While it is the Government’s overarching policy to provide a greater level and volume of care in the community and to support older people to live at home for longer, it is recognised that nursing home care will continue to be an important part of the continuum of care into the future. In Ireland, long-term residential care is provided by the private, voluntary (not for profit) and public (HSE) sectors. As of January this year, the Health Information and Quality Authority (HIQA) reports 556 designated centres for older people with a maximum capacity of 31,650. 20% of these designated centres are publicly provided (HSE), 77% are provided by private providers, and 3% are provided by voluntary organisations (funded bodies under section 38 & 39 of the Health Act 2004).
The Government continues to invest in public nursing homes through the Community Nursing Unit Programme. The programme commenced in 2016 with the intention of ensuring that all public residential care units would comply with HIQA Regulations and Standards. As of December 2022, 43 projects have been completed, construction is underway on several more facilities, while the remainder are at various stages of appraisal, planning and/or design. In December 2022, I also announced the awarding of the contract to deliver seven Community Nursing Units under the HIQA compliance programme through Public Private Partnership. The CNU PPP Project will deliver 530 beds in residential care facilities for older persons at facilities across the country. In the private sector, there was also a net gain of 88 beds in 2022.
COVID-19 has highlighted the important need to move to new models of care for older people. This will involve short and long-term reform across Government in order to provide new housing models, new ‘home-first’ care models, and where long-term care is needed, ensure that it is provided with innovative designs that can meet infection prevention and control requirements and provide an appropriate home for those who need this type of care. This year, the HSE will be finalising the future operational model for Community Based Public Residential Services. This model will include a blueprint for future service delivery for long-term care and intermediate care across the full health service and the implementation plan will have the older person and their needs at its centre.
It is essential that all aspects of the nursing home sector are scrutinised over the coming years to ensure that service delivery and configuration meet the needs of service users in a sustainable and safe manner. For those who avail of long-term residential care, it is also critical that public investment in this infrastructure is maintained at a level that enables the appropriate standards to be met and that public residential care capacity is increased in the coming years.