The State needs to spend up to €500m to replace or refurbish very old Health Service Executive-run nursing homes, according to Minister for Health, Leo Varadkar.

The minister also described as "completely unacceptable" the provision of showers fortnightly - and sometimes monthly - to elderly residents in St Patrick's Community Hospital in Carrick-on-Shannon and rejected excuses that resource shortages caused the practice.

On Tuesday the health watchdog, HIQA, revealed that elderly residents of St Patrick's Community Hospital in Carrick-on-Shannon were being offered a shower or bath once a fortnight if staff were available and once a month otherwise.

Speaking today in Sligo, Minister Varadkar reiterated that the Department of Health had requested an action plan from the HSE on the Leitrim facility.

He emphasised the hospital was one of many very old public nursing homes which need improvement or refurbishment.

Concern over staff numbers and facilities at Roscommon nursing home

In Roscommon, the HSE-run Sacred Heart Hospital has also been found by HIQA to have inadequate showering and toilet facilities and staff shortages as well as insufficient space for residents.

During last March's HIQA inspection only eight staff were available for 93 elderly residents at night.

The watchdog said that residents who were sharing bedrooms with between three to ten others endured significant breaches of privacy and dignity.

For example, residents, staff and visitors had to walk through bedroom areas to access other residents' bedroom areas.

Inspectors found that when very ill residents required a lot of supervision, other very dependent residents could not get the attention they needed.

The watchdog also criticised the requirement on some residents to walk or be assisted over a distance of 20m to the nearest toilet or bathroom.

HIQA inspectors found that the centre was well managed and complied with most of the regulations covered in the inspection. Residents and family members told them they were very happy with the services provided.

However, inspectors found that three of the four units had inadequate showering and toilet facilities and that many of the toilets were not wheelchair accessible, forcing residents to use commodes or to be assisted long distances to the nearest accessible convenience.

Also, some residents' space was limited by sharing with other residents, hindering their levels of privacy on a daily basis.

In most cases, lockers and wardrobes were quite small and there was no lockable storage facility for some residents' personal possessions.

Inspectors criticised the lack of sufficient communal space for relatives to visit and have private conversations in the day room and bedroom areas.

Communal areas were inadequate and too small to meet residents' and staffing needs.

Inspectors observed inappropriate storage of medications in some of the units and complained that security issues at the main entrance had not been addressed since previous inspection.

They said the age and layout of the building presented significant challenges and that the centre required a number of actions to ensure it met the requirements of legislation.

They underlined that these issues were identified on the last registration inspection and that in October 2014, the HSE promised to send HIQA costed and time-bound plans.

However HIQA said that to date no proposal has been received in relation to this.