Management at some nursing homes threatened to end tenancies over complaints - report

The report also noted it had received anecdotal evidence suggesting that some nursing homes threaten to end the tenancy of residents who choose to make a complaint. Picture: John Stillwell/PA

An independent review of the complaints processes in nursing homes has found anecdotal evidence of management threatening to end the tenancies of residents who make complaints.

The report from consultancy firm Crowe, commissioned by the Department of Health, recommended that a positive complaints culture in nursing homes should be supported.

“Complaints processes should continue to be underpinned by regulations, including any increased specificity in the requirements for private and voluntary providers,” it said. 

“Regulation will be needed to ensure equitable and consistent access to complaints procedure for residents and families.” 

The report noted that 440 of the 576 nursing homes in the State are delivered by private and voluntary operators. 

It said that while the HSE manages complaints through its “Your Service, Your Say” policy, those in non-HSE-operated nursing homes do not have access to this process.

Crowe said it reviewed a sample of complaints policies in Ireland, reviewed international policies, and engaged in stakeholder consultation and analysis as part of the preparation of its final report.

A planned engagement with nursing home residents and families had not been feasible to arrange, but the consultancy firm said it did consult with advocacy group Care Champions which “provided some insights into family member concerns in relation to the complaints processes”.

Findings 

As part of its key findings, the report said that the typical number of complaints in any given nursing home each year is low, and the nature is “rarely serious”.

The examples of complaints we were given were typically relatively straightforward concerns like missing items that were resolved quickly when located, for example. Nonetheless, any robust complaints process should be able to handle serious complaints.

The report also found there was no requirement to report complaints data to any organisation, other than maintaining records for Hiqa inspection. 

It said that private operators who used the HSE complaints model as a basis had been “useful and successful” for some non-public providers. This “indicates that consistency may be less challenging than might be considered by some”, it said.

As part of its 10 recommendations, the Crowe report said that complaints processes should support a positive complaints culture in nursing homes and that processes should be as far as possible aligned with the HSE’s policies.

It said: “Consideration should be given to the extension of current resources, locally or nationally, to provide an intermediate level of escalation when a complaint cannot be resolved at the nursing home level.” 

Furthermore, it said that complaints procedures should be supported by adequate safeguarding and abuse reporting mechanisms.

It noted that it was apparent that many complainants view the jump to the Ombudsman as “daunting and significant”, and that the practice of proactive visits by advocacy providers to nursing homes should be supported and encouraged.

“Anecdotal evidence suggests that some nursing homes end, or threaten to end, the tenancy of residents who choose to make a complaint,” it said. 

“This practice must stop and the power to act against these nursing homes must be clearly expressed to all stakeholders.”