Nursing home providers are ultimately responsible for the safe care of their residents.
Under the Health Act 2007 (Care and Welfare of Residents in Designated Centres for Older People) Regulations 2013 as amended each resident must have a care plan prepared following a comprehensive assessment, carried out by an appropriate health care professional immediately before or on admission to a nursing home. Registered providers must provide appropriate medical and health care, including a high standard of evidence-based nursing care in accordance with professional guidelines. In addition all nursing homes are required to have an accessible and effective complaints procedure, including an appeals process. They must investigate all complaints promptly, and following investigation put in place any measures required for improvement.
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.
During the response to COVID-19 nursing homes continue to be regulated by HIQA. HIQA, in discharging its duties determines, through examination of all information available to it, including site inspections, whether a nursing home meets the regulations in order to achieve and maintain its registration status. Should a nursing home be deemed to be non-compliant with the Regulations and the National Quality Standards, it may either fail to achieve or lose its registration status. In addition, the Chief Inspector has wide discretion in deciding whether to impose conditions of Registration on nursing homes. HIQA welcomes information about designated centres for dependent persons, reviews all information about services received and evaluates it against the regulations and standards. As a regulator HIQA has no formal legal role in examining individual complaints, however, the Authority does take into account all information it receives, including complaints from the public, when carrying out inspections. If a concern is raised about a nursing home, HIQA reviews all information received to inform its on-going risk-based regulation activities.
On 19 August 2020, both Minister Donnelly and I launched the COVID-19 Nursing Homes Expert Panel Report. This is a significant piece of work which provides a range of recommendations in line with lessons learned to date and international best practice, aimed to safeguard the residents in nursing homes over the next 12-18 months and into the longer term. The report is also informative in identifying areas of older persons’ service and care delivery requiring consideration for further reform. Many of these themes are reflected in the Programme for Government.
Implementing the Report’s short-term recommendations will ensure the ongoing protection of nursing home residents, the preparedness of the nursing homes sector and the health system in response to COVID-19 and the winter ahead. This will involve building on emerging good practice.
In relation to the payment aspect of the request I have asked the HSE to reply directly to the Deputy.
