The Health Information and Quality Authority (Hiqa) published a 15 year overview report on the regulation of nursing homes.
“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,” it said.
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.
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: “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.
“Notwithstanding the progress made with achieving higher standards of care during the period of regulation by the Chief Inspector, there are significant current and future challenges facing the sector, and further reform of the regulatory framework is required.
“The profile of centre ownership in the sector is changing, and based on the experience in the UK, this poses potential risks to the sustainability of services in the event that a parent company gets into financial difficulty.
“The sector is also experiencing ongoing challenges in recruiting and retaining staff. There is also an absence of a national strategy for social care to enable the country to have a clear vision for how social care is to be provided, funded and staffed into the future to meet the changing needs of those that require care and the changing population demographics.
“As people get older, they must be supported to live active and fulfilling lives where their human rights are protected and promoted and in settings that are local and promote their independence as far as possible.”
