The well-being of older people living in nursing homes is of critical concern. Formal standards are a key requirement for inspection and registration. The present standards for nursing homes are set out in the 1993 Care and Welfare Regulations and the Health Service Executive (HSE) inspects private nursing homes on the basis of these standards.
In 2006 a HSE Working Group produced a report on nursing home inspections and registrations. Last July the Executive began a phased implementation of all the Group's recommendations. There is now in place a national standardised approach to nursing home inspections across the system and this currently underpins the inspection process.
The HSE has made important improvements to its nursing home inspections process since the Working Group report was completed. It has been working to standardise the reports and has engaged with the nursing home inspection teams and with the private nursing homes sector. It is now putting in place dedicated Nursing Home Inspection Teams. All inspections are now unannounced and nursing homes are now inspected at least twice a year. All inspection reports are now available on the HSE website. I allocated an extra €6m for the further development of the nursing home inspection process in 2007-2008.
The Executive has advised my Department that the principal expertise involved in inspections is that of medical, nursing and environmental health professionals. Staff are currently employed on both a full time and part time basis and the position can be summarised as follows. In HSE West, there are 6 teams comprising of 6 Medical Officers, 6 Nursing Staff, 9 Environmental Health Officers (WTE) and 2 Clerical Officers undertaking inspections in Limerick, Clare, North Tipperary, Donegal, Roscommon, Mayo Galway and Sligo/Leitrim. In HSE South, there are 9 teams with 9 Medical Officers, 9 Nursing Staff and 9 Environmental Health Officers undertaking inspections in Cork -South Lee, North Lee, West, and North, Carlow/Kilkenny, South Tipperary, Waterford, Wexford and Kerry. In HSE Dublin North East there is one centralised team covering Dublin North East, Cavan, Louth, Meath and Monaghan. The team comprises 2 Medical Officers, 7 full-time and 2 part time Nursing Staff and an Environmental Health Officer as required.
In HSE Dublin Mid Leinster there are 9 teams consisting of 10 Medical Officers, 19 Nursing Staff, 7 Environmental Health Officers and 10 Therapists undertaking inspections in Dublin South City, Dublin South West, Dublin South East, Dublin West, Dublin South/Dun Laoghaire, Wicklow, Kildare/West Wicklow, Laois, Offaly, Longford and Westmeath. Donegal, Limerick and Dublin North East teams work full time on the inspection process. The remaining teams consist of staff working on inspections part time. Forty additional posts have been approved since the beginning of 2007 and the majority of these posts have now been put in place. The approach in the implementation of these new posts is being tailored to meet the needs of each area.
The Health Act 2007 provides for the establishment of the Health Information and Quality Authority on a statutory basis. It also provides for the registration and inspection of all nursing homes — public, private and voluntary. Inspections will be carried out by the Social Services Inspectorate, part of HIQA. The HSE is liaising with HIQA to facilitate this and transition arrangements will be agreed as we move towards the new system of inspections which will be governed by HIQA in line with the recently enacted legislation.