'Elderly care standards will raise costs'

  • Niall Hunter, Editor

New quality and safety standards for the care of older people in private and public residential settings were published today by the Health Information and Quality Authority (HIQA).

Nursing home owners, however, have warned that it is inevitable that the new standards will drive up the cost of care, and that this issue needs to be addressed.

The standards will be used to assess nursing home care under a new inspection regime which will be run by HIQA and is expected to be introduced later this year once the relevant regulations are drawn up by the Department of Health.

HIQA said today that under the new system, for the first time, all residential care settings for older people run by private and public providers will be inspected by an independent authority. 

Dr Tracey Cooper, Chief Executive of HIQA, said today that for the first time we now have quality standards that clearly set down what is expected of a provider of services and what a resident, their family, carer or the public can expect to receive in residential settings.

There is a set of 32 quality standards now set out, which detail the rights of residents in the areas of protection, health and social care needs, quality of life and staffing. 

For example, under the protection heading, the standards stress that a resident should be protected from bullying, neglect, harassment, discrimination and any other form of abuse. 

Under the quality of life heading, residents are allowed exercise choice and control over their lives and are encouraged and enabled to maximise their independence in accordance with their wishes, and are entitled
to a nutritious diet.

Under staffing, the guidelines stipulate that staff should be suitably qualified and trained, should be checked to ensure that they are safe to work in the residential care setting, and that staffing should be sufficient in terms of numbers.

Under the care environment, the guidelines state that the residential care setting should be run in a way that protects residents from avoidable harm, should be hygienic and free from offensive odours.

The guidelines also specify care standards for dementia-specific residential care units.

HIQA Chief Inspector of Social Services Dr Marion Wilton said as part of the consultation exercise in drawing up the guidelines, they asked for the views of residents on what they sought in residential care.

She said the quality of staff ranked high on residents' list of priorities, in particular that there should be enough staff and that they should be friendly and kind to residents.

Residents, Dr Witton said, did not want to be seen by staff as old and incapable and many were fearful of losing their self-confidence and identity in a residential care setting. 

They also wanted to choose what time they went to bed and what time they got their meals and stressed that maintaining dignity was very important.

Dr Witton said residents did not want to fear the consequences of saying they were not happy with some aspect of their care.  She said they also wanted a home-type environment that was kept clean, especially in the kitchen area, and that had a secure garden area.

On the question of elder abuse, Dr Cooper said one of the aims of the new standards was to prevent all forms of abuse.

She said there were already many service providers who would be meeting the new standards and there may be many who are achieving them in whole or in part, but the test would be when the new inspection process began.

The representative organisation for the private and voluntary nursing home sector , Nursing Homes Ireland (NHI), said the publication of the guidelines was welcome.

Tadhg Daly of NHI said they welcomed in particularly confirmation that the Department of Health would undertake a regulatory impact assessment in advance of the implementation of the new standards.

"Before they are implemented, there must be a very thorough examination of the financial impact (of the standards) on nursing homes. It is inevitable that the new standards regime will drive up the cost of care, and this has implications not only for our members but also for those in our care."

Mr Daly said current funding arrangements do not meet the true cost of care and there needs to be a recognition by all stakeholders that quality and high standards cannot be compromised through underfunding.

The Government's new 'Fair Deal' funding system for residential care has been delayed, following the postponement of its introduction before Christmas.

Age Action Ireland welcomed the new standards, saying the publication represented a landmark development on the road to helping protect some of the most vulnerable people in our society. 

It warned, however, that the existence of standards alone will not ensure that nursing home residents are any safer than they were in the past.

Age Action said it will be watching to ensure that firm regulations are introduced by the Department of Health to support the new standards and that the regulations are then strictly enforced.

The full set of standards can be viewed by clicking on...



Anonymous - 31/07/2008 21:50

I wonder will Dr wilton etc also ensure that patients care is not just about task orientation,ie getting all patients up at a certain our so the staff can get all the beds done etc and will the patients be left lining the walls of a day room like statues with nothing to do?where is the day long activities of the residents choice that they would have in their own homes?why would we put our loved ones into residence to be left lonely and bored out of their minds in a room full of others just looking at each other,what psychological benifit does this provide?nursing homes are getting far to much money for the limited care they provide,its time they are made spend some of this money on the provision of quality day long programmes and beauty treatments for their residents both long term and respite alike as they are getting paid for each individual in their care. i have wittnessed patients patients being sat around the daty room for hours and some put back to bed earlier than they would go if they were in their own homes,its so unfair

ursaminor - 29/05/2009 16:57

I agree with the above comments, and the other comment I would make is , that while I agree that standards and a means of assessing them are vital, how can nurses in public long stay residential units manage to provide optimal care when they are being encouraged to retire early, and with no replacement. There will be huge sums of money spent on Hiqa teams around the country, between training them, trialing them and paying them, but not enough spent on keeping enough staff on the ground to carry out the standard of care they will require.

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