We continue to regulate nursing homes. Read on to learn more about our ongoing inspections to drive improvements in infection control in nursing homes and the changing profile of nursing homes.
We continue to carry out inspections each week in nursing homes across Ireland to ensure the care and welfare of residents. This includes risk inspections, inspections with a specific focus on infection control and inspections with a specific focus on fire precautions.
During our inspections, we focus on the lived experience of residents, and we speak with residents about their day-to-day life in the nursing home, and the care and support provided to them.
Changing nursing home profile
Over the last few years, we have seen the number of nursing homes offering less than 40 beds reducing. In 2018 there were 217 such centres, and by 2021 this reduced to 188. This trend is continuing this year; so far in 2022 we have seen four nursing homes offering around 40 beds close.
When ceasing operations, smaller nursing homes cite difficulties in terms of financing and resources. Undoubtedly the COVID-19 pandemic and regulations on premises which came into effect at the end of 2021 have also had an impact.
At the same time, the sector is not seeing a loss in the number of beds, as the new nursing homes opening are much larger, offering more than 40 beds in the centres. This often balances the loss of beds associated with such closures.
However, HIQA believes that the closure of smaller nursing homes should be considered in the context of a loss of a particular model of care and not just in terms of bed numbers. Smaller nursing homes that are embedded in the local community offer person-centred care in a very homely environment. Their closure sometimes means that older people in need of residential care have to travel further in order to receive care. This has knock-on effects for residents, particularly in terms of visitors, social activities and links to their preferred general practitioner (GP) or pharmacy.
Infection control
In line with the recommendations of the COVID-19 Nursing Home Expert Panel report, we continue to recruit new staff, and are increasing the numbers of inspections we carry out in the coming months. A key focus of these inspections will be on infection control.
Under Regulation 27 of the Health Act 2007 (Care and Welfare of Residents in Designated Centres for Older People) Regulations 2013, the registered provider is required to ‘ensure that procedures consistent with the standards for the infection prevention and control of healthcare-associated infections published by HIQA are implemented by staff.’
Last year, we commenced a programme of inspections focused specifically on infection prevention and control. Earlier this year, we hosted webinars for almost 700 registered providers on the key findings and learnings from the first six months of the inspection programme. We highlighted areas of good practice including:
- Strengthened governance
- Appointment of infection control leads, and established links with public health
- Outbreak management and reporting
- Promotion of vaccine uptake
- Implementation of infection prevention and control guidance and mandatory training for staff.
We also highlighted a number of areas which require improvement in nursing homes, including:
- Antimicrobial stewardship
- Adherence to standard-based precautions and transmission-based precautions
- Audits
- Visiting risk assessments
- Oversight and supervision of cleaning practices
- Oversight of training.
Infection control inspections continue to help drive improvements in practice across nursing homes. Find out more about these inspections here.