Over 2,500 nursing home beds may close due to failed standards

Knock-on effect on hospital overcrowding possible through lack of step-down care

New standards essentially require nursing homes to move from providing multi-occupancy wards with shared toilets to single and double rooms with en-suites. But many public nursing homes are located in older institutional building that are expensive to convert. File photograph: Bryan O’Brien/The Irish Times
New standards essentially require nursing homes to move from providing multi-occupancy wards with shared toilets to single and double rooms with en-suites. But many public nursing homes are located in older institutional building that are expensive to convert. File photograph: Bryan O’Brien/The Irish Times

More than 2,500 beds in public nursing homes may have to be closed from July because they fail to meet strict new accommodation standards set by the State’s public health watchdog.

Such closures would have a severe knock-on effect on hospital overcrowding through increasing the number of older patients needlessly occupying hospital beds because of a lack of step-down care.

A surge in the number of delayed discharges in hospitals was a major contributory factor behind this month’s record figures for patients on trolleys.

HSE director general Tony O’Brien has warned there is currently insufficient funding to bring accommodation standards in 30 large public nursing homes up to the levels required by the Health Information and Quality Authority (Hiqa).

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The challenge of re-registering public long-stay beds with Hiqa was a significant issue to be dealt with over the coming months, he told the Oireachtas health committee.

New standards

The new standards essentially require nursing homes to move from providing multi-occupancy wards with shared toilets to single and double rooms with en-suites. However, many public nursing homes are located in older institutional building that are expensive to convert.

Minister of State for Primary Care Kathleen Lynch said this week Hiqa had agreed to extend the deadline for closures by up to three years, provided there was a commitment to a timeframe for the works.

A spokesman for Hiqa denied any blanket guarantee had been given, but said the standards provided by each nursing home would be considered on a case-by-case basis.

He said a lot of private operators had spent considerable sums upgrading their premises, and public nursing homes could not be treated any differently.

Where a home fails to meet the new standards, Hiqa can attach conditions to its operation. This could involve a temporary or permanent reduction in the number of residents, or more extreme “restrictive actions”.

Demographic factors are increasing the pressures on the nursing home sector.

As Mr O’Brien pointed out to the committee, the over-65s population is growing by about 20,000 a year, while over-80s are increasing by 4 per cent.

Paul Cullen

Paul Cullen

Paul Cullen is a former heath editor of The Irish Times.