Smaller nursing home operators fear closure in face of ‘no future’

Warning of social value of facilities with fewer than 40 residents as Hiqa concerned about loss of ‘homely’ model of care

To date in 2022, 10 nursing homes offering about 40 beds have either closed or said they would be closing in the coming months, the Health Information and Quality Authority says. Smaller nursing homes embedded in the community offer person-centred care in a very homely environment.  Photograph: Barry Cronin
To date in 2022, 10 nursing homes offering about 40 beds have either closed or said they would be closing in the coming months, the Health Information and Quality Authority says. Smaller nursing homes embedded in the community offer person-centred care in a very homely environment. Photograph: Barry Cronin

An increasing number of smaller nursing-home operators “feel there is no future” and will close without an “injection of confidence” into the sector, the chief executive of Nursing Homes Ireland (NHI) has warned.

Tadhg Daly was speaking as the Health Information and Quality Authority (Hiqa) also raised concerns about the loss of the “homely” model of care as the number of smaller operators continues to decline.

A spokesman said the number of nursing homes offering “less than 40 beds” was reducing.

“In 2018 there were 217 such centres and, by 2021, this reduced to 188. This trend is continuing this year; so far in 2022, 10 nursing homes which were offering around 40 beds have either closed or advised that they will be closing in the coming months.

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“Hiqa believes that the closure of smaller nursing homes should be considered in the context of a loss of a particular model of care and not just in terms of bed numbers. Smaller nursing homes that are embedded in the local community offer person-centred care in a very homely environment and are people’s homes.

“Their closure sometimes means that older people in need of residential care have to travel further in order to receive care. This has knock-on effects for residents, particularly in terms of visitors, social activities and links to their preferred doctor or pharmacy,” he added.

Increasing size

An upward trend in the size of nursing homes is noted, he continued.

“This is evident in the average number of beds per centre and also in the size of new nursing homes applying for registration. The average number of beds has increased in each of the last five years and now stands at 54.6 nationally,” said the spokesman.

While rising costs were hitting smaller operators most acutely, without interventions larger operators would soon be “under pressure too”, said Mr Daly.

Asked how many closures could be coming, he said, it was “very hard to put a number on it”.

“What we have seen over the last couple of years is that they were on the front line of Covid. Many will have exhausted their reserves and now we enter into another unprecedented series of crises. This does need to be recognised as a ‘force majeur’ event.

He agreed increasing costs were affecting businesses in every sector, but nursing homes were “essential services”. And while other sectors might be able to increase prices, nursing homes were on a “fixed rate” from the Government though Fair Deal subsidies.

Kitty Holland

Kitty Holland

Kitty Holland is Social Affairs Correspondent of The Irish Times