Allegations have been made against a Cork city nursing home and in my view they require immediate investigation. I have a signed statement in my possession but I have received two other detailed accounts of conditions from two persons who are willing to provide signed statements. I am pleased that the person who runs the nursing home in question, Woborn House, rang a radio programme in Cork confirming that she is happy that I am raising the issues surrounding the case in the Dáil. I am doing so in the long-term interests of the patients and the nursing home. Obviously, I have to be extremely careful even though I am speaking under privilege not to list the complaints. Some of the complaints made are extremely serious and I am sure the Minister would like to have them investigated. The allegations related to patient care and other issues in the home and I intend to furnish the details to the Minister.
Adjournment Debate. - Cork City Nursing Home.
(Limerick East): Will the Deputy furnish them also to the health board?
Yes. Given that we are not certain of the sources of the allegation and that the sources may have their own agenda it is in the interests of the owner that she be given an opportunity to state her case.
It is opportune to make a number of suggestions on nursing homes. The patients' charter applies generally to hospitals and I suggest that it should be extended to nursing homes, convalescent homes, retirement homes and residential homes. It is important that the monitoring of homes be rigorous. I am aware the Minister has issued guidelines for nursing homes but the general view is that the examination is carried out at the early stages to see if it complies with the Health (Nursing Homes) Act and that if subventions are to be paid they are paid to a home that can give the necessary care and attention to vulnerable elderly persons.
Will the Minister consider the possibility of setting up an independent visiting committee similar to that operating in the prison service as this would mean that a totally independent monitoring group would call intermittently? We all share a common purpose that nursing homes and convalescent homes should give the best possible care and treat the elderly with the respect and dignity they deserve. I am sure the owners of such homes would agree with that. They face the difficulty that allegations may be made against them from time to time and they would be happy in the knowledge that the levels of monitoring were such that there would be no questions to answer.
(Limerick East): I thank Deputy O'Keeffe for raising this important issue. I will set out the legal position which enshrines the policy. The Health (Nursing Homes) Act, 1990 which came into operation on 1 September 1993 has two principal objectives. First, to ensure high standards of accommodation and care in all nursing homes registered by health boards under the Act, and second to provide a new system of nursing home subvention so that dependent persons most in need of nursing home care would have access to such care. The Act is a major step forward in ensuring that dependent elderly persons here will be well cared for. The Act provides the health boards with another option in meeting the needs of the dependent elderly locally and with flexibility.
Under the Health (Nursing Homes) Act all nursing homes which are for dependent persons are obliged to register with a health board. Before placing a nursing home on the register the health board will inspect the home to ensure that it conforms with the required standards of staffing, accommodation and design. Registration will help to ensure that high standards of nursing care will be the norm in every nursing home.
Only officers designated by the chief executive officer or the deputy chief executive officer of a health board may inspect nursing homes. The regulations require the health boards to inspect all homes at least once every six months. The boards may visit at more frequent intervals where this is felt necessary. It is for the board to determine the timing of the inspection, whether it should be during or outside normal working hours. In most cases, good relations with homes should enable inspections to be carried out with respect for the operations of the home and the residents' welfare but to guard against any possible misunderstanding, officers carrying out inspections should carry written authorisation. Any member of staff of a nursing home is entitled to ask to see evidence that the inspector is a designated officer.
After each inspection a comprehensive report is prepared. The registered proprietor should be informed in writing as soon as possible of the outcome of the inspection. If a designated officer has found evidence of non-compliance with the Act or regulations, each instance of non-compliance and the date by which compliance is required should be given. The consequences of continuing non-compliance, such as prosecution for breach of the regulations and/or a recommendation to the health board to refuse registration or to attach a condition to registration or the removal of the home from the register should be referred to.
The Deputy referred to the possibility of extending the charter of rights for patients in hospitals to nursing homes. The Deputy is probably aware of the code of practice for nursing homes which I launched recently and which was circulated to all members of the Southern Health Board. "The Years Ahead — A Policy for the Elderly" recommended that the Department, in consultation with the health boards and representatives of nursing home proprietors, should draw up a code of practice for nursing homes. Work on the code took place in parallel with the preparation of the regulations to implement the Health (Nursing Homes) Act, 1990. The code was prepared by a working party set up for the purpose, comprising members of the health boards, the Irish Registered Nursing Homes Association, the Federation of Catholic Nursing Homes, An Bord Altranais, the Council of Homes, the Department of Health, the Alzheimer Society of Ireland and the Carers' Association.
The purpose of the code is to assist nursing home proprietors and staff, officers of the health boards and the general public to a better understanding of what is involved in providing high quality care to residents of nursing homes. The code attempts to define what is currently considered to be good quality nursing home care. It builds on the best practice in nursing homes at present. While it is not explicitly directed at health boards, hospitals and homes providing long-term nursing care, it is hoped that it will be adopted by health boards and influence standards of care in their services.
On Monday last, 16 October 1995, the chief executive officer of the Southern Health Board received the first formal written complaint concerning the alleged lack of standards of care in this nursing home. The chief executive officer undertook to investigate this claim and an investigation team has been established to examine the issue. I will inform the Deputy of the investigation team's finding on this matter as soon as their report becomes available.