Metal fencing cordons off the green area in front of the large old limestone convent on Convent Road in Clondalkin, where work is due to start soon on a new nursing home.
Plans for the nursing home include shared accommodation for 25 staff members, with one living room and one kitchen.
Planning permission was granted before the Covid-19 pandemic. But concerns about infection-control within nursing homes also predate the current pandemic.
“You don’t have to have a PhD in epidemiology to see the risks,” says Dr Anthony Staines, professor of health systems and public health at Dublin City University (DCU). “It’s a little bit obvious.”
“Once an infectious disease gets into a community setting like that, how do you get it out?” he says.
Professor Sam McConkey, head of the Department of International Health and Tropical Medicine at the Royal College of Surgeons, says having staff live on site could help to prevent them bringing in infections from outside – but that shared living would require a lot of amenities to be “good housing”.
The developer, Barta Property (NH) Ltd, hasn’t responded to queries sent on 27 May.
The Department of Housing hasn’t responded to a question sent the same day as to whether these types of development would be permitted in future.
Co-Living in a Nursing Home
The existing convent building would be altered to create 25 en-suite bedrooms, with a communal living room and a communal kitchen, “which is to be used for nursing home staff accommodation”, says the planning inspector’s report.
Early in the Covid-19 pandemic, the HSE set up a temporary accommodation scheme for healthcare workers to get them out of shared accommodation, a spokesperson for the Department of Health said.
Its guidance document says: “Where Healthcare Workers are residing in congregated domestic settings”, they “are encouraged to consider their eligibility to re-locate to alternative temporary accommodation”.
Relocating would allow them to comply with public-health guidance to limit their social interactions, the document says.
The benefits include “the interruption of transmitting the disease and preventing onward spread in long-term residential settings and the community”.
Two Doctors’ Views
The Covid-19 pandemic has highlighted issues around shared living, says Staines, the professor of public health at DCU.
Unlike neighbours in apartment complexes who have brief contacts with each other, people sharing living space are in a lot of contact, creating a “potentially substantial risk”, he says.
“There is a whole series of quite serious questions about shared living,” Staines says. “It greatly increases the risk of spread of infection.”
For generations, doctors have known that cramped living conditions help diseases to spread, he says. Shared living is “basically building modern slums”, he says.
Around 14 percent of cases of the Delta variant of Covid-19 are contracted within households, but even without the risks from Covid-19, shared living for nursing home staff is a bad idea, says Staines.
Deaths from other infectious diseases, like the flu and gastroenteritis, are common in nursing homes, he says.
Those infectious diseases will spread easily among the nursing home staff if they are all living together, says Staines. “From an infection-control perspective, I don’t see how you can control it.”
McConkey, head of the Department of International Health and Tropical Medicine at the Royal College of Surgeons, said the cost of housing is Dublin is very high.
“So it makes sense for businesses which are labour intensive to provide housing for staff at an affordable rate, to get and keep good staff,” he says.
Having staff living on site could reduce the chances of them bringing in infection from outside, he says. Some healthcare units offered that option to staff during the pandemic for that reason, he says.
“To me the issue of good housing depends mostly on square meters per person of floor space, well-lit spaces, views, green spaces, high ceilings, access to gardens for flowers and growing herbs and vegetables, play areas, open spaces, music performance room, social meeting rooms,” says McConkey.
“– nearby access to schools, colleges, sports grounds, library, fast computer access, a nice kitchen and bathroom, rather than how many people are in the building sharing some of the items above,” he says.
The Department of Housing didn’t respond to questions sent on 27 May as to whether shared living for staff will come under the restrictions on co-living introduced last year.
Apartment guidelines issued by the Department in December 2020 said that going forward new co-living developments will generally not be permitted.
An exception can be made if the local authority has carried out a housing needs assessment and finds that co-living is required to meet a specific demand.