Mercy Hospital, the Turner’s Cross Daycare and Marymount Hospice.

Eileen died suddenly in July 2020, aged 89, the date he entered the Bon Secours home.

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