Fergus O'Dowd (Louth, Fine Gael)
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339. To ask the Minister for Health the process which must be gone through, such as notification to the home itself by letter or otherwise, before HIQA and the HSE decide to become directly involved in the running of a nursing home due to concerns about that home; the legal process and consents required in which consent is given by the nursing home; the process in cases in which it is refused by the nursing home concerned; the role of HIQA and the HSE regarding same; the further process when either the HSE or HIQA disagrees with the decision; the internal reporting within both organisations; if his Department is informed of same; the level at which his Department is informed; the process gone through by HIQA and the HSE regarding the HSE taking over the operational control of a nursing home (details supplied); and if he will make a statement on the matter. [43983/20]

Mary Butler (Waterford, Fianna Fail)
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Since 2009 the Health Information and Quality Authority, HIQA, is the statutory independent regulator in place for the nursing home sector, whether a HSE managed or a private nursing home. The Authority, established under the Health Act 2007, has significant and wide-ranging powers up to and including withdrawing the registration of a nursing home facility, which means that it can no longer operate as a service provider.

This responsibility is underpinned by a comprehensive quality framework comprising of Registration Regulations, Care and Welfare Regulations and National Quality Standards.

The functions and powers of the Chief Inspector are set out in Parts 7, 8 and 9 of the Health Act 2007 (as amended). The Statutory powers include the cancellation of registration under section 51 of the Act and the urgent action under section 59 of the Act to attach, vary or remove a condition of registration or cancellation of registration.

In the first instance, the primary responsibility for the provision of safe care and service to nursing home residents rests with individual nursing home operators. If the Chief Inspector cancels a registration under section 51 and the cancellation takes effect, or if the Chief Inspector obtains an order to cancel a registration in accordance to section 59 and the cancellation takes effect then under section 64 of the Act the Chief Inspector notifies the HSE of the cancellation of the registration and of the date on which this takes effect. The HSE must make alternative arrangements, as soon as practicable for residents where registration has been cancelled and closure orders have been secured by HIQA. Pending these alternative arrangements, the HSE, either with the consent of the registered provider or by order of the District Court shall take the charge of the designated centre.

HIQA is the health and social care regulator and does not operate hospitals or social care services such as nursing homes. When the Chief Inspector pursues the cancellation of a service’s registration, she applies through the District Court under section 59 and a notice of proposal to cancel & notice of decision to cancel registration are made under section 51. I understand that HIQA would usually ensure that the HSE is aware of the proposed cancellation of a service, noting that the HSE may be required to take over operation of the designated centre. Where the Chief Inspector decides to apply to cancel the registration of a nursing home, it is normal for my Department to be informed, for information purposes.

HIQA has advised the Department that when the Chief Inspector intends to make a section 59 application, she always ensures that notice is given to the registered provider of her intention. Notification of this is given both verbally and in writing (in the form of an Affidavit). A service can appeal to a District Court or take a judicial review. HIQA and the HSE have no role in the appeal process. Section 59 is a decision by the District Court and under section 64 the District Judge will then require the HSE to assume responsibility for the residents. The court can mandate, if required, that the provider cooperates with its decision. The length of this process is highly dependent on the level of risk posed. HIQA has further advised that the decision of the Chief Inspector to pursue cancellation is independent of HIQA, as it falls under section 51. However, the cancellation of a nursing home is the decision only of the District Court, as it falls under section 59.

As the RCSI Hospital Group took over the operational management of the home in question in April, outside of the process set out above, I have asked the HSE to respond directly to the Deputy in relation to his specific queries raised.

Fergus O'Dowd (Louth, Fine Gael)
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340. To ask the Minister for Health the process which must be gone through before HIQA and-or the HSE decides to become directly involved in the running of a nursing home due to concerns about that home (details supplied); and if he will make a statement on the matter. [43988/20]

Mary Butler (Waterford, Fianna Fail)
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Since 2009 the Health Information and Quality Authority, HIQA, is the statutory independent regulator in place for the nursing home sector, whether a HSE managed or a private nursing home. The Authority, established under the Health Act 2007, has significant and wide-ranging powers up to and including withdrawing the registration of a nursing home facility, which means that it can no longer operate as a service provider.

This responsibility is underpinned by a comprehensive quality framework comprising of Registration Regulations, Care and Welfare Regulations and National Quality Standards.

The functions and powers of the Chief Inspector are set out in Parts 7, 8 and 9 of the Health Act 2007 (as amended). The Statutory powers include the cancellation of registration under section 51 of the Act and the urgent action under section 59 of the Act to attach, vary or remove a condition of registration or cancellation of registration.

In the first instance, the primary responsibility for the provision of safe care and service to nursing home residents rests with individual nursing home operators. If the Chief Inspector cancels a registration under section 51 and the cancellation takes effect, or if the Chief Inspector obtains an order to cancel a registration in accordance to section 59 and the cancellation takes effect then under section 64 of the Act the Chief Inspector notifies the HSE of the cancellation of the registration and of the date on which this takes effect. The HSE must make alternative arrangements, as soon as practicable for residents where registration has been cancelled and closure orders have been secured by HIQA. Pending these alternative arrangements, the HSE, either with the consent of the registered provider or by order of the District Court shall take the charge of the designated centre.

HIQA is the health and social care regulator and does not operate hospitals or social care services such as nursing homes. When the Chief Inspector pursues the cancellation of a service’s registration, she applies through the District Court under section 59 and a notice of proposal to cancel & notice of decision to cancel registration are made under section 51. I understand that HIQA would usually ensure that the HSE is aware of the proposed cancellation of a service, noting that the HSE may be required to take over operation of the designated centre. Where the Chief Inspector decides to apply to cancel the registration of a nursing home, it is normal for my Department to be informed, for information purposes.

HIQA has advised the Department that when the Chief Inspector intends to make a section 59 application, she always ensures that notice is given to the registered provider of her intention. Notification of this is given both verbally and in writing (in the form of an Affidavit). A service can appeal to a District Court or take a judicial review. HIQA and the HSE have no role in the appeal process. Section 59 is a decision by the District Court and under section 64 the District Judge will then require the HSE to assume responsibility for the residents. The court can mandate, if required, that the provider cooperates with its decision. The length of this process is highly dependent on the level of risk posed. HIQA has further advised that the decision of the Chief Inspector to pursue cancellation is independent of HIQA, as it falls under section 51. However, the cancellation of a nursing home is the decision only of the District Court, as it falls under section 59.

In the case of the nursing home in question, HIQA has advised that there was a COVID-19 outbreak which meant that the registered provider was unable to sustain the ongoing delivery of services. The Chief Inspector pursued the cancellation of registration, and the HSE assumed responsibility of the running of this nursing home. I have asked the HSE to reply directly to the Deputy on the operational issues raised that come within its remit.