Máire Hoctor (Tipperary North, Fianna Fail)

I would like the opportunity to continue to give my answer. This Adjournment debate provides me with an opportunity to update the House on this matter and to outline the background to the current situation and the action taken by the Health Service Executive. I want to reassure the older people concerned and their families about the future.

The HSE has operational responsibility for the delivery of health and social services, including those at facilities such as Bethany House. Bethany House is a welfare home which opened in the 1970s. It is currently operating as a 30-bed unit, of which 28 beds are residential and two are respite. At present there are 25 long stay residents, with one long stay admission to the facility in the past six months.

In December 2008, I confirmed to this House that the HSE had commissioned a review of elderly services within the Carlow-Kilkenny region in 2006, which included Bethany House. The review was conducted in 2007. The report was received by the HSE in early 2008. Last December Bethany House was the subject of local and media speculation that it faced closure. At that time I confirmed that no such decision had been taken and that as soon as any decision was made in respect of the future of Bethany House, the HSE would inform residents and those directly affected by such a decision.

The HSE has now decided on the future of the facility. Following consultation with the general hospital manager and director of nursing, a decision was made on Tuesday, 13 Jan 2009 by the local health manager to relocate residents from Bethany House to alternative accommodation. This decision was put forward to the assistant national director of primary care and continuing services in the HSE south who approved it as part of 2009 HSE south service plan. On 15 January the HSE announced the service plan for the local health offices and hospitals in the southern area at the regional health forum. The plan identified a programme to address infrastructural deficits to meet new standards, health and safety and fire requirements.

The HSE advised the forum that the 30-bed Bethany House welfare home is no longer able to provide appropriate services owing to the increasing levels of dependencies of its patients. The independent review highlighted the lack of facilities to provide appropriate care and the home's inability to support high-dependency patients. This inadequacy increases demands in terms of maintenance, standards and health and safety issues, including infection control.

The HSE decided it was necessary to discontinue admitting patients to the home and to arrange for the current residents to be accommodated in facilities more appropriate to their needs. The director of nursing met all 25 residents on Thursday, 15 January. She explained the situation to them and said that every effort will be made to ensure a comfortable move for residents to facilities that will meet their care needs. Family members were contacted by telephone to give assurances that a further meeting with each resident and their family will be arranged to discuss and agree the facility most suited to each resident. Options outlined include Sacred Heart Hospital, a modern setting which is purpose-built to cater for highly dependent patients, private nursing homes or other welfare homes in the Carlow area for the few more independent residents.

After consultation with residents and their families, all 25 will be relocated to better and safer facilities that are purpose built to cater for their health and well-being. The immediate next steps for the HSE are to consult each resident, the families or representatives to explain the options available with a view to agreeing preferences for relocation.

This is an unsettling time for all 25 residents. We owe them a duty of care and we must ensure our primary focus has to be each one of them. Each hospital, local health office, manager, clinician, etc. working in the health services has a responsibility to ensure they strive to provide the best possible service to patients and other clients of our health services.

I am sure this House will agree that the safety and well-being of older people living in nursing homes is of critical concern. Quality care and patient safety comes first and all patients should receive the same high standard of quality-assured care. Bethany House will continue to be used as a health care facility and preliminary discussions have commenced with the Alzheimer's Society with a view to day care services being provided from the facility.