Updated 8.03am to include directives issued by the MUMN -

The nurses’ union on Tuesday issued directives to its members at state care homes, claiming inquiry conclusions that St Vincent de Paul staff failed to follow basic procedures when a resident walked out of the facility in June, were "misleading". 

The Malta Union of Midwives and Nurses' directives follow Monday's publication of the results of an internal investigation into the disappearance of Carmelo Fino, also known as Karmenu and Charlie. Fino was caught on CCTV leaving the Luqa home at 3am on June 28 and he has been missing since. 

In his inquiry findings, retired judge Geoffrey Valenzia pinned the responsibility for Fino's disappearance on staff members on duty that night.

A gate was left open and unguarded by four staff members, the judge concluded, while another four did not provide a handover that would have proven whether routine checks had been carried out throughout the night.  

The MUMN, however, says those conclusions do not paint a true picture of what led to Fino being able to slip out unnoticed. 

“We are disappointed by the inquiry’s findings, and we condemn the report, which is misleading,” MUMN president Paul Pace told Times of Malta. 

MUMN representatives will also be meeting with Active Ageing minister Jo Etienne Abela on Tuesday morning, to discuss the report.

Abela said on Monday that he would now be able to sleep better at night as the report had concluded that "this was not a system failure."  

'Report failed to mention misdiagnosis of Fino'

Union boss Pace, however, saw things differently.

“This incident is the result of a systematic failure, so much so, that the judge conveniently ignored the recent introduction of drastic measures to upgrade the security measures in the home,” he said. 

Following Fino's disappearance, St Vincent de Paul management escalated its security measures, with elderly residents ordered not to leave their wards, go for a walk or attend mass unless accompanied by a nurse, carer or relative.

Pace said Valenzia's conclusions made no reference to the fact that Fino had dementia, and should not have been placed in an open ward in the first place.

"The report failed to mention the doctor's huge misdiagnosis of Fino," he said.

He said there was also no reference to the shortage of staff at St Vincent De Paul, and that the ward, hosting 34 residents, should be manned by a minimum of two nurses. 

'Only one nurse assigned to ward'

He said that on the night of the incident only one nurse was assigned to the ward.

The nurse, he said, was a reliever and not one who usually worked on the ward. 

On Monday, Abela said there were four staff members on duty at Fino's ward.

Pace added that a handover did take place on the night that Fino went missing.

"It is normal that at 7am Fino would not be present in the ward, he could have gone to mass or the grounds. The fact he was not there at 7am does not sound alarm bells," he said.

"We are concerned for the nurse who was present that night, as they can face criminal consequences or disciplinary action when they were not at fault. For years, MUMN has been highlighting the issue of the shortage of nursing staff and how the issue is a time-bomb that will explode in the nurses' face," he said. 

Union directives

In a statement on Tuesday morning, the MUMN said staff at St Vincent de Paul and other homes for the elderly are not to admit additional patients until all wards in St Vincent de Paul have at least two nurses in all open wards during the night shift.

All big open wards are not to exceed the 30 patients limit and all wards are to have at least three nurses during the day and two nurses during the night. 

The union warned that it would issue further directives if criminal charges are filed against the staff indicated in the report.