Ms Mary Dunnion:

It is probably easiest to go by way of the example of someone who is opening a service. First, he or she must apply for a registration and, in the context of that, he or she must be compliant with the registration regulations. Once that person goes through that process, an inspection takes place whereby we assess the regulations for the safety and welfare of residents. Again, they are nationally mandated regulations. If it is all well, then that is fine and the centre is registered. Thereafter, a monitoring process begins whereby the provider has to notify us of specific mandatory notifications. We conduct an inspection every year and renew the registration inspection every three years. The service provider has to apply for that within a given time. That is what happens if everything is sailing along beautifully.

If there are problems in the context of the quality and safety of the service for residents, there is a suite of actions that we can take. It all begins by making an inspection and verifying the non-compliance. It is never done without having the facts and evidence gathered.

We can give the provider a warning and tell them they must make the changes within a given time, determined by the office of the chief inspector, following which another inspection happens. It may be that we decide we continue the registration but with the condition that, until the situation improves, they cannot take any more residents into the nursing home. We can give a formal, legal notice of proposal to cancel a registration and then the provider has 28 days to respond. In many cases the response is adequate to address the non-compliance. If it is not, the next step would be to cancel the registration of the provider.