Wide-ranging reform of nursing home sector recommended by Oireachtas committee

A draft report by the Oireachtas Covid-19 committee has recommended wide-ranging reform of the nursing home sector, including a governance shake-up and closer oversight of clinical practice.

The potential recommendations of the report, seen by The Irish Times, were drawn up by committee staff and will be discussed by members at a closed session on Thursday.

It states that the committee is “of the opinion that the lack of national clinical oversight of care for patients in the private nursing home sector is one of the biggest weaknesses exposed by Covid-19”.

It recommends that the Department of Health "urgently review clinical oversight and governance arrangements for private nursing homes". It also recommends that an independent review be commissioned into the circumstances of all deaths in nursing homes during the pandemic.

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The draft document is subject to change, with committee members having until next Monday to submit amendments. It also recommends a series of structural reforms, including the integration of private nursing homes into “the wider framework of public health and social care”, and that the care of older people be planned for as part of the implementation of Sláintecare.

It also recommends that a review should take place of how patients are allocated under the State’s € 1 billion per annum Fair Deal scheme to ensure their needs are central to any placement and “that patients are not placed in centres which have consistently not complied with Hiqa standards”.

Strengthening the role of Hiqa (Health Information and Quality Authority) in enforcing the regulation of care homes is also recommended, as are the introduction of regulations regarding staffing and staff ratios which “need to be strengthened in order to protect patient health”. Staffing structures, salaries, terms and contracts should also be reviewed, the draft report states.

‘Matter of urgency’

The report recommends the Department of Health should “urgently support nursing homes which have planned capital works in order to fulfil statutory obligations under the Health Act, 2007”. It says this work should be completed as a matter of urgency, given the ongoing threat of Covid-19 to the health of residents living in congregated settings.

Informed sources said on Wednesday that the private nursing home sector does not receive any State capital funding.