NEW STANDARDS of care in nursing homes are to be introduced by Government following their approval by the Health Information Quality Authority (Hiqa). It is not before time. Almost three years ago, an RTÉ television programme into the treatment of vulnerable people at Leas Cross Nursing Home caused a public outcry; forced the closure of the institution and focused attention on legislative deficiencies and inadequate policing.
Now, the needs of elderly patients are to become the driving force behind the provision of services. Residents of public, private and voluntary nursing homes will be consulted about their personal preferences in terms of room sharing, meal times, daily routines and management of their money. Basic standards of accommodation, sanitation, medical care and hygiene will be established. And certain staffing ratios, qualification levels and record-keeping will become mandatory.
When Minister for Health Mary Harney signs these regulations into law, the new dispensation will represent a fundamental shift in the quality of care for that 10 per cent of the elderly population likely to need it. For too long in this society, elderly people were officially regarded as an unwelcome drain on limited resources. These new regulations, when fully implemented, may go some way towards compensating for past neglect.
Responsibility for inspecting nursing homes and enforcing new rules will fall to Hiqa. Inspectors from this newly-established and independent body are already advising nursing home owners about new standards. At the same time, the Health Service Executive (HSE) is conducting an audit of public nursing homes to establish whether they should be upgraded or demolished. One way or another, a major programme of capital investment will be required.
Many homes provide comfortable accommodation and a high quality of medical care for residents. But others are located in inappropriate buildings; are overcrowded and employ inadequate staff numbers. A five-year hiatus is envisaged before regulations governing the physical environment become mandatory. In that period, Hiqa inspectors are expected to concentrate on medical and welfare requirements.
Already, there are signs of potential difficulties. An under-funded HSE has said it will wait until regulations become law before it decides on a timeframe for upgrading its facilities.
Passage of the long-promised Nursing Home Support Bill, designed to reshape the State's duty-of-care to elderly citizens will coincide with these developments. Up to 80 per cent of a person's disposable income will be taken in public nursing home charges under that legislation, while the State will underwrite the cost of private nursing home care and then recover up to 15 per cent of all assets from the deceased's estate. Resistance to this legislation, along with concern about bed capacity and access to services, is likely to grow.