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LAST UPDATE | 18 Jun
SHUTTING DOWN A nursing home is considered a “nuclear option” when considering sanctions for poor standards of care, the regulator has told TDs.
Representatives from the Health Information and Quality Authority (Hiqa) appeared before the Oireachtas Health Committee today following an RTÉ documentary which exposed poor care at two nursing homes in Co Dublin and Co Laois, respectively.
The issue also dominated Leaders’ Questions in the Dáil today.
Sinn Féin leader Mary Lou McDonald asked Taoiseach Micheál Martin how it was possible that it took an RTÉ documentary to expose the crisis when Hiqa had received almost 200 complaints related to one nursing home, The Residence, in Portlaoise.
“How can we have 198 allegations of abuse at just one nursing home, and yet it took an RTÉ program to expose this scandal,” she said.
“What we witnessed on our TV screens was horrific. Vulnerable elderly people, manhandled, neglected, disrespected, pushed down hallways, roughly forced into chairs.
“All by the very people who are supposed to care for them.
“Their families are absolutely devastated, and they are calling on the government to act now,” McDonald added.
In response, the Taoiseach acknowledged that the recent revelations have been “deeply traumatic” for the families involved.
Deputy Chief Inspector Susan Cliffe told TDs and Senators today that Hiqa does not have the power to regulate the parent company of the nursing homes, Emeis Ireland, and explained that the care providers at the facilities are different firms.
Senators and TDs on the committee were told that Hiqa does not have the power to issue fines, to parent companies or firms in control of facilities in the country, and that nursing homes are regulated through an “escalating process”.
This can range from the ordered cessation of new admissions at facilities, which occurred at The Residence Nursing Home in Co Laois earlier this year, or the suspension of the provider’s licence – considered the “nuclear option”.
Chair and Social Democrats TD Pádraig Rice questioned if Hiqa had powers beyond escalating regulatory processes. Cliffe said no, adding later that Hiqa would need additional powers to deal with parent companies of providers, such as Emeis.
Speaking during the second session, Minister of State with responsibility for Older People Kieran O’Donnell clarified that Hiqa can take legal action against private providers and seek fines in court. He accepted that that can be costly, however.
The Fine Gael TD agreed that parent companies of care providers need to be properly regulated, and highlighted that Hiqa does not need to be notified in instances where the parent company of providers change hands.
He said that that is one example of issues with private ownership that he wants to fix.
More than 200 complaints were made about care at Beneavin Manor in Dublin 9, Hiqa told the committee today. Some of these complaints have been forwarded to gardaí, politicians heard.
Hiqa’s Cliffe later explained that incidents and locations are referred to gardaí for investigation considerations, not parent companies or individual staff members.
Questioned later on long-awaited safeguarding legislation – which activists and families have called on government to implement in order to give greater regulatory powers to Hiqa – O’Donnell said his department will be considering all suggestions to the new laws.
He pointed to the fact that Hiqa already have the authority to refer incidents to An Garda Síochána. Sinn Féin Senator Maria McCormack highlighted Cliffe’s previous remarks about only incidents being forwarded to gardaí.
She said that the current mechanism is not good enough when, using an example from the RTÉ documentary, staff and residents at facilities are not given enough resources, and questioned if private operators would be punished for such.
O’Donnell said it was “unforgivable” that items such as incontinence pads were not stocked properly by management. He said that all options will be considered by the Department of Health for safeguarding legislation.
Fine Gael TD Colm Burke highlighted that over 40 complaints were made about the standards of care at The Residence in Portlaoise within its first year in operation.
Chief Inspector Finbarr Colfer said, for all nursing homes, meeting regulatory requirements is seen as the basic standards for facilities. He said that Emeis has a “troubled history” and that Hiqa was working with the firm to increase compliance.
Hiqa’s representatives stood over the findings of previous inspections at The Residence in Laois and Beneavin Manor in Dublin, claiming that there were significant operational changes at both facilities between the date of inspection and the RTÉ documentary.
Politicians later heard that just over 75% of nursing homes in Ireland are privately run – a rise of 30% in a short number of years, according to Sinn Féin TD David Cullinane.
Responding to questions by Cullinane, O’Donnell said private ownership will always be a part of the nursing home sector but stressed that its participation needs to be met with proper oversight.
Hiqa’s Chief Executive Angela Fitzgerald pushed back on suggestions by TDs that CCTV be used by the regulator to monitor or identify failures by care providers. She does not want that to be the outcome of the RTÉ programme.
With reporting from Jane Matthews
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