Today, the Health Information and Quality Authority (HIQA) has published a 15 year overview report on the regulation of nursing homes. 

The report shows that significant progress has been made in enhancing the quality of care in nursing homes, although continued improvement is necessary. 

It also highlights how, during the last 15 years, HIQA’s Chief Inspector of Social Services has used the regulatory framework and her regulatory powers to drive improvements in the sector, working to ensure that residents are protected and are receiving safe, quality care and support. 

Carol Grogan, Chief Inspector of Social Services in HIQA said: “Over the past 15 years we have consistently seen how important the relationship between regulatory compliance and good governance and management is in nursing homes. Many providers have worked hard to improve their compliance, resulting in stronger governance and management arrangements being put in place. This has led to better outcomes for residents and tangible improvements to their lived experiences. Many services are now providing care that is more person centred, with residents exercising more choice, enjoying a greater degree of privacy and dignity and being supported to live more meaningful lives.”  

The report shows that nursing home care has moved away from a medical, institutional model towards a social model of care. HIQA has also worked with providers during this time to embed a human rights-based approach to care in the sector. In addition, the Chief Inspector’s approach to regulation has evolved over the years, including changes to its inspection process, using IT to better support regulation, and an increased emphasis on promoting the voice of residents. 

Significant current and future challenges facing the sector are identified in the report. Many smaller, local nursing homes, especially in rural Ireland, have closed in recent years, leading to a loss of these community-based homes. The report also demonstrates the trend towards larger nursing homes with more beds. In addition, the profile of nursing home ownership in the sector is changing, with evidence of consolidation by large corporate groups. If one of these organisations experience financial difficulties, this would pose a significant risk to the nursing home sector and impact significantly on the people living in these centres. 

The need to continue the programme of reform of the regulatory framework is also highlighted in the overview report. 

Susan Cliffe, HIQA’s Deputy Chief Inspector of Social Services said: “We welcome the recent commencement of the Health (Miscellaneous Provisions) Act 2024 and Patient Safety (Notifiable Incidents and Open Disclosure) Act 2023 which strengthen the Chief Inspector’s powers within nursing homes. Further enhancements to the regulatory framework are still needed, and we look forward to continuing to work with all stakeholders to improve care standards and develop a regulatory framework that meets the evolving needs of Ireland’s ageing population.”

ENDS  

For further information, contact:
Marty Whelan 
Head of Communications and Stakeholder Engagement 
085 805 5202 
mwhelan@hiqa.ie

Notes for the editor:

• HIQA was established on 15 May 2007. The Office of the Chief Inspector of Social Services was established within HIQA, with the Chief Inspector charged with the inspection and regulation of nursing homes. 
• On 1 July 2009, regulations governing the care and registration of nursing homes came into effect. 
• The number of nursing homes increased year-on-year between 2013 and 2019, when there were 585 nursing homes. Since then, there has been a decrease in the number of nursing homes, with 553 registered nursing homes in 2023. 
• The number of nursing home beds has increased by 12% since 2013 and at the end of 2023 there was a total of 32,314 nursing home places in Ireland, up from almost 29,000 in 2013.
• The Health (Miscellaneous Provisions) (No. 2) Act 2024 came into effect on 23 September 2024. The Act introduces a new enforcement power for the Chief Inspector to issue compliance notices, provides for the collection and maintaining of specified information and changes the timelines for registered providers to make representations to the Chief Inspector in relation to a proposed decision by the Chief Inspector to place a condition on registration or to cancel a registration, among other powers. 
• The Patient Safety (Notifiable Incidents and Open Disclosure) Act 2023 will, in the future, introduce a new discretionary function for the Chief Inspector to undertake a review of a specified incident in nursing homes where the Chief Inspector becomes aware of that incident. This Act also sets out the timeline within which providers of nursing homes must submit notifications of specific incidents to the Chief Inspector.