Dáil Éireann Debate, Tuesday - 11 May 2004
246 Mr. M. Higgins asked the Minister for Health and Children if he will reply to a submission made to him on residential care for the elderly in April 2004 raising such issues as the ratio of carers to patients, qualifications and training for non-professional staff, facilities for the occupational recreation of persons, freedom of choice, respect for rights and privacy; and if he will make a statement on the matter. [13153/04]
View answerIn Ireland there is no established ratio of nurse to patient. This ratio varies in different healthcare settings and is related to the changing phenomenon of patient acuity. Patient dependency measures do exist and various methods have been utilised but this is decided at a local level rather than at a national level. The commission on nursing recommended the examination and development of appropriate systems to determine staffing levels and to this end a group was established in the Department of Health and Children and is currently undertaking this work.
Furthermore, the CEO of each health board has responsibility for the management of the workforce in public nursing homes, including the appropriate staffing mix, precise grades of staff employed in line with service priorities. It is a matter for each employer to ensure that staff in their employment have adequate training and skills to perform the duties expected of them.
Direct care of patients is undertaken by either professional nurses or health care assistants. It is Government policy that carers are referred to as health care assistants and that their education and training is standardised. All health care assistants should be educated to NCVA level 2 of FETAC. The national programme to implement this throughout the public health service is in its infancy. A module specifically for care of the older person has been developed and is currently undergoing validation by FETAC and should be available in the autumn. This training programme is available to private nursing homes and can be purchased through the nursing and midwifery planning and development unit in each health board area. Alternatively, nursing homes can establish their own programme. It is a matter for each employer to manage the ratio of staff to patient in the services they provide in light of their duty of care to patients.
The responsibility for the provision of occupational and recreational facilities rests with the nursing homes in the first instance. Age and Opportunity's Bealtine Festival is open to all older people regardless of their location and provides older people with the opportunity to be involved in creative activities. In public health institutions, some activity nurses have been appointed and are involved in supplying such therapies as reminiscence therapy, cognitive therapy and acupuncture.
Privacy to undertake personal activities should be facilitated wherever possible. However, leaving residents unsupervised may result in an increase in falls. Of older people living in the community, 20% fall each year sustaining serious injury. This figure is thought to be higher for hospitalised elderly and up to two thirds of older women living in nursing homes fall at least once per year. Many of these falls result in serious injury. Ultimately, the level of competency of the individual should be assessed and patients should be afforded privacy where possible, however, this must be balanced against overall concerns for the persons' safety.
