Kieran O'Donnell (Limerick City, Fine Gael)

I welcome the opportunity to discuss nursing homes and the care of older people with Members of the Seanad.

I acknowledge the "RTÉ Investigates" programme that was broadcast on 4 June. This hard-hitting and harrowing programme highlighted a litany of poor care standards in two nursing homes, showing clear neglect and abuse of older people, namely, The Residence Portlaoise and Beneavin Manor in Glasnevin. The welfare of both the residents and their families was obviously at the forefront of my concerns following the RTÉ programme. I am very conscious of the impact this programme will have had on the residents, their families, and the staff in the nursing homes featured in the broadcast. I am also conscious of the impact of the programme on the nursing home sector more generally.

It is important to acknowledge the committed, compassionate, and dedicated providers and care staff operating in nursing homes across the country. Like everyone else watching the programme, I was shocked and deeply concerned at the level of non-compliance with care standards in evidence from the distressing footage that was aired. Nursing home residents deserve, and should expect, the highest standards of care at all times. Poor care, mistreatment, neglect, or any other form of abuse of any person living in a long-term residential care centre is completely unacceptable. I expect the highest standards of care to be upheld by providers for every resident in every nursing home in the country, and anything less than this standard will simply not be tolerated.

I welcome confirmation that referrals have been made to An Garda Síochána. Responsibility for the safety and care of residents ultimately rests with the individual provider of each nursing home and their staff. The governance and management of nursing homes is a critical aspect of ensuring the safety and welfare of all residents. Staff must be equipped with the tools and supports they need to provide those in residential care with person-centred care.

As the national independent regulator of nursing homes in Ireland, I expect HIQA and the office of the chief inspector to utilise all powers available to them to ensure rigorous oversight and accountability in nursing home care. HIQA's role is to ensure that the systems, structures and processes that have been put in place by nursing homes work to ensure safe and effective care and support for residents in residential care.

I, along with officials from the Department of Health, met with HIQA on 4 June to discuss regulatory activity relating to the nursing homes featured in the "RTÉ Investigates" programme. At this meeting, HIQA's chief inspector confirmed its continuous intensive engagements with the two nursing homes in question. As requested, on 13 June, HIQA furnished me with an interim report on its engagement with the two nursing homes in the previous two weeks, which was published on 17 June. This interim report details HIQA's inspection of these nursing homes since the "RTÉ Investigates" programme was broadcast and its ongoing work in this regard. It also provides a brief overview of the Emeis Ireland group.

The Minister, Deputy Carroll MacNeill, and I, along with officials from the Department of Health, met with HIQA on 17 June to discuss the interim report. It is critically important that residents of nursing homes reside in a caring and safe environment. I have had significant engagement with key stakeholders in the nursing home sector, as well as HIQA, plus the HSE and representative bodies from the sector. I am continuing this engagement with an immediate focus on delivering the highest quality of care to the residents of nursing homes in Ireland.

A review of safeguarding concerns raised about the two nursing homes is ongoing. The HSE has also confirmed that it will be engaging with all nursing homes in the Emeis group in the coming period. HIQA's chief inspector continues to intensively engage with the two nursing homes featured in the RTÉ programme. HIQA has completed a series of recent unannounced inspections of both nursing homes in the evening, the early hours of the morning and during the day to ascertain the level of care being provided at all times - day and night. Both providers were issued with an official warning of cancellation of registration by HIQA should they fail to implement significant improvements in the care of residents. I assure Members of the Seanad that the Minister for Health, Deputy Carroll MacNeill, and I and the Department of Health will continue to closely monitor developments regarding both nursing homes. The welfare of residents and their families will remain our highest priority.

Last Friday, as requested, I received a report from HIQA which provides a comprehensive overview of the Emeis group and its regulatory history, including, but not limited to, regulatory compliance, escalating enforcement actions, and any additional conditions of registration. The contents and findings of both reports are being considered, including the need for additional regulatory powers in respect of nursing homes, with actions in this regard to be taken as a matter of priority. HIQA has acknowledged the importance of examining its processes and methodology. It is essential that these are continually being looked at for ways to improve the inspection and regulation of nursing homes.

The Minister, Deputy Carroll MacNeill, and I are fully committed to introducing an adult safeguarding policy for the health and social care sector, including nursing homes. The policy will commit to the development of adult safeguarding legislation for the sector, including nursing homes, and will build on the range of existing legislation, policies, and procedures already in place in the sector for preventing, reporting and responding to abuse. The policy is at an advanced stage and our intention is to bring it to the Government as a matter of priority. The Government has included a health (adult safeguarding) Bill in its current legislative programme to facilitate this. It is recognised that this will be an important further development in preventing and protecting vulnerable adults from abuse.

I also advise the Seanad of ongoing work by the Department of Health to develop a framework for safe nurse staffing and skill mix for long-term residential care settings for older people. This work is being overseen by a task force. A research team from UCD and UCC have undertaken substantial research and testing of a methodology for determining safe staffing in the sector. The work is nearing completion and I expect to receive recommendations shortly on how it can be implemented.

The Government is committed to continued investment in healthcare infrastructure which supports the highest quality care for the older population. It is recognised that long-term residential care will continue to be a crucial part of the overall continuum of care. In this context, the Department of Health, alongside the HSE, is developing a new long-term public residential care additional capacity plan, which will be published in 2025. The programme for Government commits to building more public nursing home beds. This is an absolute priority for the Government.

People are living longer and the number of older people in the total population is growing. The success that has been achieved in improving health outcomes and extending life expectancy must be acknowledged and celebrated. However, we also recognise the challenges we will face in a range of areas in the coming years as our population ages. It is within this context that, in March 2024, the Government established an independent Commission on Care for Older People. The commission is charged with examining the provision of health and social care services and supports for older people and with making recommendations to the Government for their strategic development. Subsequently, a cross-departmental group will be established under the auspices of the commission to consider whether the supports for positive ageing across the life course are fit for purpose and to develop a costed implementation plan for options to optimise and implement these supports. The commission will publish its first report in due course.

The Government's strategic goal is to deliver a new model of integrated older persons' health and social care services across the care continuum, supporting older people to remain living independently in their own homes and communities for longer, in line with the Sláintecare vision for receiving the right care in the right place and at the right time. Engagement with the older population clearly indicates a preference to age in place, in their own homes, for as long as possible. As Minister of State with responsibility for older people, in conjunction with partners in the health sector and beyond, I am determined to support and facilitate this.

The 2025 programme for Government commits to a range of actions that will advance a social care model that supports older people to live full and independent lives, in their own homes and communities, with the appropriate wrap-around supports.Home support is an essential and highly valued service for thousands of people each day in the country. The programme for Government commits to design a statutory home care scheme, which is a key priority for me as Minister of State with responsibility for older people. That statutory home care scheme is something on which I am actively working and it is an priority for me and the Government. In my dual role as Minister of State with responsibility for older people and housing, I am also committed to a particular focus on housing options for our older population in the context of the new housing plan to follow Housing for All. It is absolutely vital we continue to increase the housing options and choices available to older people.

Across the country, nursing homes in the public, private and voluntary sectors play a vital role in the provision of long-term care and other services. It is important to acknowledge the committed, compassionate and dedicated providers and care staff operating in the sector. There are a lot of very good nursing homes. What we saw on the "RTÉ Investigates" programme was horrific and showed an absolute neglect and abuse of older people, but there are a lot of very good nursing homes out there with good and dedicated staff providing good care, and that is something that needs to be acknowledged as well.

It is clear that the scenes that were witnessed in the recent RTÉ programmes have highlighted clear deficiencies in the standards of care being provided in some long-term residential care settings. I want to firmly reiterate that poor care, mistreatment or any other form of abuse of any person living in a long-term residential care centre is wholly unacceptable and will not be tolerated. Every resident of a nursing home deserves dignity, respect and the highest standard of care. The Minister, Deputy Carroll MacNeill, the wider Government and I are committed to ensuring everything possible is done to ensure the distressing scenes we witnessed in the recent "RTÉ Investigates" and "Prime Time" programmes do not happen again in any nursing home across the country. Furthermore, I want to state clearly that I am committed to delivering a better future for older people in this country.