Alex White (Dublin South, Labour) | Oireachtas source

I thank Deputy McNamara for raising the issue and for his insights and observations on it. I will make some general remarks at the outset.

The overarching policy of the Government is to support older people to live in dignity and independence in their own homes and communities for as long as possible and to support access to quality, long-term residential care where that is appropriate. If it becomes necessary for an older person to move to a nursing home, their safety and well-being is of paramount concern. We must ensure that the highest standards of care are provided to all residents in a safe and secure environment, and that we meet the needs of those who require our services in the very best way possible.

The Health Information and Quality Authority, HIQA, is the independent body responsible for promoting quality and safety in the provision of health and personal social services for the benefit of service users. On 1 July 2009 statutory responsibility for inspecting and registering nursing homes was given to HIQA's chief inspector of social services. That is underpinned by a comprehensive quality framework comprising the Health Act 2007, Care and Welfare Regulations and the National Quality Standards for Residential Care Settings for Older People in Ireland. Members will agree that it is important to have effective mechanisms to maintain and enhance public confidence in the delivery of quality residential care. Residents, their families and the public need to be reassured that the care people receive is monitored. The Health Act 2007 provides that, with a regime designed to protect the public through an independent inspection and registration system for residential services.

Patient safety and quality assurance in nursing homes is secured by setting quality standards, reinforced by regulations that specify how the best service possible can be delivered in an effective and appropriate way. The national quality standards to which the Deputy refers are an essential component in ensuring the quality and safety of residential care for the older population. There are 32 standards under seven groupings: rights, protection, health and social needs, quality of life, staffing, the care environment and governance and management. They are patient-centred, providing a blueprint for the provision of a higher standard of care delivered against a set of clear and comprehensive criteria. In summary, the standards promote health, well-being and quality of life, and older people are entitled to their effective implementation and monitoring and for effective steps to be taken if they are not met.

All nursing homes for older people, whether public, private or voluntary, are subject to the same core standards for quality and safety. As Deputy McNamara indicated, HIQA carries out inspections across the nursing home sector to ensure that the standards are being met and that residents are receiving the best possible care.

I expect we would all agree that lessons had to be learned from some very unsatisfactory and well-publicised incidents in nursing homes in recent years and from reports such as that of the Leas Cross commission of investigation. Our system of regulation and inspection was established for the sole purpose of ensuring safety and quality of care for nursing home residents. While standards of care are, thankfully, generally very good, we cannot and must not be complacent when it comes to the protection of older people.

The Deputy raised a query on one of the categories of requirement concerning nursing homes. It is an interesting point, in particular on the extent to which there was consultation with older people themselves in respect of the standards. Deputy McNamara would agree that we can only operate on the basis of standards that are put together in a rational way. They cannot be nursing home-specific or area-specific; the standards must be national in order for them to be understood and properly monitored.

As the Deputy is aware, the current standards were approved in 2009. They were developed by a working group that was chaired by HIQA, which importantly comprised the regulator, service providers of private, voluntary and HSE nursing homes, older people's advocacy groups, people involved in the care and treatment of older people and the Department. There was an important and, as the Deputy indicated, necessary, input on behalf of persons directly affected, in particular the active and effective advocacy groups for older people who operate in this country. I reassure the Deputy and the House that such groups who are engaged in the issue were consulted. It is important that they should be. There is no harm in there being continuing debate on the issue but I reassure the Deputy and the House that it is something that was taken carefully into account when the standards were being put in place.

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