The Health Information and Quality Authority has published 36 inspection reports on nursing homes conducted this year.

The reports cover inspections in February and March - prior to the introduction of visiting restrictions due to Covid-19.

The remaining reports are based on inspections when they resumed in May and June.

HIQA found evidence of non-compliance in 20 centres.

Among the centres inspected in June was Kilbrew Recuperation and Nursing care in Ashbourne, Co Meath.

It was from this centre that 79-year-old Ultan Meehan was transferred to a Dublin hospital at the end of May with tumorous facial wounds infected and infested with maggots. He died two weeks later.

HIQA inspectors visited Kilbrew on 4 June and reviewed a sample of residents' care planning documentation.

The inspection report notes that in some circumstances, it was found that the records of the medical and nursing condition of the residents and details of their plan of care did not accurately reflect their state of health and / or circumstances at the time.

It cites the example of wound care management and daily nursing records.

Inspectors also found that there was a delay in taking timely action to ensure that residents received appropriate medical care.

Inspections of other centres showed personal protective equipment (PPE) was not being used correctly to protect staff and residents from Covid-19 and staff turnover was impacted on services.

On 7 July inspectors visiting Kilcoole Lodge Nursing Home in Wicklow observed that staff were not using PPE in line with the national guidelines.

HIQA said staffs were not wearing face masks when attending to residents in communal areas and staff told inspectors they did not always wear a mask when attending to resident's personal care.

The inspection also showed that recent staff resignations had impacted particularly on the housekeeping department and while the provider was actively recruiting to fill vacancies, the allocation of staff to housekeeping was not in line with the centre's Covid-19 prevention and contingency plan.

Staffing was also an issue at the Sancta Maria Nursing Home in Kinnegad, Co Meath when inspectors called on 24 June.

The report notes that staffing levels had been severely impacted by the outbreak of Covid-19 throughout the months of April and May 2020, as extended sick leave absences had further depleted the management structures.

Inspectors identified a significant number of considerable infection control concerns at this centre, which posed a risk to the welfare of the residents in the centre.

The report notes that most of these issues had already been identified in an infection control audit carried out by public health two weeks prior to the inspection, however the registered provider had failed to act and address them in a timely manner.

PPE use such as facemasks was not in line with the national guidelines according to the report.

Today's HIQA inspection reports also show that Health Protection and Surveillance Centre guidelines around social distancing were not adhered to correctly in all nursing home settings.

Inspectors who visited Birr Community Nursing Unit in Co Offaly on 4 June found that the option to socially distance was not possible due to the close proximity of residents' beds.

Inspectors found 15 multiple occupancy bedrooms with three and four residents in each room which did not ensure that residents would be protected from risk of cross infection in the event of a further outbreak of Covid-19 infection in the centre.

Inspectors discovered a similar problem at the Killarney Community Hospitals (Fuschia, Hawthorn and Heather Wards) on 3 June.

They reported that the layout of six bedded rooms in particular was so confined, that socially distancing in accordance with the HPSC guidance could not be adhered to.

There were ten six bedded rooms in the centre on the day of inspection.