Dáil Éireann Debate, Thursday - 9 September 2021
1035. Deputy Fergus O'Dowd asked the Minister for Health if HIQA or the HSE have undertaken any prosecutions against any residential care facilities, proprietors, persons in charge and entities for any breaches of regulations; if so, the regulations breached by each such facility, persons and entity; the name of the persons, facilities and entity prosecuted; the outcome of such prosecutions; and if he will make a statement on the matter. [41625/21]
View answerThe Chief Inspector of Social Services in 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 Chief Inspector, 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.
As the independent regulator of nursing homes, the Chief Inspector determines the appropriate approach and interventions required to monitor and ensure compliance with the regulatory framework. The Chief Inspector adopts a risk-based approach to regulation, prioritising monitoring, inspection and enforcement, based on the assessment of the risk, including the type of enforcement action to be taken.
Part 8 of the Health Act 2007 sets out the tools for enforcement available to the Chief Inspector in the event that a provider is non-compliant with specific provisions within the Act or the aligned regulations.
Specifically the Chief Inspector may issue the provider with a warning and time frame to come into compliance and where there is a sustained failure to achieve compliance the Chief Inspector may:
- place conditions on a centre’s registration;
- cancel the centre’s registration or refuse to renew the registration;
- prosecute the provider.
Conditions on a centre’s registration
Every designated centre is registered with 3 standard conditions which reflect the service, the building and the number of residents who can live in that centre. Applying additional conditions to the registration of a nursing home makes it clear that the ongoing registration of the nursing home is dependent on the registered provider adhering to the condition. The following is an example of an additional condition:
"Condition 4
Notwithstanding the requirements placed on the registered provider to comply with the Health Act 2007 (Care and Welfare of Residents in Designated centres for Older People) Regulations 2013, the registered provider shall take all necessary action to comply with: Regulation 23: Governance and Management Regulation 4: Policies and Procedures Regulation 26: Risk Management Regulation 27: Infection Control Regulation 8: Protection Regulation 17: Premises Regulation 6: Healthcare Regulation 5: Individualised assessment and care plan to the satisfaction of the Chief Inspector ."
To date:
- 113 nursing homes have additional restrictive conditions placed upon them.
Cancellation of a centre’s registration or refusal to renew its registration
Repeated findings of regulatory non-compliance and concern about the care and welfare of residents may result in the Chief Inspector cancelling the registration of a centre or refusing to renew the registration of a centre.
Since the beginning of 2020 the Chief Inspector has:
Used Section 50 of the Health Act to:
- refuse an application to register a nursing home on the grounds that the applicant could not demonstrate compliance with relevant regulations;
- refuse an application to renew the registration of a nursing home on the grounds that the applicant could not demonstrate compliance with relevant regulations; and,
- to reduce the occupancy of a nursing home from 53 to 37 when the provider failed to come into compliance with relevant regulations.
Used Section 51 of the Health Act to:
- cancel the registration of one nursing home when the provider passed away; and,
- issue a notice of proposed decision to cancel the registration of one nursing home when the provider failed to come into compliance with relevant regulations.
Used Section 52 of the Health Act to:
- reduce the occupancy of a nursing home from 86 to 43 when the provider failed to come into compliance with relevant regulations.
Used Section 59 of the Health Act to:
- apply to the District Court to cancel the registration of two nursing homes:
1. Donore Nursing Home, Bray (Registered Provider: Brecon Care Limited)
2. Oaklands Nursing Home, Listowel (Bolden (Nursing) Limited.)
Prosecutions
The Chief Inspector has twice prosecuted registered providers of nursing homes for breaches of the Health Act 2007.
Chief Inspector v Registered Provider, Carysfort Nursing Home
Section 65 of the Health Act 2007 requires a registered provider of a designated centre to submit information to the Chief Inspector of Social Services which the Chief Inspector deems necessary for the performance of her functions under the Health Act 2007. The defendant was named on the register maintained by the Chief Inspector as the registered provider of Carysfort Nursing Home. In March 2018, the defendant failed to submit information requested by the Chief Inspector under Section 65 of the Health Act 2007 to enable the Chief Inspector to carry out her functions under the Health Act 2007. The Chief Inspector commenced a prosecution against the defendant in March 2018 contrary to section 79(2)(a) of the Health Act 2007 as amended, the penalty for which is provided for under Section 79(4) of the Health Act 2007 as amended. The defendant pleaded guilty to the offence at Dublin District Court on the 12 March 2020 and was convicted and a fine was imposed of €500 with 6 months to pay.
Chief Inspector of Social Services v. Hillcrest House Nursing Home Limited
Section 46 of the Health Act 2007 prohibits the operation of a nursing home in the absence of registration and this is an offence under Section 79 of the Health Act 2007. This prosecution was commenced by the Chief Inspector of Social Services on the 21 December 2018 against the provider of residential service to older persons, namely Hillcrest House Nursing Home Limited. The prosecution was for failure to comply with Sections 46(1) and 79(1)(b) of the Health Act i.e. failure by the service provider to register the residential service with the Chief Inspector in accordance with the legislation. Hillcrest House Nursing Home Limited pleaded guilty to the offence at a sitting of Donegal District Court on the 20 March 2019. The District Court convicted the defendant and imposed a fine of €500 with 3 months to pay.
