Mary Harney (Dublin Mid West, Progressive Democrats)

The inspection of private nursing homes is the responsibility of the Health Service Executive under the Health (Nursing Homes) Act 1990. The 1990 Act provides for the registration of private nursing homes and for procedures for attaching conditions to the registration and de-registration of nursing homes.

The Nursing Homes (Care and Welfare) Regulations 1993 set out the standards to which private nursing home owners must adhere in the provision of nursing home services. In accordance with the regulations, the HSE carries out inspections of private nursing homes. The HSE has inspection teams in each area and those teams are composed of a chairperson who is usually the senior medical officer, a director or assistant director of public health nursing, and a principal or senior environmental health officer.

Following inspection each nursing home receives an integrated report which contains recommendations on best practice conditions which are required for continued registration. Under the 1990 Act and the 1993 regulations, the HSE can attach particular conditions to registration. The inspection team liaises with the proprietor to ensure compliance with the regulations within an agreed timescale. The type of breaches that are identified during inspection by the HSE include contracts of care with relevance to the detail of fees and updating of same, hygiene levels, undertaking regular fire drills and the maintenance of firefighting equipment, accident prevention policies, accuracy of staff rotas-records maintenance systems and appropriate stimulation and entertainment activities for clients. Two inspections per year of every nursing home are required in accordance with Article 24 of the regulations. In addition, the inspection teams carry out follow-up inspections, as required, and conduct advice visits for prospective nursing homes.

A nursing homes inspection and registration working group was established in July last by the HSE and its report made a number of recommendations in specific priority areas in regard to nursing home inspections. The working group is confident the implementation of these recommendations will be the first test towards bringing consistency to the whole area of nursing home inspections and registrations, with new standardised processes being put in place and the appointments of dedicated inspection teams whose remit solely covers all aspects of nursing home inspections, registration and investigation of complaints.

A training programme is also being developed for the HSE nursing home inspection team. The HSE has advised that mandatory inspections will be unannounced and follow-up inspections may be announced or unannounced. The HSE is committed to publishing inspection reports on nursing homes and these are expected to be published from mid-July onwards.

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