Dáil Éireann Debate, Tuesday - 21 September 2021
640. Deputy Carol Nolan asked the Minister for Health if he and the Minister of State for Mental Health and Older People will address concerns raised with their respective offices by care champions pertaining specifically to safeguarding concerns within the nursing home sector; and if he will make a statement on the matter. [45098/21]
View answerThe Government takes adult safeguarding and matters and allegations of suspected neglect and abuse in health settings very seriously. Safeguarding adults at risk of abuse and harm by others in the context of their interactions with the health sector is a key objective of the Department of Health, every statutory body under its aegis, and every health and social care service that interacts with such adults.
In the health sector, a framework of standards, policies and procedures for safeguarding adults who may be at risk of abuse, harm and exploitation within the sector is in place, and further measures are being developed to strengthen this framework. The framework includes:
- joint national adult safeguarding standards developed by the Health Information and Quality Authority (HIQA) and the Mental Health Commission, approved by the Minister for Health and launched in 2019;
- the significant inspection and other regulatory powers of HIQA and the Mental Health Commission in relation to the quality and safety of healthcare and social care provision generally (under the Health Act 2007 and the Mental Health Acts);
- the HSE’s national operational adult safeguarding policy Safeguarding Vulnerable People at Risk of Abuse – Policy and Procedures (2014), which is in place primarily in all HSE and HSE-funded social care settings.
A range of structures and processes are established by the HSE to support and further develop its national operational adult safeguarding policy, including:
- a HSE National Safeguarding Office leading policy development and oversight;
- specialist Safeguarding and Protection Teams in each of the 9 HSE Community Healthcare Organisation (CHO) areas;
- over 1,700 designated safeguarding officers nominated by service providers and provided with additional training; and,
- clear guidelines set out in the existing policy for HSE and HSE-funded staff to follow in cases of suspected abuse or neglect of adults at risk;
- an adult safeguarding policy and procedures training programme, and a requirement that staff must attend training. The training is also accessible to non-HSE and HSE-funded services;
- a “zero tolerance” approach to abuse, meaning that abuse must be reported by staff in all instances; and
- implementation planning for a revision by the HSE of its operational adult safeguarding policy which is expected to extend the policy outside of the social care pillar and to all HSE and HSE-funded services.
I have met with and corresponded with Care Champions on their issues of concern. I have also met with HIQA and I have been assured that it has robust mechanisms in place to address safeguarding matters. Specifically in relation to the nursing home sector, under existing law nursing home providers have an obligation to take all reasonable measures to protect residents from abuse. The person-in-charge of the nursing home has a legal obligation to investigate any incident or allegation of abuse. The nursing home is obliged to maintain a record of any incident in which a resident suffers abuse or harm, and the records must include the nature, date and time of the incident, whether medical treatment was required, the name of the persons who were respectively in charge of the designated centre and supervising the resident, and the names and contact details of any witnesses, the results of any investigation and the actions taken. There is also a statutory requirement that the nursing home notify the Chief Inspector of any allegation (suspected or confirmed) of abuse of any resident within 3 days.
The Chief Inspector, in discharging her duties determines, through examination of all information available to her, including site inspections, notifications received and records, whether a nursing home meets the regulatory requirements 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.
Significant regulatory reform is ongoing in conjunction with HIQA, in line with the COVID-19 Nursing Homes Expert Panel’s recommendations and lessons from the pandemic. Earlier this year, Government agreed the progression of interim enhancements to the current regulatory framework for nursing homes this year, with a view to commencing a wider, root and branch review of nursing homes regulation in 2022. Subject to Government approval, the interim enhancements to the legislative framework are expected to include enhanced powers and oversight for the Chief Inspector and enhanced reporting of key data by nursing homes providers.
To strengthen the health sector’s wider adult safeguarding framework, the Department is currently developing a national policy on adult safeguarding in the health and social care sector. This national sectoral policy will be in place in all private, voluntary and public health and social care settings and services and will be underpinned by any legislation that may be required. To date, the Department, assisted by a high-level Steering Group, has completed key stakeholder consultation and primary evidence development phases of this major and complex policy project. In developing the policy, the Department is considering the merit of a number of issues including appropriate access to non-public health settings.
The Department is now preparing for a formal public consultation exercise, to be launched later this year, and a costing study, with a view to submitting a draft policy to Government for approval and, thereafter, preparing any legislation required to underpin the approved policy.
