Since 2009 the Health Information and Quality Authority, HIQA, is the statutory independent regulator in place for the nursing home sector, whether a HSE managed or a private nursing home. The Authority, established under the Health Act 2007, has significant and wide-ranging powers up to and including withdrawing the registration of a nursing home facility, which means that it can no longer operate as a service provider.
This responsibility is underpinned by a comprehensive quality framework comprising of Registration Regulations, Care and Welfare Regulations and National Quality Standards.
HIQA makes judgments on whether the registered provider or person-in-charge is: compliant, substantially compliant or not compliant with the regulations associated with the findings.
- Compliant means the provider and or the person-in-charge is in full compliance with the relevant regulation.
- Substantially compliant means that the provider or person-in-charge has generally met the requirements of the regulation but some action is required to be fully compliant. This finding will have a low risk-rating.
- Not compliant means the provider or person-in-charge has failed to comply with a regulation and that considerable action is required to reach compliance.
Continued non-compliance or where the non-compliance poses a significant risk to the safety, health and welfare of residents will be given a high risk-rating. In such cases, HIQA will set a deadline for the provider to comply with the regulation.
Where the non-compliance does not pose a significant risk to the safety, health and welfare of residents using the service, it is risk-rated moderate and the provider must reach compliance within a reasonable time frame.
HIQA identifies that the regulatory actions taken where a registered provider is non-compliant are proportionate to the risks identified.
The non-statutory options the Chief Inspector employs include:
- Increased regulatory activity;
- Issuing compliance plans following inspections (setting out the non-compliances and requiring a provider to submit how they intend to comply;
- Seek assurance from the provider;
- Provider meetings (including both cautionary and warning);
- Warning letters.
The Statutory powers in the Act that can be employed include:
- Seeking information under section 65 of the Act;
- Attaching, vary and removing a condition of registration under Section 51 of the Act;
- Cancelling of registration under section 51 of the Act;
- Urgent action under section 59 of the Act (to attach, vary or remove a condition of registration or cancellation of registration);
- Prosecution for an offence under the Act.
The functions and powers of the Chief Inspector are set out in Parts 7, 8 and 9 of the Health Act 2007 (as amended). HIQA has prepared a Regulation Handbook which is a guide for providers and staff of designated centres. This is available on the Authority’s website.
