A new era in protecting older people will begin in Ireland (1 July) as the independent inspection of all nursing homes will begin nationwide. 

The Health Information and Quality Authority will be responsible for the registration and inspection of all residential care services for older people. For the first time HSE run centres, as well as, private and voluntary nursing homes will be subject to independent registration and inspection.

Dr Marion Witton, Chief Inspector of Social Services at the Health Information and Quality Authority, said “this new development in the regulation of nursing homes is a significant step forward in the protection of the rights of older people living in residential care settings across the country. Residents, relatives and the public will know what to expect in a residential care setting, regardless of where the service is located or who delivers it.”

“Our aim is to safeguard and drive improvements in the quality of life of older people by emphasising what life should be like for people living in residential care,” she said.

Services will only be allowed to operate if they are registered by the Social Services Inspectorate and they will be inspected regularly to ensure they maintain a high level of care.

If the Health Information and Quality Authority’s inspectors find that a service is unsafe or the standards are not being met, the Chief Inspector will have the legal power to take a number of actions in the best interest of the residents. These include requiring changes to the service be made, prosecuting for offences under the Health Act 2007 or cancelling registration of a centre - so it will no longer be able to operate.

Inspections will begin across the country in the coming months. They will take place at any time during the day or night and may be either announced or unannounced.

The registration and inspection process will be completely independent and reports will be published after every inspection. “We will report publicly on what it is like to be a resident in each centre. As well as their protection and safety, we are also concerned with the quality of life of individual residents. If they have choices about what time they get up in the morning, what food they eat, how their day is spent. The things that are important to every one of us in our daily lives are no less important to those living in residential care. It is our role to promote the rights of individuals and ensure that all residents are treated with dignity and respect,” Dr Witton said.

All inspection reports will be available to download from the Health Information and Quality Authority’s website, www.hiqa.ie.

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For further information please contact:

Marty Whelan, Head of Communications and Stakeholder Engagement

01 814 7481 / 086 2447 623 mwhelan@hiqa.ie

Notes to the Editor:

The Standards Nursing homes will be inspected against the National Quality Standards for Residential Care Settings for Older People in Ireland and regulated under the Health Act 2007 to see if they are safe and whether the residents are cared for properly. These standards place the resident at the centre of the process and work on the basis that the centre is the person’s home.

The standards, which were mandated by the Minister for Health in Children in March this year, were developed by the Authority in consultation with a wide variety of people, including those who use the services and those who provide them - nursing homes residents and their representatives, the Health Service Executive, professional organisations, advocacy organisations, and voluntary and private providers.

They cover everyday practical concerns for people living in these centres such as the quality of care provided, how people are protected from abuse, how privacy is respected, what mealtimes should be like and whether a person-centred care plan is in place for each resident.

The registration process In order to be granted a registered certificate to operate as a residential care centre, providers will have to undergo a rigorous registration process to ensure that the service they are providing is able to meet the needs of their residents.

The Authority will do its part through regulation of services and the people who provide the services are key to the delivery of high quality, person-centred care. Guidance will be provided to the service providers on the new system, which has already been piloted to test the processes and the Authority will work in collaboration with them to bring about improvements and facilitate change.

The Authority will be inspecting residential services on an ongoing basis after July 2009 and will re-register each centre every three years. The Authority already inspects children’s residential care centres, and similarly to the existing procedures for residential childcare services, inspections of residential care settings for older people will be a mixture of both announced and unannounced visits. These will happen by day and also in the evenings, at weekends and at night.

What happens during an inspection? During an inspection visit, inspectors will talk to residents and their families and with managers, staff and interested people who wish to speak to them. Inspectors will focus on the experience of the resident living in the residential care centre and what it is like to live there.

They will also observe daily routines, quality of accommodation and meals, and other aspects of daily life. Inspectors will always check to make sure that the information and records they receive or read, or what they observe, is an accurate reflection of what happens in practice.

All inspectors are fully trained staff of the Authority and have a wide range of relevant professional experience.

What actions can be taken The Health Information and Quality Authority’s Social Service Inspectorate has the legal authority, under the Health Act 2007, to take a number of actions. If, during the registration process, or later during a routine inspection, the inspectors discover that a service is unsafe or the National Standards are not being met, the actions that can be taken, in the best interest of the residents, include:

• requiring that changes to the service be made and then checking that these improvements are carried out
• prosecuting for offences under the Health Act 2007, such as failing to comply with a condition of registration
• cancelling registration of a centre - so it will no longer be able to operate.

It is important to stress also that if the Authority’s inspectors come across a situation which poses an urgent risk to residents, and where the owner is unwilling or unable to take the necessary action, emergency steps can be taken to address the situation. The Authority also expects to see a lot of good quality services being provided and these will be acknowledged and highlighted in the inspection reports.

Inspections will be fair and proportionate in actions with the focus being on the welfare of the residents in the centre.

Inspection reports Following an inspection, a report will be produced, based on the findings from the inspection, and published on the Authority's website.

Inspection reports will give factual information about the residential care centre, its location, number of places and general facilities. They will also outline the findings of the inspection and will comment on all areas of the service. Reports will highlight where standards of care are good as well as where improvements are required. Any necessary actions required on the part of the provider will be clearly indicated in the report. The reports will be fair and will reflect all aspects of the service that is being provided.

These inspection reports will provide information to the residents themselves, their families and the general public about the standards of care in individual centres.