Kieran O'Donnell (Limerick City, Fine Gael)

I am grateful for the very good contributions of Senators. I probably will not get to every point but I want to deal with the points as raised.

Senator Byrne was first up and said we had a balance in the model. Regulation is key to that, and that is why I want to strengthen the regulation in terms of HIQA to give that reassurance. She asked if funding could be provided to ensure activities for people in nursing homes. We can certainly look at that.

Virtually everyone brought up safeguarding. I will give the House the context. It is correct that the legislation is there. It is being prioritised, to answer Senator Black. The programme for Government commits to bringing forward a national safeguarding policy. Within that will be the provision of legislation. The Law Reform Commission has done a huge body of work on this. We are very much looking at that in this context. It is a priority for me, the Minister, Deputy Carroll MacNeill, and the rest of the Government. I have been in this role a relatively short time, but it is something I take very seriously.

Senator Costello made a couple of points. HIQA has a power to go in unannounced to any nursing home, whether public or private. It regulates all nursing homes, regardless of whether they are public, private or voluntary, in the same way across all sectors.Senator Nicole Ryan referred to its powers. HIQA has the power to go to the District Court to enforce any aspect, including asking the court to impose fines. HIQA cannot impose fines directly. We are very open to giving HIQA the power to fine nursing homes directly.

Financial penalties were mentioned. Senator Costello referred to safeguarding, which is hugely important. I covered all the points raised by Senator Ryan. At the moment, HIQA carries out inspections and publishes reports after inspections. These reports deal with the day of the inspection. I want the reports to provide an update as to when there has been compliance with any conditions. It is a logical thing to do. It means that when reports are published, we will not only learn about the inspection, we will also learn about nursing homes that have complied with conditions or requirements imposed by HIQA. This is a positive thing. It would allow people looking at a nursing home on the HIQA website to see it in real time.

Fines constitute the other area we will look at and, if there were to be a significant shift in staffing levels in a nursing home, it would be obliged to inform HIQA. This was a key issue regarding Beneavin Manor and is something we need to look at. There is a lacuna where HIQA carries out inspections of individual nursing homes but does not have power regarding an audit of the parent company of that group. We are going to change that. I would like to see these companies audited and that any change in ownership of a nursing home, whatever form that takes, would necessitate re-registration. It makes sense that when a sole trader who owns a nursing home sells it, anyone who buys that nursing home would have to apply to re-register it. At the moment, anyone who buys the shareholding in a nursing home takes on what is the existing regulatory history of the nursing home and does not have to reapply. It has to inform regarding a change of directors. In terms of consistency, these are things we can do.

Senator Stephenson asked about the changes that will be made. It is a valid point. A body of work is under way with HIQA on processes in which it is engaged. The two nursing homes are key along with the overall Emeis group. There is safeguarding legislation coming in. The Senator asked about safeguarding. The HSE has set up a national safeguarding office. It does not have the powers to enter a nursing home uninvited but most nursing homes will allow it to come in. We will be looking at that in terms of overall safeguarding. There are regulations from 2013 and HIQA publishes standards on safeguarding with which nursing homes must comply. We will strengthen safeguarding.

We want to provide safe nursing homes for older people. We are all working collectively in that regard. Senator Clonan made reference to the collective. I note the work he is doing with the Minister for Children, Disability and Equality. It is something I want to keep an eye on in terms of its general application. As Minister of State for older people, I am in two Departments - the Department of Health and the Department of Housing, Local Government and Heritage - so I look at health and housing. I want to provide statutory home care. The first step in doing this is regulating home care providers, which are unregulated at the moment. I hope to bring legislation on that to Government very soon. Once that is up and running, we have to define what statutory home care is. What do we want to see? We then need to bring in a system that gives people the choice to stay at home for as long as they wish. There will always be a requirement for long-term residential care because people's needs may be so great, so we need to make sure people feel safe in that environment. It is already there in that local authorities are working in the area of independent living, but I want to do that in a more structured way. The Department of Housing, Local Government and Heritage is looking at policies in this area. The programme for Government commits to local authorities looking at suitable sites for the provision of independent living. We also want to assist AHBs in that area by looking at a multitude of areas from the cradle to the grave in order that people can stay at home, go to work, etc. It might be independent living but light independent living, and the next step is more supported independent living. It is about the degrees so that people have that choice. It is something I feel very strongly about.

HIQA has acknowledged that there is a need for an ongoing review of procedures, which is something we will strengthen. In response to Senator Rabbitte, we will look at transitional schemes. Senator Clonan referred to the younger cohort. It does not come under my direct remit but nursing homes do. However, it is something I will look at with the Senator.

I thank Members for a very constructive engagement. We are all looking to ensure that nursing homes are safe for older people. We have a responsibility. It is all about that for me. Nursing homes have the ultimate responsibility but it is how we can enhance regulation in this area so that if older people choose to go into a nursing home, they feel safe and have good care.