The establishment of a transparent and rigorous inspection system for nursing homes is having its difficulties, not least in the demands of some nursing home owners that they should be allowed place any rebuttal of inspection findings on the Health Service Executive website.
This demand is ludicrous. Provided inspection teams are fair, take into account the views of nursing homes, and are attentive to any problems a nursing home might have, there is no denial of natural justice in uploading the report on a particular nursing home on to the website.
The developing inspection system is not without its critics. Inconsistency, and an unevenness and varying emphasis between different reports, can lead to confusion about standards. Encouragingly, however, it seems that the teams are aware of the need to champion the overall care of an older person under different headings.
Worryingly, as has been highlighted by Dr Virpi Timonen, director of the Ageing Research Centre at Trinity College Dublin, there is no register of care workers. Minimum training requirements for home-care workers are not defined. Nor were such workers subject to Garda vetting. She makes the apposite point that the proposed national nursing homes inspectorate does not seem to extend to home care. This is an anomaly considering that Government policy is expressly geared to encouraging older people to stay in their own homes for as long as they wish.
All caring services for older people, both institutional and domiciliary, need rigorous inspection. It is vital that there is oversight of who goes into an older person's home and the agencies that employ staff for such work. This is not to be critical of the many wonderful home- care workers. It is purely to ensure that standards are upheld and that any potential for abuse is reduced.
Ireland is a long way from the Danish experience where there is a prohibition on the building of more nursing homes and free home care is available for all older people. It is time for the State and other stakeholders to take stock. Do we need more nursing homes? If so, are we relying too much on the private sector? This issue, and the demand for pensions to be linked to the average industrial wage, should keep older people's representatives busy for some time.