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Information for nursing home providers and social care professionals
From 1 July 2009, the registration and inspection of designated centres is being implemented on a phased basis.
Services will only be allowed to operate if they are registered by the Authority’s Social Services Inspectorate and they will be inspected regularly to ensure they maintain a high level of care.
Learn about our methods of inspection, ensuring compliance and how we report on our findings. Read the guidance developed on the new regulatory process and understand requirements on providers to comply with the Health Act 2007.
Guidance
The Authority’s Social Services Inspectorate has produced a series of guides which provide all the information you need on the processes of registration and inspection of designated centres.
A guide to registration
This guide leads you, the provider through the registration process and informs you of your responsibilities in relation to the registration of a centre.
Are you ready for your inspection?
This guide outlines the inspection process and explains what those involved in the provision of services can expect before, during and after an inspection.
Guidance for providers on compliance
This guide sets out how the Authority intends to use its enforcement powers under the Health Act 2007 to protect the health, safety and welfare of the residents of designated centres and to improve the quality of care provided in these centres.
Code of Conduct
The purpose of the code of conduct is to define how staff of the Authority conducting inspections, investigations or reviews will conduct themselves.
Fit-person Entry Programme
The Fit-person Entry Programme is a self assessment tool, designed as a means for you to self-assess your fitness to run a centre (as defined by the Health Act 2007). The purpose of the Fit-person Entry Programme is to assist you in considering the Standards as a guide on how to provide, review and continually improve good care. The Fit-person Entry Programme will help you assess the way you operate your centre, and identify gaps in your services or areas of learning.
Forms
Notifiable Events
Those in charge of a designated centre must ensure that the Authority is formally notified when certain events or incidents take place – these are known as ‘notifiable events’.
This guidance document explains what each notifiable event is and what providers need to do when a notifiable event occurs.
| Form | Incident or event you need to tell us about | When |
|---|---|---|
| NF01 | The death of any resident under the age of 70 including the circumstances of the resident’s death | Within three working days of the incident |
| NF02 | Outbreak of any infectious disease | Within three working days of the incident |
| NF03 | Any serious injury to a resident | Within three working days of the incident |
| NF05 | Any unexplained absence of a resident from the designated centre | Within three working days of the incident |
| NF06 | Any allegation, suspected or confirmed abuse of any resident | Within three working days of the incident |
| NF07 | Any allegation of misconduct by the registered provider or any person who works in the designated centre | Within three working days of the incident |
| Quarterly returns: NF10 - NF14 |
Quarterly returns must be submitted each year by the following dates:
|
|
| NF10 | Any recurring pattern of theft or reported burglary | |
| NF11 | Any accident | |
| NF12 | Any fire, or loss of power, heating or water | |
| NF13 | Any incident where evacuation of the centre took place | |
| NF14 | Any change to the trading name of the centre | |
| NF20 | Person in charge absent for continuous period of 28 days | One month in advance of the proposed absence |
| NF20 | Person in charge absent for continuous period of 28 days where the absence arises as a result of an emergency | Within three working days of the person in charge leaving |
| NF21 | Return of person in charge after being absent for 28 days or more | Within three working days of the return of the person in charge |
| NF22 | If the centre has been
|
Before the change is made |
| NF30 | Change of the person in charge
|
Within 10 days of the change |
| NF31 | Change in any key senior management personnel (other than the person in charge of the centre)
|
Within 28 days of the change |
| NF32 | Change in ownership of the body corporate | 8 weeks in advance |
| NF33 | Change in identity of the director, manager, secretary or any similar officer of a body corporate | 8 weeks in advance |
| NF34 | Change in the name or address of a body corporate | 8 weeks in advance |
| NF35 | A registered provider’s intention to cease to carry on the business of the designated centre and close the centre | Not less than six months |
| NF36 | Any change in the membership of the partnership | 8 weeks in advance |
| NF37 | Any change to the committee of management or other controlling authority of an unincorporated body | 8 weeks in advance |
| NF38 | Any change to the person responsible on behalf of a partnership, company, unincorporated body or statutory body | 8 weeks in advance |
More information
For more information on the registration and inspection of nursing homes, as well as on the National Standards, read our frequently asked questions.
Who’s who during registration?
Q. Who is the registration body?
The Health Information and Quality Authority was established under the Health Act 2007 to drive quality, safety, accountability and the best use of resources in our health and social care services. Under the Health Act 2007, responsibility for the regulation of the quality of residential care in designated centres for children, older people and people with disabilities rests with the Office of the Chief Inspector. The Chief Inspector’s team within the Authority is known as the Social Services Inspectorate or “SSI”.
Q. What is a “fit person”?
Under section 50(1)(a) of the Health Act 2007, registered providers and others who participate in the management of the designated residential care service for older people must be fit to do so. Providers must demonstrate to the satisfaction of Authority that they are suitable or fit for the role. It is vital that the registered provider understands the requirements of operating a nursing home, and ensures that staff have the necessary and appropriate skills to care for residents.
Q. Who is the registered provider?
The provider of services, referred to in the Health Act 2007 as “the registered provider”, is the person with overall responsibility for the residential service. The registered provider is legally responsible for the designated centre and will be held accountable for any faults with the services.
Q. Who is the applicant?
The applicant is the person who is responsible for the registration application.
- In the case of an individual/sole trader, the individual will be the applicant.
- In the case of a partnership, one nominated partner will be the applicant and will be responsible on behalf of the partnership for the application.
- In the case of a company, one nominated director will be the applicant and will be responsible on behalf of the company for the application.
- In the case of an unincorporated body, one nominated member of the committee of management or other controlling authority will be responsible on behalf of the unincorporated body for the application.
- In the case of a statutory body, one nominated person will be responsible on behalf of the statutory body for the application.
The person responsible for the application must be a senior member of the organisation involved in supervision of the management of the designated centre, sufficiently senior to make decisions and implement recommendations arising from an inspection of the designated centre.
Q. Who is the “person in charge”?
The person in charge is distinguished from the registered provider and is sometimes described as the “manager”. The person in charge of the residential service is the person with responsibility for the day-to-day running of the centre. The person needs to be an appropriately skilled member of staff suitable to the responsibilities of the role. The person in charge could be the same individual who is the registered provider or another to whom functions have been assigned.
Services covered by the new system
Q. Which services must be registered?
Under the Health Act 2007, all designated centre (residential care centre for older people) must be registered. There are three categories of residential services for older people, which will be required by law to register with the Social Services Inspectorate of the Health Information and Quality Authority:
- residential services for older people that have been previously registered by the Health Service Executive (HSE)
- existing residential services for older people that have not been registered by the HSE
- new residential services for older people applying for first-time registration.
Q. If I need to register, are there deadlines I need to be aware of?
A person currently carrying on the business of providing residential services for older people must notify the Chief Inspector of this within six months from 1 July 2009. If an applicant wishes to apply for first-time registration, they must do so six months prior to the time they wish to commence operating. The person wishing to be named as the registered provider should apply to be registered.
Fit-person Entry Programme
Q. What is the Fit-person Entry Programme (FPEP)?
The Fit-person Entry Programme is based on the National Quality Standards for Residential Care Settings for Older People in Ireland and is a tool for providers to self-assess their fitness to provide the service. Under section 50(1)(a) of the Health Act 2007, registered providers and others who participate in the management of the designated centre must be fit to do so. As a provider you must demonstrate to the satisfaction of the Authority that you are suitable or fit for the role. The Fit-person Entry Programme is in the format of a programme with defined learning outcomes and self-assessment activities and is designed to be used without the need for any specialist training or additional resources.
The Programme takes a participative approach by encouraging the provider to reflect on and consider their experience, competence and knowledge, together with their staff and residents. Its purpose is to prompt the provider, to:
- consider the National Quality Standards for Residential Care Settings for Older People in Ireland as a guide on how to provide, and continually improve care services
- assess the way in which the centre is operated
- identify gaps in the services of the centre or areas of learning
- increase awareness of changes that need to be made to some areas of practice.
Applications for registration
Q. How long do we have to complete and return the Application to Register form?
The applicant must complete and return the Application to Register form within four weeks of receipt. Providers will have to apply to register their centre six months prior to the expiration of their current registration once they have gone through the first registration process with the SSI.
Information on fees
Q. What is the fee structure?
The Minister for Health and Children has decided that the regulation of residential services for older people will be largely self-financing. Fees payable in respect of designated centres are as follows:
- application fees
- to register or renew your centre’s registration
- if you want to apply to vary a condition of your registration (the amount will depend on the variation applied for and the complexity of the method of assessment required in respect of the variation).
- annual fees.
There is an annual fee in respect of each centre. These are set by the Department of Health and Children and the fee structure is set-out in the Health Act (Registration of Designated Centres) Regulations 2009.
The inspection process
Q: What does the registration inspection involve?
The inspector will meet with the applicant and carry out a fit-person interview with you and the person in charge. The interview is designed to assess your fitness, some aspects of which will already have been assessed by documentation you have provided as part of your application. The interview will assess your understanding of, and capacity to comply with the requirements of the Health Act (Registration of Designated Centres) Regulations 2009, the Health Act (Care and Welfare) Regulations 2009 and The National Quality Standards for Residential Care Settings for Older People in Ireland. A full inspection of the premises will also be undertaken including reviewing documentation, observing practices and speaking with staff and residents. The SSI may also ask the applicant for certain documentation to be provided for review in advance of this inspection.
Q. How will you assess my service?
The inspector will gather evidence in a number of ways. They will read documents, observe activities and listen to the people in the centre. Inspectors will spend a considerable amount of time speaking to residents, if they wish to speak to inspectors, during an inspection, which will inform them of what it is like to be a resident in that centre. They will also spend time around the service in order to get a good understanding of what that service is like as a whole.
Q. Will inspection reports be published?
Yes, inspection reports will be published on the Authority’s website.
Concerns and complaints
Q. What can I do if I am not happy with the findings of an inspection report?
The inspection report will be sent to the provider in advance of it being published on the website. They will be asked to comment on factual accuracy and they will also be given an opportunity to comment on the report finding. The provider's response will be appended to the report when published on the website.
Q. How do I make a complaint about an inspector?
All inspectors are expected to work in accordance with the Authority's Code of Conduct for staff conducting statutory inspections, investigations or reviews. Service providers who are unhappy with the conduct of an inspector, should, in the first instance, contact the inspector directly. If the matter remains unresolved or if the provider wishes to bypass the initial step, you should contact the inspector’s line manager who will review the matter. He/she can be contacted at either (Cork) 021 240 9300 or (Dublin) 01 814 7400 or you can email us at inspections@hiqa.ie.
New service planning
Q. I am considering building or operating a nursing home. Where can I look for advice?
For providers who are considering building or making an extension to their centre we would recommend that they speak with a member of the SSI who may be able to offer advice. Contact the dedicated SSI advisory telephone line: 021 2409660. Details on room requirements are contained in the National Quality Standards for Residential Care Settings for Older People in Ireland, Standard 25: Physical Environment. Standard 25 sections A and B refer to existing buildings and section C refers to new builds, new extensions and first time registrations. Please note that the criteria are indicative and not prescriptive.
Alternatively, further information can be obtained by:
- calling the advice line: 021 240 9660
- email: inspections@hiqa.ie
- writing to: Health Information and Quality Authority, Social Services Inspectorate, 1301 City Gate, Mahon, Cork