The long-awaited new draft standards for nursing homes, which will cover public care institutions for the first time, were launched by Minister for Health Mary Harney yesterday. Miriam Donohoe, Political Staff , reports.
The draft "National Standards for Residential Care Settings for Older People" will cover private, public and voluntary nursing homes and will provide the basis for the best quality of care to be provided, monitored and enforced, Ms Harney said.
Central to the standards will be the drawing up of an individual care plan for all residents in care institutions.
"They will be an objective and transparent way for both care providers and inspectors to implement and enforce standards of care for nursing home residents," the Minister added.
The present standards for nursing homes are set out in the 1993 care and welfare regulations and have only been amended twice in the last 14 years in relation to issues around fire safety.
The HSE inspects private nursing homes on the basis of the 1993 standards, but public homes are not inspected.
The new regulations will cover all public, private and voluntary care settings where older people are cared for and for which registration is required.
The new draft code includes 38 standards in relation to patients and the nursing-home setting.
They cover various areas including the personal dignity of residents, social relationships and activities, healthcare, health and safety and staffing.
The standards contain a number of new initiatives including requirements for nursing homes to:
• Prepare individual care plans for all residents;
• Ensure a minimum of 50 per cent of care staff should have further education and training awards council level five or an equivalent qualification;
• Provide continuous quality assurance mechanisms to monitor the provision of care.
Ms Harney said inspectors will, as part of investigations that standards are being met, be able to interview residents and their families and friends, physically examine residents and observe daily life in the residential care setting.
The draft standards are to be handled by the interim Health Information and Quality Authority which will establish a working group to oversee a public consultation on the draft standards and finalise them over the coming months. The first meeting of the group will take place next Tuesday.
Yesterday, Ms Harney commenced the Second Stage Debate on the Health Bill 2007 which will provide for establishing the new authority on a statutory footing.
It also provides for the authority to set the new standards on a legislative basis.
The consultation period is expected to take two to three months and the standards are expected to be in place by the middle of the year.
Ms Harney acknowledged the need for a significant increase in the number of nursing-home inspectors, who will operate under a chief inspector.
New standards: main aims
• Focus on a resident's "personal identity" and ensure residents are treated with respect and that their dignity is preserved at all times.
• Give each resident a contract setting out what they should be able to expect regarding accommodation, care and services.
• Allow each resident to chose meals and meal times.
• Provide residents with a physical and social environment to ensure their independence is preserved.
• Ensure that residents have a flexible daily routine which can be varied to suit their needs.
• Facilitate and encourage links with family and friends.
• Give residents a say in room-sharing arrangements.
• Keep a record of all complaints made and include details of investigations and any action taken. The residential-care setting should provide an environment that is conducive to residents, staff, family and visitors to raise issues and make suggestions and complaints.
• Keep residents safe from physical, financial, material, psychological or sexual abuse and neglect.
• Provide at least one toilet for every five residents and one handbasin for each resident. En-suite toilet and handbasins are to be provided for all residents in new nursing homes and extensions from 2008.
• Desist from using physical or chemical restraints to compensate for inadequate staffing levels, or in the routine management of residents.
• Ensure that specific healthcare needs of all residents are allowed for, including nutrition, wound management, continence and oral health.
• Ensure that residents' wishes regarding religious and cultural practices concerning death and dying are recorded and implemented, and that upon death, time and privacy is allowed for family and friends.
• The person in charge should be qualified to run the residential-care setting and should have at least three years' experience in a senior management capacity.
• Clear guidelines must be in place on the management of the residents accounts and ensure that they control their own money, except where they state they do not wish to.
• Medical, nursing and the organisation's records should be secure and up to date.
• All qualifications for staff must be checked and nurses' registration should be verified with An Bord Altranais and references sought.
• New staff should be confirmed only following completion of a satisfactory Garda clearance.
• Nursing home buildings should comply with various standards, including fire regulations, as set down in the new code.