Jim Daly (Cork South West, Fine Gael) | Oireachtas source

I thank the committee for its invitation to appear today. I will be very brief because I appreciate that questions and answers are probably more constructive and I have already submitted a prepared script for the members' attention.

As members are aware, public funding is provided to nursing homes under the nursing homes support scheme, NHSS, which is a system of financial support covering long-term residential care for older people. In November 2017, the Ombudsman, Peter Tyndall, published a casebook on nursing homes and the Ombudsman's experience of nursing home complaints. This casebook arose from his recently assumed role in examining complaints relating to administrative actions of private nursing homes receiving public funding and his previously assumed role in examining complaints about public nursing homes. Members may be familiar with the NHSS and the many people afforded access to long-term residential care through this scheme. Through both the review of the scheme, which was published in 2015, and the observations of the Ombudsman, issues in the administration of long-term residential care in public and private nursing homes have arisen.

The main issues identified by the Ombudsman in his casebook relate to contracts of care, security of tenure and additional charges. The Ombudsman also notes the important role that alternate care models play in meeting the changing needs of older people.

As Minister of State with special responsibility for mental health and older people, I have engaged on this issue with Nursing Homes Ireland, a representative organisation for the private and voluntary nursing homes sector. It has been my long-held view that contracts of care should be made available at the earliest opportunity and that all aspects of the contract should be transparent. I requested that NHI engage with its members to ensure that contracts are provided to prospective residents at the time of inquiry rather than on admission and that the terms of contracts have greater transparency and clarity. My Department's regulations on the care and welfare of residents require that the registered provider of the nursing home agree a contract in writing with each resident on his or her admission to the nursing home. This contract must include details of the services to be provided to the resident and the fees charged. Residents should never be charged fees which are not set out in the contract.

The provision of contracts of care to prospective and current nursing home residents is included in the regulations on care and welfare of residents. In particular, discharge of a resident from a nursing home is subject to these regulations. They require that discharge of a resident is discussed, planned for and agreed with the resident and, where appropriate, with his or her family or carer, in line with the terms and conditions of the contract agreed on entry to the nursing home.

An interdepartmental working group was established to examine the recommendations of the 2015 review of the nursing homes support scheme. I requested that the issue of additional charges also be examined as part of this group's work. A project team consisting of staff from my Department and the HSE has been actively engaged in this issue, visiting both public and private nursing homes to consider the practice of levying additional charges. I expect a report on their preliminary findings to be delivered to the interdepartmental working group in the coming months for further consideration and next steps. I have met again with Nursing Homes Ireland and Age Action to discuss additional charges following media reports on the matter. I have asked Nursing Homes Ireland to request its members to make proposed contracts of care - containing their additional fees - available to potential nursing home residents, again at inquiry stage rather than admission stage, to improve transparency. Nursing Homes Ireland has circulated guidance for members on this issue which, among other things, includes commitments on openness and transparency and making fees information available to prospective residents at an early stage. The main priority in respect of additional charges is to ensure that nursing homes continue to provide an engaging range of activities for their residents.

I think I can leave it at that. I am happy to take any questions. That was an abridged-----