Better standards ‘will mean higher care costs’

PLANNED quality standards for nursing homes will inevitably increase the cost of care.

The warning came from a private sector representative body as 32 planned standards were introduced yesterday by the Health Information and Quality Authority (HIQA).

The standards will apply to all nursing homes, including public facilities.

Once the necessary regulations are in place, all residential care centres will be inspected by the independent watchdog to ensure they are delivering care in accordance with the new standards.

Nursing Homes Ireland (NHI), the representative organisation for the private and voluntary nursing home sector, said the financial impact on nursing homes must be examined before the regulations underpinning the standards are introduced.

“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,” said NHI chief executive Tadhg Daly.

The standards were developed after shocking instances of elder abuse were uncovered at Leas Cross in north Dublin.

HIQA chief executive Tracey Cooper said the national quality standards for residential care settings for older people spelt out clearly what an older person, their family, carer or the public could expect to receive in nursing homes.

“As has been demonstrated in the past, the most vulnerable of older people must be protected and supported to live a quality life in a safe, caring and respectful environment and I believe that these are at the heart of these standards,” she said.

HIQA’s chief inspector of social services, Dr Marion Witton, said the emphasis would be on evidence that older people are being looked after properly and that individual needs are being met.

“The standards have been developed to promote good practice. The new system of registration and inspection will provide a rigorous process to drive improvements in the quality of care,” said Dr Witton.

She said the registration and inspection process would also be a deterrent to unqualified or inappropriate people establishing residential care homes.

The Health Service Executive welcomed the development of the standards and had been working with the HIQA to arrange the smooth transfer of responsibilities.

In the meantime, the HSE continues to inspect private nursing homes in line with legislation. Dr Cooper said many nursing homes were already meeting the standards but the HIQA wanted to ensure older people received a consistently high level of care, regardless of who was providing it.

Dr Witton said the inspection reports would be published and the public would access an up-to-date list of the registered nursing homes.

She said resources would be concentrated on those homes needing improvement while those providing a consistently good service would have less frequent inspections. “I think that is a better way of going about it,” she said.

SIPTU welcomed the standards but said it was unfortunate employment standards barely got a mention. The union’s nursing homes organiser, Paul Hardy, said the proposals did not go far enough in protecting staff who work in the sector.

“Poor employment standards, especially in many private nursing homes, means dedicated staff are not encouraged to develop their skills and expertise in the sector, resulting in a high turnover of nursing care staff, which is not good for the residents,” he said.

Mr Hardy said a reference to employment standards was included in the original draft but was removed by the HIQA.

“We consider such an omission from the new standards to be a very serious matter and will be calling on the minister to re-examine the proposals before they become law,” he said.

The union is also unhappy with the varying practices in pay and conditions for all grades of staff within the private nursing sector.

Many staff in private nursing homes were expected to exist on minimum rates of pay with no premiums for working unsocial hours and national pay awards were not always implemented.

The union also claimed that some employers have told staff they would have to pay for their own training as the standards made no reference to them having to cover the costs.

Mr Hardy said the union would be urging Health Minister Mary Harney to address pay and conditions in the sector.

* Copies of the National Quality Standards for Residential Care Settings for Older people can be downloaded at www.hiqa.ie.