(Updated 2^nd May 2008)

The Health Information and Quality Authority (HIQA) is responsible for setting standards on safety and quality in relation to nursing homes. It must submit proposed standards to the Minister for approval.

A draft version of the standards, which have been submitted to the Minister, was published on 11^th March 2008. A Regulatory Impact Assessment (RIA) must be carried out before approving the standards or finalising the Statutory Regulations to give effect to the relevant sections of the Health Act 2007.

A draft of the statutory regulations is expected to be circulated by the Minister in September. The Minister has committed to consulting with the nursing home sector prior to finalising the regulations. The Minister has also indicated that the proposed standards will be subject to a cost benefit analysis which will be undertaken by an external firm, independent of her Department.

The above would suggest that the new standards for residential settings for older people are unlikely to come into effect until the first quarter of 2009 at the earliest. This means that the HSE will continue as the “regulator” of the private nursing home sector until that time. In the meantime nursing homes should embrace the spirit of the draft quality standards.

The “Draft Quality Standards for Residential Care Settings for Older People” outlines 32 standards and criteria under the following headings: -

·         Rights

·         Protection

·         Health and Social Care Needs

·         Quality of life

·         Staffing

·         The Care Environment

·         Governance and Management

There are Supplementary Criteria for Dementia-Specific Units

The Care Environment

The (draft) Standard requires that “The location, design and layout of the residential care setting are suitable for its stated purpose. It is accessible, safe, hygienic, spacious and well maintained and meets residents’ individual and collective needs in a comfortable and homely way” There are supplementary criteria for Dementia-Specific Units

There are 58 criteria against which the standard for the Care Environment will be measured. These include compliance with statutory provisions; fire safety; equipment and its maintenance; insurance; infection control; furnishing and décor; heating; lighting; cleaning; storage space; alarms and accommodation.

Issues such as fire safety, insurance, infection control and compliance with building regulations are already dealt with as part of current statutory requirements. As such most registered providers will be familiar with them.

In some areas the criteria specify different requirements for new homes and extensions to those specified for existing homes. The following is a summary of some of the criteria: -

·         They   specify requirements regarding kitchens, cleaning rooms, laundry, sluice rooms, lift, offices and issues such as heating, lighting and hot water

·         The residential care setting provides safe areas for walking and has regularly spaced seating areas and areas of interest and diversion. New buildings must provide safe outdoor space accessible to all residents including those with mobility problems

·         Communal rooms and bedrooms are domestic in character and residents are encouraged to personalise their own rooms

·         Existing homes must have a specified amount of communal space exclusive of halls and corridors, for each resident. New buildings have a higher requirement for the amount of communal space for each resident

·         Doorways into communal areas, bedrooms and other facilities are wheelchair accessible and accessible to those with sensory or other impairments

·         There is appropriate accommodation to facilitate the services of allied health professionals

For new buildings the criteria specify: -

·         All single rooms have a minimum amount of useable floor space—excluding en-suite

·         The care setting has a minimum percentage of residents accommodated in single rooms facilities

·         Minimum requirements for shared rooms

·         A room to accommodate up to six highly dependent residents is used only for those who need 24 hour high support nursing care

·         All bedrooms must have en-suite facilities

·         There is one assisted bath—or assisted shower to eight residents

·         Communal bathrooms have a minimum floor area

·         Toilets and assisted toilets have a minimum floor area

·         Additional toilets that are wheelchair accessible are available for use by visitors

For existing homes the criteria specify that: -

·         Single bedrooms must have a minimum amount of useable floor space. Where rooms are less than that what is required this must be provided within six years

·         Existing bedrooms which are shared have at least 7.4 square metres of useable floor space per person

·         Within six years of implementing these standards there are no more than two residents per room except a high dependency unit where up to six can be accommodated together

·         There is at least one assisted bath, or assisted shower, to 11 residents

Comment

Clarification will be needed regarding the interpretation of some aspects of the draft standards and the criteria. An area of particular concern will be the manner in which the requirements of the new standards are applied to new registrations of existing homes, where the ownership passes to another family member or to an alternative owner. One interpretation of the draft standards could effectively make existing homes valueless. Clarification on this and other matters will need to be included in the Regulations to be prepared by the Minister.

If you need assistance in adapting your nursing home to meet the anticipated quality standards or if you are proposing a new development why not contact O’Cathain & Hynes at 091-865518 or by e-mail at This e-mail address is being protected from spam bots, you need JavaScript enabled to view it