Nursing Homes Standards Launched

Date of publication:

The Minister for Health and Children Mary Harney, TD, and Dr Tracey Cooper, Chief Executive of the Health Information and Quality Authority, today published the National Quality Standards for Residential Care Settings for Older People in Ireland.

Speaking at the launch, Dr Tracey Cooper, said: “These standards are an important and significant milestone for the protection of the rights of our older people in residential care settings across the country. They will also guide and assist service providers in the provision of the highest quality of care to their residents. They have been developed following extensive consultation, and with ongoing advice from an expert advisory group - for which we are extremely grateful.”

Dr Marion Witton, Chief Inspector of Social Services at the Health Information and Quality Authority, said: “These standards put great emphasis on what it should be like for older people living in residential care settings. They are about promoting not only the best possible care for older people in these settings, but also ensuring that they can enjoy the best possible quality of life.

“Under these standards, each resident must now receive a contract setting out what they can expect regarding accommodation, food, care and services. As we have stressed previously, the emphasis will be on evidence that residents are being looked after properly and that individual needs are being met.”

“From the 1st July, our Social Services Inspectorate in the Authority will begin the independent inspection of all such services, whether in the public, private or voluntary sector. We will continue to work with residents and their families, providers of the services and our other stakeholders to ensure the effective implementation of these new standards,” Dr Cooper said.


Further Information: 

Marty Whelan, Head of Communications and Stakeholder Engagement
01 8147481 / 086 24476233

Notes to the Editor: 

Frequently Asked Questions - Nursing Homes Standards

What is inspection and registration of nursing homes about?

Inspections occur to check that residents in nursing homes are safe and are well looked after. By law, nursing home services have to be registered every three years (to ensure they are able to provide such services in the first instance) and inspected (in order to ensure they are maintaining standards required to operate and are continuously upholding high standards) by the Social Services Inspectorate. When an individual applies for registration to run a nursing home, he/she has to give the Social Services Inspectorate information about themselves and the kind of service they will provide. This information includes proof of identity, a medical report, Garda clearance and other checks. If Inspectors are satisfied that the person running the nursing home meets the requirements they will then inspect the nursing home against the Regulations (set by the Department of Health and Children) and the National Quality Standards for Residential Care Settings for Older People in Ireland.

What does the inspection process consist of?

Inspections can be announced or unannounced. Inspectors will focus on the experience of the resident and what it is like to live in the centre. In an announced inspection, prior to the visit inspectors will review records of staff rosters, accidents and incidents, policies and complaints handling, before visiting the nursing home. Once in the nursing home, inspectors will talk with residents, family members of residents, managers, staff and interested people and will observe routines, choices, relationships, quality of accommodation and food and other aspects of daily life. Reports of inspections will be made available on the Authority’s website.

Who will carry out the inspections, and how long does an inspection take?

Inspections will be carried out by inspectors from the Social Services Inspectorate. All inspectors have professional qualifications in health or social care (such as nursing, environmental health and social work) and relevant professional experience. All of the Authority’s inspectors will be trained and will work within established procedures. The length of an inspection can vary. In general a full inspection will last two to three days, but it could be shorter if the inspector is checking on a particular area, or following up to see if a previous recommendation has been put in place or depending on the size of the nursing home.

Are new inspectors being recruited by the Authority, and if so, how many are being recruited and how many are needed?

In total, we will recruit 48 inspectors. The Health Information and Quality Authority has undertaken an extensive recruitment process for inspectors. Some experienced nursing homes inspectors who currently work for the HSE will be moving to the Authority. We are now in the process of making offers to potential candidates and hope to make appointments as soon as possible.

Will inspections be announced or unannounced?

Inspections will be announced and unannounced, similar to our existing inspection procedures for residential childcare services. If they are announced, certain documentation will be requested from the provider in advance. The inspection process itself will entail lengthy interviews with the centres’ management and staff, a documentation review on-site, and talking to residents where possible (but residents do not have to talk to the inspectors if they do not wish to) and their families. Any item which we believe represents an immediate risk to the safety and welfare of patients, clients, or residents will be communicated immediately to the operators of centres. Follow-up inspections may be necessary to ensure compliance with our recommendations.

What actions can be taken if a nursing home is not meeting your standards?

As outlined in the Health Act 2007, we have the power to take legal action in the event of non-compliance. If the Authority believes during a registration or following an inspection that the nursing home (residential care centre) is not safe or the standards are not being met, there are a number of actions that can be taken in the interests of the residents. These include the following:

  • refusing to let it open until it complies with the law and shows how it intends to meet the standards
  • making a recommendation for changes to be made and checking that these are carried out
  • prosecuting for offences under the Health Act 2007. For example, failure to comply with a condition of registration is an offence
  • if inspectors come across a situation which poses an urgent risk to residents, which the owner is unwilling or unable to correct urgently, they can take emergency action to close a residential care centre.

Every effort will be made to ensure residents of nursing homes are not inconvenienced. However, if a nursing home does not comply with the laws and residents are at risk, arrangements may have to be made for residents to be moved to a different nursing home, which does comply with these laws and provides safe quality care.

What will happen with existing complaints made to the HSE about nursing home standards?

Discussions are taking place at present with the HSE about existing complaints, which must continue to be resolved.

How much will the Authority be charging each nursing home?

The amount paid will reflect the size of the nursing home, larger homes will pay more and smaller homes will pay less. The scale of fees will reflect the resources necessary to provide appropriate independent oversight of each facility.

Is this method of financing of nursing homes inspections and registration unique to Ireland or does it happen anywhere else in the world?

Ireland is not unique in setting a registration fee for residential care centres for older people. Internationally, service providers have to meet consistent standards in the quality and delivery of their services and many countries charge a registration or accreditation fee to cover this cost. In England and Scotland fees are charged both to register a care setting and also to be registered as a manager of the centre. In Australia, residential care centres pay a fee on commencement and on an annual basis and is dependent on the number of beds.

Will nursing homes pay application fees to the Authority?

Yes, nursing homes will have to pay an application and annual fee to the Authority.

Will the HSE also have to pay the new charges?

Yes, the HSE as the major provider of health and social care services in Ireland will have to pay the new charges, as will private and voluntary providers of health and social care.

Is the inspection process totally independent of the Health Service Executive and private nursing home operators?

Yes, Inspectors report to the Chief Inspector of Social Services within the Health Information and Quality Authority. The findings published in inspection reports will be based on evidence found on inspection and published without fear or favour.