Peter Fitzpatrick (Louth, Independent) | Oireachtas source

Nursing homes play a pivotal role in providing care in the community for those older persons whose high dependency needs are not suitable for home support services, while also facilitating the provision of short-term care services for older persons discharged from acute hospitals, freeing up bed capacity and enabling them to ultimately return to their own home.

Although nursing home bed capacity has increased over the past decade, the population aged over 65 has grown at a rate three times faster. There is, therefore, a decreasing proportion of nursing home beds available to those over 65. Ireland’s ageing population, longer life expectancy, and increasing prevalence of chronic diseases will place significant pressure on the healthcare system in the coming years, amplifying the importance of nursing homes. On top of this, increased use of home support services means that individuals are staying in their homes for longer and those entering nursing homes are now older and with higher dependency.

In line with the objectives of Sláintecare, nursing homes play a critical role in providing care in the community for older persons. They facilitate the discharge of older persons from acute hospital settings either through long-term residential care or step-down rehabilitation and reablement services, thus freeing up acute bed capacity.

Nursing Homes Ireland commissioned an independent report on the unprecedented crisis the sector is currently going through. Its findings present an uncertain future for the care of our ageing population and the home care sector.

Over the last three years, there has been a marked increase in the number of private and voluntary nursing homes closures, with 31 nursing homes leaving the sector with the loss of 915 beds. These were primarily located in regional and rural areas. The closures have led to some residents being relocated from their local communities, resulting in significant trauma and the loss of regional employment for nursing home workers.

The financial sustainability of the private and voluntary nursing home sector is being threatened by the rising cost of care. I received an email from Mr. Alan Hynes, registered provider of ACH Nursing Home and Healthcare Limited, in Blackrock Abbey Nursing Home, Blackrock, County Louth. Mr. Hynes highlighted, in line with the Nursing Homes Ireland's report, the significant pressures placed on nursing homes as they deal with complex resident profiles and as they incur rapidly rising operational costs driven by infection prevention control requirements, recent inflationary pressures, and industry-wide staffing shortages. There has been a 6.4% year-on-year increase in the cost of a resident’s care in contrast to a 3.1% increase in weekly fair deal rates. The need for reform of the NTPF pricing mechanism for determination of weekly fair deal rates has been highlighted by the inability of the system to respond to recent increases in the cost of care, including staffing, regulatory compliance, and a higher dependency resident profile.

Over the past five years operational costs per resident have increased by 36%. Costs have risen across nearly all categories of operational expenditure. The biggest impact, however, has been in staffing, rent, energy, and food costs. Resourcing challenges and staff turnover have placed further pressure on nursing homes with increased reliance on higher-cost agency staff, driving further increases in day-to-day operational expenditure.

Yet, despite the necessity for further nursing home capacity to accommodate the ageing population, new developments in the sector are extremely unlikely to commence over the coming years due to insufficient returns for providers, increased costs and insufficient revenues, coupled with rising interest rates, construction costs and land prices. Immediate short-term action is needed to stave off a further wave of nursing home closures.

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