In Ireland, nursing homes generally fall into two categories:
- Private nursing homes
- Nursing homes run by the Health Service Executive (HSE)
The quality and safety of nursing home service (both private and HSE operated) is subject to standards and primary legislation. The Health Information and Quality Authority (HIQA) has a lead supervisory role in this regard, and conducts inspections of nursing homes, checking for and reporting on compliance.
Inspectors look for compliance with the Health Act 2007 (Care and Welfare of Residents in Designated Centres for Older People) Regulations 2009 (as amended) and the National Quality Standards for Residential Care Settings for Older People in Ireland, the latter being standards for nursing home care as developed by HIQA.
There are many factors to be considered when choosing a nursing home for a relative:
- Quality of care
- Location: How close/convenient is it to the people who will be visiting the relative
- Facilities available
- Financial: How much will it cost & what supports are available?
- Expected duration of stay
The HIQA inspection reports for nursing homes are published on their website: HIQA Nursing Home Inspection Reports, and these indicate in detail, the areas where the nursing home is compliant to the legislation and standards, and where improvement is needed. These provide a useful resource when trying to choose a nursing home from a shortlist.
One or two visits (at different times of the day) to candidate nursing homes is also recommended. These provide an opportunity to view the facilities, meet the staff and observe at first hand how they look after the residents. To give some focus to the visit, there is a checklist that you can take with you. This will act as a prompt and will reduce the chance that you forget some important aspect.
Financial Support
The HSE operate the Nursing Home Support Scheme (a.k.a. Fair Deal). This scheme applies where long-term nursing home care is required. Under the scheme, the person requiring nursing home care pays a contribution to the care cost and the State (via the HSE) pays the balance. In order to benefit from the scheme, a formal application must be made, and this is followed by various assessments, including a financial assessment by the HSE. No claim can be made under this scheme unless the application is approved.
Care Needs Assessment
One of the assessments is the Care Needs assessment. Its purpose is to determine if long-term nursing home care is the appropriate choice for the applicant. It is conducted by a HSE appointed health-care professional (e.g. a nurse). It considers the following aspects:
- The ability of the applicant to perform the tasks of daily living, such as: bathing, dressing, moving around, shopping, etc.
- The medical, health and personal social services required by and being provided to the applicant.
- The family and community support available to the applicant
- The wishes and preference of the applicant.
The assessment may also include a physical examination by a healthcare professional.
Financial Assessment
This assessment examines the income and assets of the applicant. The applicant is expected to contribute 80% of his/her income and 7.5% of the value of any assets, per annum, to the nursing home costs, with the Scheme paying the balance. For a couple, the income of the person needing care will be taken as half of the couple’s income. The first €36,000 (or €72,000 for a couple) will not be counted at all in the financial assessment. For assets including land and property, the 7.5% contribution based on such assets can be deferred and collected from the applicant’s estate after their death. If the person’s assets include their principal residence, it will only be included in the financial assessment for the first 3 years of the person’s participation in the Scheme.