Dáil debates

Thursday, 1 October 2020

Saincheisteanna Tráthúla - Topical Issue Debate

Nursing Home Accommodation

6:25 pm

Photo of Alan KellyAlan Kelly (Tipperary, Labour)
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The Minister of State has had a long afternoon and I am sure she will be well aware of this topic. I am sure it has been raised with her before. The Dean Maxwell Community Nursing Home in Roscrea is something that is cherished by the people of Roscrea and its surrounds. It has looked after its residents for a long time. It provides care that is second to none. It is an incredible unit based in the centre of the town.

There have been an awful lot of promises made about the unit. In the northern part of Tipperary there is a fantastic state-of-the-art public elderly care unit in Thurles, Community Hospital of the Assumption. In Nenagh a new 50-bed unit is being built, St. Conlon's Community Nursing Unit, beside the hospital. Work is commencing soon and it will be a fantastic facility. Roscrea is the other major town that has a public unit which needs to be rebuilt.

There is a history in regard to this. The people of the town have had enough. We need to get this sorted. HIQA has done inspections, which the unit has passed. I have all of the details, but on top of that we also need to ensure there are long-stay beds. It is not good enough to say that it will be turned into a short-stay facility. The people of Roscrea and surrounds will not tolerate that. I, as a public representative, will not tolerate that because those who are resident now and who will be resident there in the future want it to be a long-stay facility.

The building is very similar to St. Conlon's in Nenagh. It needs to be completely redone. It does not meet HIQA requirements in terms of single bedrooms, space, facilities and everything else. It is on a site in the middle of the town beside a church and is within walking distance of many people. The site can be rebuilt on. The council is willing to work with the HSE to build on the site if necessary. Before the last general election another public representative made a commitment that a new nursing home would be built in Roscrea. That seems to have disappeared.

We need to draw out a plan. We need more public beds and capacity in Tipperary so that we can look after the elderly. We need a plan for the home. I must commend the Minister of State's predecessor, Jim Daly. He was the first person to say that we will deal with the units and make sure it is a long-stay facility. I and other Deputies met him on 17 December in Government Buildings. He visited Roscrea with a local community group on 27 January. He gave assurances that under no circumstances would the unit be closed and that consideration would be given to how it would be funded. He gave assurances which were the most comprehensive assurances we had ever been given. To be fair to him, he was quite a good Minister.

We need to chart a plan for the nursing home because the community of Roscrea will not tolerate anything else. To be honest, neither will I. Other public representatives feel the same. We are all united in this. This has been going on for too long. The town has been let down in many ways. It has lost industry. No other issue unites the people of the town as much as this nursing home and its future. I ask the Minister of State to look at her funding capacity. We do not mind waiting as long as there is a plan.

Photo of Mary ButlerMary Butler (Waterford, Fianna Fail)
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I thank the Deputy for raising the issue of the Dean Maxwell Community Nursing Home. I heard about it recently.

A key principle underpinning Government policies is to support older people to live in their homes with dignity and independence for as long as possible. In recent years there has been a shift in healthcare provision focused towards home care. Home support services are key in facilitating older people to remain at home, and with our ageing population, they will become even more important in the future.

While our stated objective is to promote care in the community so that people can continue to live with confidence, security and dignity in their own homes and communities for as long as possible, we also have patients who are in genuine need of residential care, either on a long or short-stay basis. Their safety and well-being is of paramount concern.

Residential care is provided through a mix of public, voluntary and private provision. It is worth highlighting that the budget for long-term residential care in 2020 is in excess of €1 billion. The Health Service Executive is responsible for the delivery of health and personal social services, including those at facilities such as Dean Maxwell Community Nursing Unit. There are 27 beds in the unit providing continuing care, respite and palliative care, as the Deputy has said. The HSE has confirmed that it is committed to ongoing improvements at the unit. The current capital programme of works is managed and delivered by the HSE’s estate division. I understand there have been extensive works carried out in Dean Maxwell in 2019 and in 2020, which includes the repainting of bedrooms, new lights fitted, rewiring completed throughout the unit, and fire safety works completed in early 2020 with sign-off by fire safety consultants in June 2020. Further development works were completed in April 2020 with a new nursing office, clinical room, and a hairdressing and activity area.

Dean Maxwell remains a facility registered under the Health Act 2007 with HIQA for the provision of a range of care services to older people. The unit is currently registered until March 2022. The most recent inspection report was published by HIQA on 11 September 2019. The report was very positive and the facility has complied with HIQA standards. However, HIQA has recommended that from 2021 the single bedrooms in the unit are unsuitable to meet the needs of the residents due to their current infrastructure.

There is no capital project in the HSE capital plan to replace Dean Maxwell. The HSE intends to move the emphasis at the Dean Maxwell facility from long-stay to short-stay care, which is an increasing area of service requirement. However, it is the intention that this will take place over a number of years and the changes will occur in a seamless fashion to ensure that they will not impact on individual service users. Were any such eventuality to arise in an unavoidable individual situation, the HSE has assured the Department that the resident or his or her family would be fully involved and included in any plans. Dean Maxwell services will continue and will be supported by the other community nursing units with increased capacity in north Tipperary. This will create county-wide access to older person services, which will include long-stay, short-stay, respite care, palliative care and day services. The HSE has assured the Department that it is committed to engaging in partnership with all of the relevant stakeholders. This engagement will be key to prioritising the service requirement for the population of north Tipperary and I inform the Deputy that I am also willing to engage on this issue.

6:35 pm

Photo of Alan KellyAlan Kelly (Tipperary, Labour)
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I thank the Minister of State. Her response is actually going backwards from that of her predecessor. The people of Roscrea and the surrounding area will be furious when they see this. Dare I say it but the Minister of State’s own party members are going to be furious. This is just not acceptable. We, collectively, across politics, are going to have to get a plan here. To say that we are gradually going to move to short-stay and that this will not impact on families is not acceptable. The Minister of State’s own colleague, who is the mayor of Tipperary, Councillor Michael Smith, has done some work with me on this and has worked with the council on a plan to build on the site. I have spoken to the chief executive of the council on this and the council is willing to give over land for this, such is its importance to the community.

There is going to be a new capital plan. In that capital plan service provision is going to have to be widened out because we are going to have to look after our elderly in a different way. Can this unit be put on the capital plan? In the past three weeks I have seen what can be achieved. Some €2.4 million is going into the hospital's Assumption grounds for units to look after the elderly in the area. Some €1.4 million is going into the grounds of Nenagh hospital, which I was pleased to tell people about this week. That amounts to €3.9 million. These are all hospital prevention measures and all are designed to look after the elderly in the majority of cases. Here we have Roscrea, again, not getting any form of Government support. Some €4 million was given out in three weeks. I welcome and support this but we have to have a plan. To say that this unit is just going to close to long-stay patients and will not have any such patients is a regression from the position with the former Minister of State and Deputy, Jim Daly, who had a very good meeting with the representatives down there, including the Minister of State’s colleague, Michael Smith, and members of the Roscrea Community Development Council, RCDC, and they were very happy with this. We know that there are deadlines in capital plans and with HIQA but there has to be a new capital plan. It is the Minister of State's and her Government’s decision to choose whether this is going to be on the plan.

Photo of Mary ButlerMary Butler (Waterford, Fianna Fail)
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To reiterate for the Deputy, the HSE has confirmed that it is committed to ongoing improvements in the unit, which is the first thing. The current capital programme of works is managed, as we have said, and many improvements have taken place. The Deputy can correct me if I am wrong, but I am unsure if this facility was ever included in a capital plan after prior commitments had been given. I have been informed it is not currently included.

Photo of Alan KellyAlan Kelly (Tipperary, Labour)
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What about a future plan?

Photo of Mary ButlerMary Butler (Waterford, Fianna Fail)
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As I have mentioned earlier, the HSE intends to move the emphasis of the Dean Maxwell facility in Roscrea away from long-term to short-term stay. There has been investment at Dean Maxwell in recent times and the HSE has confirmed its commitment to the ongoing provision of services. It is very important as we leave here this evening on this topic that this point has to be made very clear. Whereas a new build is not included in the HSE capital plan, as I have just said, there has been investment and a commitment given by the HSE on the provision of ongoing services. The HSE has also assured the Department that it is committed to engage in partnership with all of the relevant stakeholders. This engagement will be key to prioritising the service required for the population of north Tipperary. We do not need to run away with ourselves here. The HSE has confirmed its ongoing commitment. The new build is not included in the capital plan but many good things have happened in the past couple of years and the facility is compliant with HIQA, but I will certainly speak to the Deputy about this issue.