Ireland, New rules to apply higher standards to nursing homes

International Journal of Health Care Quality Assurance

ISSN: 0952-6862

Article publication date: 13 June 2008




(2008), "Ireland, New rules to apply higher standards to nursing homes", International Journal of Health Care Quality Assurance, Vol. 21 No. 4.



Emerald Group Publishing Limited

Copyright © 2008, Emerald Group Publishing Limited

Ireland, New rules to apply higher standards to nursing homes

Article Type: News and views From: International Journal of Health Care Quality Assurance, Volume 21, Issue 4

Keywords: Healthcare improvement, Services for older people, Nursing home regulations

Many public care facilities will need to be upgraded or redeveloped in order to comply with new regulations for nursing homes to be published shortly.

The standards, approved by the Health Information Quality Authority, will cover public facilities for older people for the first time.

They are understood to set out more than 30 requirements regarding the care and welfare of residents such as mandatory levels of training for staff and individual care plans for all nursing home residents. Other requirements relate to minimum bedroom sizes, en-suite facilities and limits on numbers of patients per ward.

A team of up to 90 inspectors from the authority will enforce the new standards which are expected to come into force later this year.

However, there is concern among health authority officials over the scale of modifications for older public nursing homes needed to meet the new requirements.

The Health Service Executive (HSE) has commissioned an audit of all its community units to identify facilities which will not comply with the new standards. Officials will then decide whether they should be refurbished or replaced entirely.

In particular there is concern over a number of publicly-run facilities in Dublin such as St Mary’s Hospital in the Phoenix Park, which is the largest public long-stay institution for older people. The 320-bed hospital has several large wards in a complex of buildings, parts of which were built well over a century ago.

A spokesman for the HSE confirmed that a major capital investment programme will be needed to either modernise or replace unsuitable buildings. He said the health authorities were waiting for the new regulations to be signed into law before deciding on a timeframe for the upgrading programme.

It is understood that the new standards will give all existing nursing homes up to five years to meet requirements relating to the physical environment. Other requirements relating to care and welfare will come into force immediately after they are signed into law.

The authority’s chief inspector of the Social Services Inspectorate said that she expected major improvements would be needed, but emphasised that the quality of life for residents was the priority.

“There will need to be upgrading work done … but some institutional lay-outs can be used in creative ways, while there are new places where residents could be bored silly. What we’re most interested in is the quality of life for residents,” she said.

Nursing Homes Ireland, the main representative group for nursing homes in Ireland, says it too expects some older homes will be affected, although on a much smaller scale.

The new standards have been signed off by the board of the health authority and will cover all public, private and voluntary care settings where older people are cared for.

Nursing homes will be required to meet these standards in order to be registered. While those in breach of the standards may be registered with conditions, those who repeatedly fail to meet the grade may be closed down.

The new code covers various areas including the personal dignity of residents, social relationships and activities, healthcare, health and safety and staffing.

Among the standards contained in a draft document include a requirement that a minimum of 50 per cent of care staff have relevant further education; that each resident be allowed to choose meals and meal times; and requirements over heating and ventilation.

The new standards are part of a wider reform of the care system for older people, including a new financing arrangement known as the “fair deal.” It will replace the current nursing home subvention scheme and will include levying charges on the estates of older people after their death.

However, ongoing legal difficulties over the plan means it is likely to be delayed until the summer, according to government sources.

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