The Nursing Homes Support Scheme (NHSS), commonly referred to as Fair Deal, is a system of financial support for people who require long-term residential care. Participants contribute to the cost of their care according to their means while the State pays the balance of the cost. The Scheme aims to ensure that long-term nursing home care is accessible and affordable for everyone and that people are cared for in the most appropriate settings.
The HSE operate the payment system of the Nursing Homes Support Scheme (NHSS) to private nursing homes. However, this is purely an administrative function after the rate for the nursing home has been set by the NTPF.
The HSE was prior to the Health Act 2007 the registration and inspection authority for nursing homes. This is no longer the case as this function has transferred in totality to HIQA as established under this same Act.
The HSE source Transitional Care Beds from private nursing homes for people leaving hospital where required and where their onward care plan has not yet been finalised. The HSE secure this using the same rate that the NTPF have approved for the nursing home under the NHSS. The HSE has no function beyond this as Transitional Care is for a short period and is entirely voluntary on the part of the service user.
The HSE can in certain circumstances be requested by HIQA or the Court to step in to provide governance but only where the nursing home is being pursued in respect of a breach of the regulations to such an extent that HIQA believe it is in the public interest to remove registration or to replace the provider. In these limited cases the HSE will oversee the management of the home. However, this is relatively rare.
The HSE is itself a provider of public nursing homes and is subject to the same registration and inspection requirements of HIQA as that of a private nursing home.
The HSE does not have a statutory or regulatory function in respect of the governance of private nursing homes.