Patricia Ryan (Kildare South, Sinn Fein)
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439. To ask the Minister for Health the actions he will take to ensure older persons will get their full visit entitlement under the Health Protection Surveillance Centre guidelines; and if he will make a statement on the matter. [7394/22]

Patricia Ryan (Kildare South, Sinn Fein)
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440. To ask the Minister for Health the recourse open to nursing home residents and their families who are not being afforded their full visit entitlement under the Health Protection Surveillance Centre guidelines; and if he will make a statement on the matter. [7395/22]

Mary Butler (Waterford, Fianna Fail)
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I propose to take Questions Nos. 439 and 440 together.

The Health Protection Surveillance Centre (HPSC) has recently published “COVID-19: Normalising Access in Long Term Residential Care Facilities (LTRCFs)”, which will come into effect on 8 February 2022. The guidance takes account of the significant changes to national public health measures in general, whilst also recognising the need for continued vigilance in healthcare settings, including homes due to the increased vulnerability of people receiving care and/or living in these settings. The guidance continues to recognise the importance of visiting and meaningful social contact for residents. This is a positive further step forward to a return to more normalised access and visiting for people living in nursing homes and their families.

Key changes of note to the guidance are as follows:

- The minimum level of visiting should normally be daily visits by up to 2 people at one time;

- The introduction of a “nominated support person”, who should normally have regular and unrestricted access to the resident in the nursing home for whom they are nominated, except if that person is a specific risk to residents (e.g. is subject to self-isolation) or there is specific public health or infection prevention and control advice to limit visitors. This will be in addition to regular visiting;

- Unless specifically advised by public health, at an early stage of outbreak, the nominated support person should continue to have access for some part of each day. If a resident does not have a nominated support person, visiting should generally not be less than 2 visits per week by one person during an outbreak;

- Limitations on visiting should be justified by an up-to-date risk assessment and should be reassessed twice each week;

- There should be no restrictions on movement of residents within the nursing home after going on outings or visits outside of the nursing home, unless a significant exposure risk occurred during the outing;

- There will no longer be a need for visitors to show immunity through vaccination or previous infection;

- In line with established guidance, there remains no infection prevention and control requirement to restrict window visits.

This revised visiting guidance is yet another significant step forward in the return to more normalised access and visiting for people living in nursing homes and their families. I expect that all nursing home providers will ensure that they facilitate visiting in line with this new guidance to the greatest extent possible.

Visitors are reminded of their responsibilities with regard to self-checks for COVID-19 in advance of visits, and infection and prevention control and social interaction with others other than the resident they are visiting whilst in the nursing home.

It is important to note that nursing home providers are ultimately responsible for the safe care of their residents. Under Regulation 11 of the Health Act 2007 (Care and Welfare of Residents in Designated Centres for Older People) Regulations 2013 it is the legal responsibility of each registered provider to make arrangements for a resident to receive visitors, having regard to any risks that may present for the resident or other residents. Public health guidance has been developed in order to assist and support providers in this regard. Furthermore, I will write to HIQA and all nursing home providers, as I did before, to remind them of their obligations for facilitating visiting in nursing homes, in line with the updated visiting guidance, and the rights of residents to receive visitors.

COVID-19 is a continuing risk, especially when community transmission is high. It is appropriate that the significant infection prevention and control and public health guidance remains in place for residential care settings. The State continues to provide substantial support to aid the ongoing management of COVID-19 in these settings.

Patricia Ryan (Kildare South, Sinn Fein)
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441. To ask the Minister for Health if he will establish a nursing home regulator to ensure there is proper oversight of the sector; and if he will make a statement on the matter. [7396/22]

Mary Butler (Waterford, Fianna Fail)
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The Health Information and Quality Authority, HIQA, was established under the Health Act 2007. HIQA is the independent Authority established to drive continuous improvement in Ireland’s health and social care services. The Authority comes under the aegis of the Minister for Health.

The Health Act 2007 also established the office of the Chief Inspector of Social Services in HIQA. The functions of the Chief Inspector are to:

1. establish and maintain registers of designated centres (including nursing homes);

2. register and inspect designated centres to assess whether the provider is in compliance with the regulations and standards.

Under the Act any person carrying on the business of a residential service within a designated centre (i.e. a nursing home) can only do so if the centre is registered under the Act and the person is its registered provider. As part of the registration and onward process of regulation, the provider must satisfy the Chief Inspector that she or he is fit to provide the service and that the service is in compliance with the Act, the regulations and specified standards.

The purpose of regulation in relation to designated centres is to safeguard people who are receiving residential services. Regulation provides assurance to the public that people living in designated centres are receiving services and supports that meet the requirements of National Standards, which are underpinned by regulations.

The Chief Inspector 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 Chief Inspector, in discharging their duties, determines through examination of all information available to them, including site inspections, whether a nursing home meets the regulations in order to achieve and maintain its registration status. Should a nursing home be deemed to be non-compliant with the Regulations and the National Quality Standards, it may either fail to achieve or lose its registration status. In addition, the Chief Inspector has wide discretion in deciding whether to impose conditions of Registration on nursing homes.

Having regard to the “COVID-19 Nursing Home Expert Panel: Examination of Measures to 2021”, HIQA’s paper on “The Need for Regulatory Reform” and learning from the pandemic, Minster Donnelly and I approved a two-phased approach to examining the legislation with a view to proposing enhancements to the primary and secondary legislation governing nursing homes.

Phase 1 will bring forward interim enhancements to the primary legislative framework to enhance governance and oversight of nursing homes. The proposals will, amongst other things, provide new and enhanced enforcement powers for the Chief Inspector; reduce timelines and processes for regulatory actions and introduce a new reporting system for the reporting and publication of key operational data to support national planning in an integrated way and improve the information available.

The Government is committed to the reform of the regulatory framework governing nursing homes and approved the inclusion of a Health (Amendment) Bill on its legislative agenda. It is expected that, subject to Government approval, a draft General Scheme will be published in early 2022, with a Bill being developed and published thereafter.

In addition, secondary legislation will be drafted to enhance the current regulations. A bilateral project group comprising representatives from the Department and HIQA, is supporting the legislative process.

A wider review of the regulatory framework, phase 2, will commence later in 2022. It will take into account a programme of longer-term strategic reform considerations arising from, inter alia, pandemic learnings.