National survey shows that nursing home residents experience good care, but highlights areas for improvement.
The results of the first National Nursing Home Experience Survey have been launched today.
The survey, which is the first ever national survey of nursing home care in Ireland, asked residents in participating nursing homes — HSE, private and voluntary — about their lived experience of nursing home care, the quality of care and support they receive, and how this meets their needs. One nominated family member or friend of each resident was also invited to take part in the survey and comment on the care provided to their loved one.
A stratified sample of nursing homes, representative of the entire population of nursing homes in Ireland, was selected to participate in the survey between March and May 2022, a time when COVID-19 was still prevalent.
The National Nursing Home Experience Survey was developed in close collaboration with public and private providers. In order to be more inclusive of residents with cognitive impairment or residents who may lack the capacity to complete a paper questionnaire, a face to face interview-based survey was developed for residents. The survey aimed to gather information about their experiences of living in a nursing home and their experiences during the COVID-19 pandemic. It asked over 40 questions on topics such as person-centred care, daily routines and activities, privacy, involvement in decisions, staff, and food and nutrition, as well as questions on how the COVID-19 pandemic affected them.
A separate questionnaire was developed for relatives and friends to get an understanding of their experiences of having a loved one in a nursing home, particularly during the COVID-19 Pandemic.
The overall results of the survey were very positive with over 90% of residents reporting that they had a ‘good’ or ‘very good’ overall experience in their nursing home. While residents were particularly positive about the living environment and the staff and caregivers who cared for them, 10% of participating residents had a poorer experience. Areas where residents were less positive included the experience of moving into the nursing home, and person-centred care.
In terms of the experience of relatives and friends, 87% said that they had a ‘good’ or ‘very good’ overall experience with the nursing home. 13% of relatives and friends said that they had a fair-to-poor experience with the nursing home. Areas highlighted included the need to support residents in terms of their emotional wellbeing and participation in activities, and safekeeping of belongings.
The survey found that there were no significant differences in the overall experience of residents based on the size or provider type of the nursing home.
Respondents were also asked about the impact of COVID-19 on their experience of nursing homes. Residents were typically positive about the care they received during the pandemic but talked about missing visits from family and the psychological impact of the restrictions. Relatives and friends frequently noted and appreciated the efforts of staff and how they were supported in staying in touch with residents during this time. However, concerns about how the resident declined during periods of limited social interactions were also expressed by family members.
Responding to the survey findings, Minister of State for Mental Health and Older People, Mary Butler, TD said: “This survey is an important initiative to help drive positive change in the nursing home sector. I firmly believe that by listening to the voice of people who use our health and social care services we can use their direct experiences to help improve these vital services. The survey findings provide a rich source of information that will help identify where policy and legislative changes may be required and will be used to inform the Department of Health’s work in this area.”
HIQA CEO Angela Fitzgerald said: “By putting the voice of residents, family members and friends at the centre of nursing home care, we can make sure that the needs and wishes of the people who matter most are met. This survey ensures that their voices are heard by those who can implement change to improve the standard and quality of nursing home care in Ireland.
“Upholding the principles of person-centred care and respecting an individual’s human rights are fundamental to the provision of high-quality health and social care. HIQA is committed to promoting and protecting equality and the human rights of people using health and social care services. The findings of this survey will inform national standards and HIQA’s regulation of Irish nursing homes.”
Commenting on the findings of the National Nursing Home Experience Survey, Stephen Mulvany, CEO of the HSE, said “The survey results provide great insights into what matters to nursing home residents and the improvements we can make to nursing home care in Ireland. I appreciate the contribution from our nursing home residents, their families and our staff in making it possible.
“We will take the time to understand and to reflect critically on what residents and families have told us, so that we can continue to improve our services.”
Tadhg Daly, CEO of Nursing Homes Ireland said “This survey represents a very positive initiative within nursing home care, capturing the voice of residents and families. There is a need to implement learnings to build upon the very positive resident experiences that emanate from this survey.
“The overwhelming positive feedback is testament to the caring committed staff and unsurprisingly the survey emphasises that person-centred connection is absolutely integral to a positive lived experience for residents and their families. Supporting residents, families and staff in being aware of the role of independent advocacy for residents is a key takeaway that will be encompassed within upcoming learnings for all nursing homes, public, private and voluntary.”
Residents, for whom a nursing home represents their home, have the right to feel comfortable, safe and well cared for. The findings of the National Nursing Home Experience Survey will be used to help improve residents lived experience of nursing home care. Providers, both public and private, are committed to using the findings of the survey to drive improvements in their nursing homes and participating nursing homes will be invited to share their response and the initiatives they have undertaken in response to the findings of the survey.
The findings will also be used by the Department of Health to inform the development of policy and strategy in relation to nursing home care, as well as informing national standards and HIQA’s regulation of nursing homes.
Three reports — a national overview, a report on residents experiences of nursing homes and another on the experience of relatives and friends’— have been published today. These reports, and the full methodology of our survey, are available at https://yourexperience.ie/.
For further information please contact: Marty Whelan, Head of Communications & Stakeholder Engagement, HIQA
Mobile: 085 805 5202 email firstname.lastname@example.org
Notes to the editor
- A stratified sample of nursing homes, representative of all nursing homes in Ireland, were invited to participate in the National Nursing Home Experience Survey. The survey sample was created by dividing all registered nursing homes into groups based on three characteristics: region (Munster, Leinster, Connacht, Ulster and Dublin), centre size and provider type (public, private and voluntary). Nursing homes were then randomly selected from each of these groups to take part.
- Persons living in participating nursing homes were invited to share their experiences of the care they receive via face-to-face interviews which took place between March and May 2022.
- One family member or friend of each resident in participating nursing homes (known as a ‘designated representative’) received a survey in the post or could complete the survey online.
- The National Nursing Home Experience Survey is part of the National Care Experience Programme, a joint initiative by the Health Information and Quality Authority (HIQA), the Health Service Executive (HSE) and the Department of Health. The Programme also includes the annual National Inpatient Experience Survey and the National Maternity Experience Survey.