NEWS
NHI News published by: Nursing Homes Ireland, Unit A5, Centrepoint Business Park, Oak Road, Dublin 12. Tel: 01 4292570 | Fax: 01 4291845 | E-mail: info@nhi.ie Visit us online: www.nhi.ie
AUT U MN
20 1 5
NHI ANNUAL CONFERENCE & CARE AWARDS THURSDAY 12TH NOVEMBER 2015
DEMENTIA STIMULATING MEMORIES BY BRINGING OUTSIDE WORLD IN
ACTIVITY PAINTING WITH EMOTIONS
COMMENT
Embracing a window of opportunity
Tadhg Daly, Chief Executive Officer, Nursing Homes Ireland
A
s I write, it appears to be definitive. An Taoiseach Enda Kenny appears to have finally committed to Spring 2016. One thing we’re sure of, our political system has most definitely moved into pre-election mode. The Government has recently announced a €27 billion spending plan and Budget 2016 has been described by many commentators as an election budget. One thing for certain, the forthcoming general election will present the private and voluntary nursing home sector with significant opportunity to engage with politicians. NHI are calling upon our Members to embrace this window. Health will always dominate the political landscape. Beyond the political statements are the real people who require timely access to specialist care. The ability / inability to access such care can be difference between life and death. The pressures upon our acute hospital services continue to escalate and are understandably a constant and ongoing national focus. As the HSE statistics continually inform, circa 80% of the persons who have completed their acute phase of care and are awaiting discharge from our hospitals – referred to within statistics as ‘delayed discharges’ – are awaiting long-term residential care. Nursing home care is intrinsic to enabling acute hospitals focus on providing acute care. Minister for Health Leo Varadkar and his colleague Minister with Responsibility for Older People Kathleen Lynch have recognised the importance of timely access to nursing home care. The provision of additional funding to support the Fair Deal scheme in 2015 – with an additional €44 allocated towards scheme budget in April - has supported HSE in reducing the waiting time to access a nursing home bed from 11 weeks to four. This has had a positive effect upon the number of persons “delayed discharged” within our acute hospitals, with the number being 01 — NHI NEWS
reduced from a high of 830 last December to 586 midSeptember. Nursing homes are essential providers of health and social care within our communities. They are intrinsic for wider healthcare delivery. As was patently evident in latter half of 2014, inability to access nursing home care in a timely manner has very serious consequences for our acute hospital services and wider health service. At end of October, with waiting period being 14 weeks and 2,135 persons awaiting Fair Deal payment approval, 782 persons were delayed discharged in our hospitals. There is a direct correlation between timely access to nursing home care and heath sector’s ability to ‘free-up’ beds within acute hospitals. This has been recognised by Minister Varadkar. He informed the Oireachtas Health Committee on 6th October the reduction of waiting period to access Fair Deal payment from 15 weeks previously to four weeks presently “has reduced delayed discharges in hospitals from 850 at its peak to under 600 now, freeing up 250 acute beds every day”. Albert Einstein said “politics is for the moment”. Election 2015 or 2016 will present opportunity to focus on present and future challenges. The rapid growth in our older population is well versed. Upon his appointment, the Department briefed Minister Varadkar on what ‘lies ahead’. Referring to long-term residential care, it stated in briefing to him: “On balance it would appear that a minimum of an additional 7,600 beds (over 1,000 beds per year) will be required between now and 2021.” The election provides a window of opportunity to again advance the critical issues pertaining to care delivery within our sector and provide the ‘bigger picture’. As Jackie Gallagher, Q4 PR, stated at our Providers Seminar 7th October, it presents a “once in the cycle opportunity,” with Government ‘at a crossroads’. Policy documents and manifestos are formulated post-election. Prospective politicians promise to advance issues arising and ‘put them on the table’. With politics intensely localised and the influence in Irish politics beginning within constituencies and transcending to Dáil Éireann, NHI Members have prime opportunity to inform of sector and measures required to support it in meeting present long-term residential care requirements and those arising because of rapid growth in numbers growing older and requiring the care of nursing homes. The Election provides opportunity for you, our Members, to realise your potential. NHI Members are key employers and healthcare providers in communities across Ireland – over 300 urban and rural communities. Private and voluntary nursing homes are providing specialist care for 22,000 persons and provide wideranging employment to 24,000 persons who fulfil the care requirements of persons requiring long-term residential care.
CONTENTS READ ALL ABOUT US One of Dublin’s oldest fans celebrates All Ireland glory; a Kingdom nursing home hosts an arts and crafts exhibition; Blind Date comes to Co Meath; famous faces in Co Mayo; the Botanic Gardens provide the setting for a day in the Sun; and the residents of Ferndene show the power of self-expression through art. All in this edition’s Read All About Us.
NHI UPDATES Read what NHI called for in its Pre-Budget 2016 submission and what the Budget contained for the nursing home sector. Valerie Joy steps forward for NMBI Board elections and Minister Varadkar states success of reducing waiting period for Fair Deal has had positive effect upon acute hospital services.
NURSE RECRUITMANT Ministers Varadkar and Lynch were again questioned by the Oireachtas Health Committee regarding measures being undertaken to address the nurse registration crisis within NMBI, with Minister Lynch stating provision of 16 additional staff would prove of “huge benefit” in addressing the crisis. Nurse Recruitment also informs of new NHI Project Officer Nurse Recruitment appointment, representations in Leinster House re the nurse registration crisis, national media coverage of the issue, and NMBI call centre becoming operational.
ANNUAL CONFERENCE The full line up of speakers for the NHI Annual Conference 2015, with details of their presentations and profiles of the respective speakers. The event is moving to a new venue – the Double Tree by Hilton Hotel in Dublin 4 – and will take place Thursday 12th November.
NHI CARE AWARDS 2015 The 2015 NHI Care Awards Final is fast approaching. See the finalists going forward for national recognition, in honour of the outstanding care being provided within NHI Member homes.
OFFICE OF THE OMBUDSMAN As of 24th August, the remit of the Office of the Ombudsman has been extended to accept complaints from or on behalf of residents in private nursing homes. Jennifer Hanrahan, Sectoral lead for Private Nursing Homes in the Office, writes that in dealing with and resolving individual complaints, the Ombudsman strives to bring about improvements in administration based on the lessons learned.
DEMENTIA CARE A West Cork nursing home has adopted a globally recognised culture change in dementia care. Fairfield in Drimoleague was recently awarded Level 1 Dementia Care Matters accreditation.
BEST PRACTICE Knightsbridge Nursing Home in Co Meath was the recipient of the inaugural Nursing Homes Ireland Innovations in Dementia Care Award. The nursing home has introduced a ‘Memory Lane’ programme that has introduced a series of features to stimulate memories and the outside world and times past into the nursing home.
THERAPY DOGS Irish Therapy Dogs is bringing warm souls with a beating heart into nursing homes to help ease nursing home residents’ sense of isolation or loneliness.
As stated within our Budget 2016 submission – detailed within this publication – a funding framework to address sustainability and capacity issues and ensure sustainability in delivery of nursing home care is an imperative requirement for likely incoming Government to address. “Fair Deal should be a reasonable rate based on ROI and capex and not an arbitrary decision by NTPF, eg county averages,” our submission states. “There should also be an agreed indexation mechanism to increase rates based on legitimate cost increases. The NTPF previously included a CPI measure so there is a precedent there. There is requirement to ensure appropriate framework is in place to support providers to expand and deliver the employment required to meet care needs of older persons. It is imperative any proposed increase in the minimum wage is recognised within pricing agreements that are agreed between State and nursing home providers.” Failure to provide a payment framework that recognises the reality of costs for provision of dedicated healthcare for persons with highly complex healthcare requirements is threatening the sustainability of private and voluntary nursing homes, our submission warns. The election will present opportunity for NHI Members to showcase to politicians the excellent care being provided by the dedicated staff within these specialist homes from home. It also affords opportunity to discuss the significant challenges facing providers and to articulate the critical requirements to support sector in meeting long-term residential care requirements of our population. Members will be supported in representations by NHI. I encourage all to utilise this rare-occurring window of opportunity and ensure your voice is heard in advancing issues that are critical for healthcare delivery in Ireland.
Tadhg Daly, NHI CEO NHI ACKNOWLEDGES SUPPORT OF
Thanks to all supporters of NHI, many of whom are featured in this newsletter. Please note, NHI is not responsible for third party services advertised in this publication. Inclusion in this newsletter does not endorse, recommend or imply any approval of the suppliers listed in this publication.
NHI NEWS — 02
READ ALL ABOUT US! What activities are taking place in your home? How are residents fulfilling their lives? What celebrations are taking place? Read all about us! offers NHI Nursing Homes the opportunity to publicise the wide-ranging activities that are taking place in homes across the country. It provides an excellent opportunity to publicise nursing home life in the positive light it should be seen in and members are encouraged to make us aware of what is going on. You can send any articles or pictures of interest to michael@nhi.ie.
Fan-tastic Dubs fan Kathleen
I
t was a very, very happy birthday for GAA fan Kathleen Fox , a 103-year-old resident of Sally Park nursing home, Co Dublin. Kathleen is a keen supporter of the Dublin footballers and her knowledge of the game was to the fore when she spoke to a local newspaper just days before the game. When asked for her prediction on what the final score would be, Kathleen said: “Now, that’s a very silly question – nobody knows that! All I do know is that Dublin’s going to win and I’m looking forward to seeing them lift the Sam Maguire.” She added: “Bernard Brogan and Jack McCaffrey are my two favourite players and I expect them to play well on Sunday. In 2011 [when Dublin won the Senior All-Ireland Football Championship], Bernard’s father brought the Sam Maguire on a visit to the nursing home and I got my picture taken with the cup.”
03 — NHI NEWS
She added: “I haven’t missed a game in years and while I’ve never made it to Croke Park, I watch every football and hurling match on the television.” Kathleen watched the game in the Sally Park nursing home and, due to her slightly ailing eyesight, the staff were on hand to keep her posted on the all-important scores. She told The Echo newspaper: “My dad went to every game when we were young and I guess he and my mam passed their love of the game onto me – and I in turn, alongside my husband Mícheál who is GAA mad, have passed it onto our three daughters. Kathleen celebrated her 103rd birthday on September 27th with family and friends P
Residents’ arts & crafts talents celebrated in the Kingdom Friends’, relatives and volunteers of St. Joseph’s Nursing Home, Co Kerry, congregated to celebrate residents’ creative talents. It encompassed an exhibition of the residents’ arts and crafts and live music added to the celebratory feel. Sr Elizabeth Farrell, Activities Coordinator at the Killorglin nursing home, states: “The large day room was filled with colour and decorations made by the residents. Visitors walked around to enjoy their loved ones creative works. Even our Dog Mattie enjoyed the praise he got for being the best therapeutic pet at the show. “All this was enhanced by the indispensable presence and amazing performance of our musician Brendan who played with excellent skill the accordion, mouth organ and the harmonica. Our residents enjoyed and joined in the songs, and with tapping feet showed their appreciation. The feast that followed was the grand finale to a great afternoon. Those with a sweet tooth were in their element, but all were catered for according to their particular taste. “The sisters, volunteers and staff were all present for this celebration of arts and culture. The atmosphere was happy and upbeat with a sense of achievement and success in the air. We all had a wonderful afternoon and hope to have similar events in the future.” P
NHI NEWS — 04
READ ALL ABOUT US
Blind Date at St Elizabeth’s There was a ‘lorra lorra’ love in St Elizabeth’s Nursing Home in Co Meath recently when staff performed a Blind Date sketch. Staff dressed to stage the performance and the late Cilla Black was portrayed with great gusto by Brenda Keyes, the Person in Charge. Residents and staff had a great laugh and afterwards enjoyed lively music with Ray Murtagh and refreshments. P
‘Celebs’ party with residents at St Attractas Joe Dolan, Tom Jones, The Spice Girls, Gay Byrne, Mrs Brown, characters from Coronation Street and Keeping up Appearances, Dolly Parton, Kenny Rodgers and Laurel & Hardy. They were just a few of the famous names to appear at St Attractas Nursing Home’s recent national gala of entertainment. The Co Mayo nursing home provides a wide array of entertaining activities that bring great enjoyment to its residents. Other recent celebrations have included: P Special Olympics Fit for Life, with a special prize-giving
ceremony for residents; P A display of millinery; P A cocktail afternoon; P An afternoon of pampering for the ladies with Baileys and
chocolates adding to the festive feel; P Country and Western Barbeque with music and
entertainment; P Imagination gym and Sonas; P Monster Bingo; P Fashion and entertainment show which saw a mock wedding
of two nursing home residents and was finished off with wedding cake, bubbly and vigorous dancing and fun; P Outings to the Knock shrine.
Bingo win for Ann Our Lady of Fatima resident Ann Maria O’ Sullivan is pictured celebrating here €400 bingo win with Radio Kerry. Fellow residents and staff were delighted with her win P
05 — NHI NEWS
Botanic Gardens welcome residents Glitz at Residents of Churchview Nursing Home, Co Dublin, enjoying an outing to the National Botanic Gardens P
Marymount The residents of Marymount Care Centre were glammed up to enjoy a recent Putting on the Ritz night P
Cappoquin residents enjoy outing Residents of Padre Pio Rest Home Cappoquin Co. Waterford, went on an outing to Villierstown recently to celebrate the Dromanna 800, celebrating 24 generations and 800 years of the Fitzgerald family living in the town P
NHI NEWS — 06
READ ALL ABOUT US
Painting with Emotions - Ferndene Painting with Emotions was a nursing home art exhibition that demonstrated the powerful self-expression of residents living within Ferndene Nursing Home, Co Dublin. Coinciding with World Alzheimer’s Month 2015, Ferndene hosted an art exhibition night on Tuesday 22nd September. Ferndene Art Therapist Mika Nowakawska-Bartosik said the exhibition showcased “some truly captivating artwork that demonstrates the latent depth of self-expression of residents, many of whom have dementia, inspired by memories from the past and emotions of the present”. In bringing the artworks together, the residents were supported by their family and friends, members of the local and wider community, and onsite specialist staff. The exhibition celebrated the passion, fun and richness of nursing home life. Director of Nursing Rizalyn Silacan said: “In a time where there are often misguided perceptions regarding life in nursing homes, it’s really important for us to draw attention to the positive impact they are often having within the community. It has been fascinating observing the depth of self expression amongst our
07 — NHI NEWS
residents throughout this project, finding ways to communicate emotions in ways they were unable to before. It has also been energising to see the impact this has had on staff and the wider community involved in the project, with all involved gaining a greater understanding of the people they care for and love”. Ivor Morgan, a keen golfer and rugby fan who discovered his artistic talent at 102 years of age, is a perfect example of how someone who, despite having difficulties communicating verbally at times, can communicate with colour, with emotion and with every brush stroke. In a UTV Ireland interview to coincide with the exhibition, his wife Elizabeth explained that she had no idea he could paint until he picked up a brush a few months ago as part of an in-house art class. Another of the 13 residents involved in the project, Olive Sheeran, had a large selection of paintings on display. Her paintings, inspired by treasured photographs of her family and friends, drew much attention on the night. “An emotionally evocative evening, it really was a special treat for family and friends alike,” Rizalyn adds P
Millbrae Lodge Paints it Pink
The positivity of ageing was celebrated at Millbrae Lodge Nursing Home, Co Tipperary, and €350 was raised to create awareness for breast cancer. As part of Age Action Ireland’s Positive Ageing Week, the nursing home staff and residents hosted a Paint it Pink Day. All staff and residents dressed in pink and participated in a pink ribbon one kilometre walk. It was then followed by a pink-themed afternoon P
Cocktail happiness for Churchview residents
Glory for Dublin nursing home at Cavan show
Cocktails were the order of the day at Churchview Nursing Home recently. Residents enjoyed a number of tasty treats and one particular resident, Mary Knowles, who loves a sing-song, entertained all with songs from the karaoke machine P
Residents of a south Dublin nursing home made a northerly trip to visit the Cavan Agriculture Show recently. Marymount Nursing Home made the journey and its knitting circle came back claiming prizes from the event. They won 1st and 3rd prize in the Show’s knitting competition and there was great delight when the results were announced P
NHI NEWS — 08
NHI UPDATES Committed to excellence in care www.nhi.ie
@NursingHomesIre
NHI Pre-Budget Submission Nursing Homes Ireland’s Pre-Budget Submission 2016 stated case for: P
Multi-annual funding for the Nursing Home Support Scheme (Fair Deal) to enable timely access to nursing home care;
P
To ensure sustainability in delivery of nursing home care – a funding framework that addresses sustainability and capacity issues;
P
Any increase in Minimum wage must be recognised with immediacy in fees payable to nursing homes under the Fair Deal scheme;
P
A lifting of the restriction on employee numbers to enable all providers avail of the Employment Investment and Incentive Scheme;
P
HSE to be provided with funding required to ensure the continuation of the National Clinical Adaptation Programme;
P
NMBI to be sufficiently resourced to process nurse registration applications in timely manner;
P
Encouragement of the private and voluntary nursing home sector from the capital and operational funding perspective to meet current and future older person needs;
P
Immediate engagement with the sector to plan for forthcoming long-term residential care requirement and to utilise the potential of private and voluntary nursing homes to deliver primary care.
In respect of Multi-Annual Funding, the submission states: “The introduction of multi-annual funding for the Fair Deal scheme will ensure timely access to nursing home care, reduce waiting time for financial approval, reduce delayed discharges in acute hospitals and play a lead role in addressing the perennial trolley crises. Access to the more cost-effective nursing home care delivers substantial savings in State health expenditure.” It adds the low rates of fees being imposed upon nursing homes by the NTPF, a monopoly purchaser of care, is threatening the sustainability of providers and deterring new builds to meet increasing requirement for the specialist care they provide. “Nursing Home Support Scheme rates must be evidenced-based and based on ROI and capex,” NHI informs Department of Finance. “They should not be an arbitrary decision by the NTPF, for example, the dominant usage of ‘county averages’ to arrive at prices for care. An annual indexation mechanism to increase rates based on legitimate cost increases is a requirement.” Referencing the proposed increase in minimum wage, the submission outlines income derived by nursing homes is effectively controlled and set by the State and therefore this must be recognised with immediacy in fees payable under Fair Deal. With regard to the Employment Investment and Incentive Scheme, NHI’s submission states the restrictive nature of the scheme may impact on the development of required increase in bed numbers in years ahead. Read the NHI Budget 2016 submission in full at www.nhi.ie under the publications section.
NHI Independent Newspapers Members are reminded of NHI partnership with Independent Newspapers to provide newspapers to nursing homes for significantly discounted rates. The partnership provides Members with the opportunity to have their daily newspapers delivered to residents on a daily basis free of charge and for a discounted rate. The Irish Independent, Monday to Friday, can be purchased for €0.95 cent (normal price €2.00), on Saturday for €0.95 (normal price €2.30) on Sunday Independent for €1.25 (normal price €2.90) and New to the service the Sunday World for €1.10 (normal price €2.45).
More information in respect of the offer is available by contacting (01) 7055806
11 — NHI NEWS
Vote Valerie Joy – NMBI Board Elections
A
gerontological nursing representative has put herself forward for election to the NMBI Board and NHI are encouraging Members and the wider sector to support the nomination. Valerie Joy, Director of Nursing at Lisheen Nursing Home, Co Dublin, will stand in the November Election. Valerie states: “I’ve extensive experience within the nursing discipline and for the past five years I have worked as Director of Nursing in this family-run nursing home that is a ‘home-from-home’ for 112 residents and employs 147 staff. My clinical experience stems from working within acute and community settings, specialising in older person care and stroke rehabilitation.” Valerie leads the 147 staff team and liaises with public health nurses, community liaison nurses and other specialist in meeting the health and social care requirements of the 112 residents. She has strong working relationships with local care services, including two large teaching hospitals that she attends regularly. Her role encompasses responsibility for overseeing the clinical care and care and welfare of all residents, liaison with families, leading and managing staff and other professionals. “As well as fulfilling my role within the nursing home, I am regularly meeting with staff from the two large teaching hospitals,” she adds. “This encompasses staff at ward level, in A & E departments and discharge coordinators. This ongoing engagement places me in prime position to represent many areas of general nursing practice.” Valerie served as a Director of Nursing Homes Ireland, the national representative organisation for private and voluntary nursing homes, from 2012 – 2015. She has participated on Department of Health, HIQA, INECMA (Irish National Extended
Care Medicine Association), IOSH (Institute of Occupational Safety and Health) and RCPI (Royal College of Physicians Ireland) advisory committees. “I believe in taking a proactive approach by empowering and enabling both residents and staff to provide high quality person-centred care,” she explains. “I support staff in the provision of personcentred care through good teamwork, continuous staff development and training, constantly seeking creative ways to foster a dynamic evidence-based learning environment. Recently I have collaborated with many nurse educators and higher education institutions to promote and validate our progressive methodology to nursing care. I will be supporting and pushing for NMBI to take such approach.” Her qualifications include a BSc in Nursing; a Higher Certificate in Health Services Management; a Masters in Nursing Practice specialising in Dementia Care and a Clinical Governance and Quality Management course in Residential Care Settings for Older People. Tadhg Daly, NHI CEO states: “The speciality that is gerontological nursing fulfils a intrinsic role within healthcare delivery and this will be further to the fore in coming years as our older population escalates rapidly. Valerie can bring to the Board an excellent background within the nursing discipline and significant experience in engaging with a wide range of stakeholders. The private and voluntary nursing home sector is a critical element of healthcare provision in Ireland, providing clinical care to 22,000+ persons. Therefore it is vitally important our sector has representation on the nursing board. NHI is delighted to endorse her candidacy and encourage our Members to back her election campaign.”
Energy offer for NHI Members As part of its ongoing procurement offering for members of NHI, First Choice Purchasing has announced a new electricity offer which is available exclusively to NHI Members. The procurement specialists will review Member energy usage and inform of best offering available from energy providers. NHI Members can proceed by contacting Martin Nolan mnolan@firstchoicepurchasing.com or 086 8368080.
NHI Providers Forum Nursing home providers from across the country gathered at the Clarion Hotel, 7th October, to discuss NHI’s pre-election campaign. The providers discussed the serious challenges facing provision of nursing home care, with funding framework for nursing home care and the challenges in the recruitment of nurses being to the fore. NHI will support Members in pre-election engagement with politicians and Leinster House candidates.
NHI represented at consultation with Health Minister Minister for Health Leo Varadkar hosted a second consultation with health stakeholders at Dublin Castle Friday 4th September. During his presentation, Minister Varadkar cited the progress in reducing Fair Deal waiting times and numbers awaiting the support of the scheme as an example of “good progress” in healthcare delivery. In October 2014 the Fair Deal waiting period was 16 weeks and numbers awaiting the support of the scheme were 2,245. In July the waiting period was down to four weeks and numbers awaiting the support of the scheme to 544. Delayed discharges are reduced from November number of 831 persons to 581 at end of August. Tadhg Daly, NHI CEO, represented NHI at the consultation.
NHI NEWS — 12
NHI UPDATES
Four week waiting period for Fair Deal has freed up 250 acute beds: Minister Varadkar Reducing the waiting time to avail of Fair Deal financial support has enabled Department of Health to reduce number of persons ‘delayed discharged’ within hospitals from a peak of 850 to below 600 and freed up 250 acute beds on daily basis, Minister for Health Leo Varadkar has informed the Oireachtas Health Committee. Delayed discharge refers to a person who is medically fit for discharge but is remaining within an acute hospital because they are unable to avail of the appropriate care that can be provided beyond acute setting. Speaking at his quarterly meeting with the Committee, Minister Varadkar stated it highlights “real progress” in health service delivery. He stated at meeting 6th October: “I have taken a personal interest in emergency department overcrowding and have secured almost €85 million in additional funding this year to alleviate the problem. This has allowed us to reduce the waiting time for the fair deal nursing home support scheme from 15 weeks to four, which in turn has reduced delayed discharges in hospitals from 850 at its peak to under 600 now, freeing up 250 acute beds every day.” Minister Varadkar said the measure is enabling Department open another 150 community beds and to “increase investment in health services and keep patients out of hospital altogether or allow them to get home earlier”. Tony O’Brien, HSE Director General, informed the Committee the number of delayed discharges fell from a peak of 850 on 4th January to 557 at end of July. “There has been a reduction in the number of patients waiting for nursing home support scheme, NHSS funding,
which is now 544, below the target range of 550 to 580,” he added. He said provision of additional €74 million in April to support HSE in addressing overcrowding throughout 2015 will ensure four week waiting period for Fair Deal is maintained, pointing to 14 week waiting period in final quarter of 2014. Additional transitional care and home care packages continue to be delivered over winter period, he added. “As a result of these combined initiatives it is hoped to have additional 440 beds open during the winter period,” he commented. Deputy Caoimhghín Ó’Caoláin, Sinn Féin Health Spokesman, asked Minister to specify where an additional 173 community beds would be opening. Minister Varadkar outlined: “There are 65 open community beds in Mount Carmel Community Hospital, Dublin; 24 in Moorehall Lodge Nursing and Convalescent Centre, County Louth, which are delivered through the private sector; 18 in Clontarf Hospital; 20 in the Royal Hospital, Donnybrook; 25 in St. Vincent's Hospital, Fairview; ten in St. Mary's Hospital in the Phoenix Park; ten in Farranlea House Community Nursing Unit, County Cork; four in Heather House CNU, Cork; two in Carndonagh Community Hospital; eight in Killybegs Community Hospital; and five in Merlin Park Hospital, Galway. There are 17 between the Community Hospital of the Assumption in Thurles and St. Ita's in Newcastlewest and there are 15 in Ballinasloe. There are 11 between Ballina District Hospital and Sacred Heart Hospital, Castlebar. Cuan Ros on the Navan Road was not opened but, instead of that, St. Mary's Hospital in the Phoenix Park has opened beds.”
Minister Varadkar: The reduction in Fair Deal waiting time has freed up 250 acute beds every day.
13 — NHI NEWS
Budget 2016: Increase in funding for Fair Deal Budget 2016 signalled an increase in funding for the Nursing Home Support Scheme, with Government promising persons requiring the support of the scheme will have to wait no longer than four weeks for payment approval. Speaking in Dáil Éireann 13th October announcing the Budget, Minister for Public Expenditure and Reform Brendan Howlin stated: “This year, for the first time, Government placed the Fair Deal nursing home scheme on a fully-funded, demandled basis. This will continue in 2016, with Government funding of €940 million. Everyone who needs Fair Deal funding will be approved within 4 weeks.” The €940m commitment signals a €22m increase in funding to support access to nursing home care in 2016. The HSE Service Plan 2015 committed €873.9m to the scheme and this was supplemented by a €44m increase in funding that was announced by Department of Health on 2nd April. This signifies commitment of €917.9 towards Fair Deal in 2015 and the 2016 allocation represents a €22m increase in funding.
Tadhg Daly, NHI CEO, commented: “The commitment to ensure waiting period to access Fair Deal funding is within four weeks is welcome and will provide reassurance for older persons requiring the specialist care that nursing homes provide. With numbers requiring nursing home care escalating by approximately 700 persons per year, we are concerned the provision of €22million could fall short of required funding levels for year ahead. Such an increase would signify required additional investment of approximately €36m. Mr Daly added: “It is very welcome that the importance of timely access to nursing home care for older persons is being recognised by Government. It is further recognition of the intrinsic role timely access to nursing home care fulfils in enabling delivery of acute hospital care and supporting wider health sector. Minister Varadkar recently stated 250 beds have become available on a daily basis within our acute hospitals because of the reduction in Fair Deal waiting times. “Moving forward it is imperative the realities of the complex care requirements of
persons requiring long-term residential care are recognised by the funding model to support nursing home care. The Dementia Services Information and Development Centre and Oireachtas Health Committee have stated an enhanced evidence-based funding model is a necessity to meet clinical, health and social care requirements of persons dependent upon nursing home care. We cannot stand idly by as pressures continue to mount on nursing home providers for provision of care. An appropriate funding framework that reflects true costs of nursing home care is imperative. The limitations with current framework are deterring providers from investing in capacity required to meet requirement. A shortfall of long term nursing beds, particularly in urban areas, will continue if appropriate payment model is not introduced. This will have very serious consequences for acute hospital and wider healthcare delivery.” Further detail re the health budget and health service provision for 2016 will be published in HSE Service Plan for year ahead, that is anticipated to be published in November.
Government capital investment plan Building on Recovery: Infrastructure and Capital Investment 20162021, the Government’s recently announced capital investment plan has identified ageing population requires “particular social infrastructure such as long-term residential care facilities for the elderly”. “The number of the population aged 65+ is projected to increase from 530,000 to over 1.4 million by 2046,” it states. The plan commits €300 million to invest in replacement, upgrade
and refurbishment of long-term and disability facilities for older people and people with disabilities. The Department of Health stated the funding will be for period 2016 – 2021 and a further €150m is earmarked for public private partnerships. No detail has been provided in respect of the proposed PPPs. In 2013 the HSE outlined a requirement of €834 million to address physical environment requirements within it long-term residential care facilities.
Increase in minimum wage must be reflected in nursing home payments The increase in minimum wage must be directly linked in payments to private and voluntary nursing homes under the Fair Deal scheme, NHI has stated to senior Government ministers. NHI has outlined the sector is unique in that its income is effectively set by the State through the Fair Deal scheme and in such effect these nursing homes operate within a constrained economic environment. “It is important to state NHI and our Members are not opposed in principle to an increase,” NHI has stated in representations. “However, it must be recognised our sector is highly labour intensive, with 61% of outgoing costs being labour costs. The consequence of increase in the National Minimum Wage will
be one arm of the State (Government) imposing significant increased costs upon nursing homes and there will be imperative requirement for increase to be recognised by another arm of the State (the NTPF/HSE) under the Nursing Home Support Scheme.” NHI referred to the recently published review of the Fair Deal scheme, which confirmed Fair Deal fees are not keeping pace with inflation. The review states in the period 2010 to 2013 the 1.71% increase in prices negotiated under Fair Deal scheme by private and voluntary nursing homes had been lower than the increase in consumer price index over the same period (3.79%). “It would be imperative for fees payable to nursing homes to reflect any increase with
immediacy,” NHI has stated. “This will require additional funding to be provided to the Nursing Home Support Scheme in Budget 2016 over and above the increased funding required to address demographic pressures.” NHI has warned in the absence of an increase in funding in the fees payable to nursing homes, the sustainability of nursing homes will be threatened. NHI has brought forward representations to Minister for Health Leo Varadkar, Minister with Responsibility for Older Person Care Kathleen Lynch, Minister for Finance Michael Noonan, Minister of State at Department of Jobs Ged Nash, Minister for Public Expenditure Brendan Howlin, and Minister for Jobs Richard Bruton.
NHI NEWS — 14
www.careersinnursinghomes.ie Promoting careers in the Irish Nursing Home sector NHI continues to promote the NHI nurse recruitment careers website nationally and internationally. The dedicated NHI Member recruitment website is currently seeing over 2,000 unique new web-users visiting it on a monthly basis. This website allows current vacancies to be uploaded as well as promoting individual nursing homes as a great places to work. Remember to visit the website regularly as it becomes an eective recruitment tool for all. The website is reaching candidates worldwide. We therefore urge you to upload your vacancies and promote your nursing home as this is one key tool we will use when meeting nurses in forthcoming recruitment drives. For further information and a step by step guide to register your vacancy please contact helena@nhi.ie
NURSE RECRUITMENT
Health Committee questions Ministers re Nurse Registration Crisis Minister: 16 additional staff will prove of “huge benefit” in addressing crisis
A
n additional 16 staff that have been sanctioned by the Department of Health to fulfil posts within the Nursing and Midwifery Board of Ireland will be of “huge benefit” in addressing nurse registration delays, Minister with Responsibility for Older Persons Kathleen Lynch has informed the Oireachtas Health Committee. Minister Lynch stated at Committee meeting 6th October the Department’s Chief Nursing Officer is leading Department response to the crisis. NHI’s lobbying for the Department to enable NMBI address the crisis has been sustained and the Health Committee was provided with NHI briefing informing of escalation of numbers awaiting registration prior to Minister for Health Leo Varadkar, Minister Lynch and HSE Director General Tony O’Brien’s quarterly appearance before the Committee. Deputy Mary Mitchell O’Connor, Fine Gael, referred to NMBI’s appearance before the Committee 2nd July when it was brought before it to be questioned in respect of the crisis and measures that would be undertaken to address it. She said the NMBI had stated it would undertake “various measures” to “improve the position” but 2,000+ applications remained outstanding, with 800+ completed and awaiting approval. “Why have the newly appointed 16 staff and whoever else is available not got through that number of applications?” she asked. “Representatives of the board were here in July and I have learned from Nursing Homes Ireland that the position on registration has worsened and that nothing seems to have improved.” Minister Lynch stated in reply: “The Department has sanctioned an additional 16 posts to the nursing board to make sure the flow continues. This will be of huge benefit. We have a difficulty in mental health and in acute hospitals and we also have a significant difficulty in the provision of services to older people within the nursing home sector, whether public or private.” Committee Chair Deputy Jerry Buttimer, Fine Gael, intervened to state NHI communication informed numbers awaiting registration had continued to rise. In her response, Minister Lynch referred to previously promised establishment of a call centre to support applicants in ascertaining status of their applications within her reply. “At a recent meeting we tried to address the issue of the call centre and the additional staff on the nursing registration board and that will have an impact,” she said. “Our chief nursing officer is very much on top of this because it is clearly
what she does best.” She said a further briefing would be provided to the Committee. NHI’s briefing to the Committee, dated 5th October, stated: “At its appearance before the Health Committee 16th July, NMBI stated it was “making progress” with regard to nurse registration backlog. The NMBI stated 2,016 applications were “being processed”. A Department of Health letter dated 23rd September stated the numbers awaiting registration are 2,260 – a 244 increase in applications (12% increase)”. The referred to Department letter stated 1,383 (61%) of applications were incomplete, which would signify 877 (39%) of applications being completed and awaiting processing, the Committee was informed. “If the 877 awaiting processing were registered it would alleviate the immediate crisis,” NHI said. The briefing also advised of the €350 fee applicable per submission of application. “This signifies the very serious intent of the applicants to fulfil nursing posts within Ireland and represents a very considerable financial commitment by them to fulfil a clinical role within our health service,” it stated. “Questions arise as to why the majority of the applications submitted with €350 are incomplete. Is sufficient guidance for applicants being provided? Are NMBI processes and application procedures reviewed? NHI recognises critical importance of applications and documentation being complete for process of registration.” NHI informed the committee the commitment of additional 16 posts is welcome but progress would be signified in the number of outstanding applications being considerably reduced and applicants reporting headway in engaging with NMBI re their applications. Deputy Mitchell O’Connor also called for gerontology nursing to become part of the registered training for nurses. “In Australia and Canada there are various nursing categories including registered practical nurses, auxiliary nurses, complementary nurses, enrolled nurses and advanced care practitioners,” she explained. “Will the Minister consider adopting the same model of nurse training here?” NHI’s briefing also outlined the ongoing challenges in funding of long-term care. Since Health Committee Meeting, the NMBI call centre has become operational, coming into effect Thursday 8th October. NHI continues to engage with Health Committee Members to inform re developments/non developments re the nurse registration crisis.
NHI Appointment: Ms Helena Gleeson – NHI Project Officer Nurse Recruitment Ms Helena Gleeson has been appointed NHI Project Officer Nurse Recruitment. Helena succeeds Ms Gráinne Hanly, who stepped aside due to medical reasons. Helena graduated from Cathal Brugha Street and Trinity College with a Bsc and Higher Diploma in Hotel and Catering Management. She then travelled and worked in the catering industry for a number of years before joining Locumotion then a small recruitment company specialising in the recruitment of GPs and Hospital doctors to Ireland.
17 — NHI NEWS
Helena worked with Locumotion from 2003 – 2012 moving from reception initially through to General Manager. During this time she worked on various areas of development as well as working closely with the Irish Medical Council, DETE (now DJEI) GPs and Hospitals. She has extensive experience in medical recruitment and looks forward to working closely with the NHI Board of Directors Nurse Recruitment Committee and NHI members.
TDs press Minister re Nurse Registration crisis Further to the representations brought forward at the Oireachtas Health Committee, a number of TDs raised the issue of nurse recruitment with Minister for Health Leo Varadkar during the first week of resumption of Dáil Éireann from its Summer recess. NHI and Members continued to inform and lobby politicians re the crisis over the Summer months. Fianna Fáil Health spokesperson Deputy Billy Kelleher asked the Minister if he is aware of the crisis in the registration of nurses, with 2,313 applications outstanding as of 4th September. He stated the €350 fee submitted with applications signals the serious intent of applicants to fulfil nursing posts in the health services and “it is extremely disappointing that applications are subject to huge delays and candidates are met with silence when they seek information as to the status of their application”. He asked what measures are being taken by Department of Health and NMBI to address crisis and when actions being undertaken would take effect. Deputy Jerry Buttimer, Chair of the Oireachtas Health Committee, asked the average waiting time from assessment to registration. Senator Colm Burke, Fine Gael Seanad Health spokesperson, stated in Seanad 7th October mechanisms NHI had been informed of to address the crisis had not been implemented. He stated he was “extremely concerned” by the crisis. Deputy Catherine Murphy, Independent, Kildare North, asked the Minister
if he was aware of the “extreme delays” in processing registrations and detrimental effect it is having upon nursing homes. Deputies Michael Healy Rae, Independent, Kerry South, and Mattie McGrath, Independent, Tipperary South, asked for explanations as to the delays. Deputies Willie Penrose, Labour, LongfordWestmeath, and Michael McCarthy, Labour, West Cork, brought forward representations on behalf of nurse candidates. Responding 24th September, Minister Varadkar stated 2,260 applications were still open and 1,383 (61%) had documentation outstanding. “The applications that have been submitted with incomplete documentation cannot be processed until full documentation has been supplied,” he stated.“For this reason a new helpline is being set up to assist people with their applications and deal with registration queries. An upgraded website is also being developed. The Department has approved the filling of 16 posts.” He said the matter of current average waitings times was one for NMBI to respond to. Responding to Senator Burke, Senator Maurice Cummins stated there is “urgent need to address the difficulties in the Nursing and Midwifery Board of Ireland in terms of granting registration. As he rightly pointed out, there is a need to reform the system…I will bring the matter to the attention of Minister for Health,” he added.
Call centre to support nurse registration applications now open A call centre to support nurse registration applicants is now established. It became operational Thursday 8th October and will be open from 9am – 5pm Monday to Friday. Callers may contact the call centre by dialling the mainline number 01 6398500 and pressing option one. NHI lobbied for introduction of the call centre to support nurse applicants in ascertaining status of applications and inform as to any matters arising. You will be aware NHI has been engaged in lobbying in recent months with NMBI and Department of Health for a commitment to be fulfiled for establishment of a call centre to support Members with queries and assist with applications re nurse registration. The Department originally provided commitment to NHI for establishment of such service in July.
NMBI stated to NHI its aim is for the call centre "to address not only the issue of callers having difficulty in contacting NMBI directly but also will provide as efficient a service as possible to our applicants, employers and agents on the status of applications going through the system." NHI has asked nursing homes to keep it updated as to the level of service they receive from the call centre. NHI can subsequently feedback to NMBI re the service. Feedback can be provided to Helena Gleeson, NHI Project Officer Nurse Recruitment, by mailing helena@nhi.ie.
Minister Leo Varadkar’s Private Secretary David O’Connor accepts letter re nurse registration crisis from 208 nursing home signatories from NHI representatives, from left, Robert Fagan, NHI Dublin Wicklow Director; Tadhg Daly, NHI CEO; Helen Dunne Barron, NHI Dublin North Director; Valerie Joy, NHI Dublin Kildare.
NHI NEWS — 18
NURSE RECRUITMENT
National media coverage of nurse registration crisis Over a three day period mid-September 12 articles appeared in national newspapers informing of the nurse registration crisis. This followed concerted engagement by NHI with media to highlight the crisis arising in the registration of nursing candidates for the nursing home sector. The Irish Independent, Irish Times, Irish Examiner and Irish Daily Mail informed readers of the crisis in editions between 14th and 16th September. The issue was also covered by RTE and discussed on UTV News. A letter signed by 208 nursing homes was released to media stating “absolute urgent requirement for the Department of Health to take control and address the severe crisis that continues to persist and escalate re the registration of nurse candidates”. The signatories stated to Minister for Health Leo Varadkar: “You, as Minister, and your Department cannot stand idly by and allow this crisis to persist; it requires urgent action.” The Department responded publicly to NHI and media coverage, stating 70% of applications submitted were incomplete and could not be processed until full documentation had been supplied. It said the number of applications had risen 122% in 2015 and a helpline and the filling of 16 posts within NMBI would improve registration process, with seven posts having
been filled. The Department further stated seven adaptation programmes had been held for the nursing home sector since 2014 and some 405 places had been made available but “only” 312 of the places had been used by the nursing home sector. It said it would continue to hold regular meetings with NMBI on the matter and ensure NHI would be kept informed of developments. Responding to Department statement, NHI stated: “The crisis in the registration and recruitment of nurses is creating chaos within the nursing home sector and the wider health service. There are some 1,500 unfilled nursing vacancies yet there is a 2,300+ backlog in the NMBI processing of registration applications. “Today’s announcement of a dedicated helpline and the allocation of 16 new staff to the NMBI is welcome, but these measures should have been undertaken long ago. NHI representations to the Department in respect of nurse registration issues date back two years and to two Health Ministers. The Minister needs to take this directly in hand now and implement an immediate action plan. Otherwise this winter will be the worst on record for our health services, with nursing home beds and by consequence hospital beds closed to patients.
“A suggestion in the statement that adaptation places have not been taken up by nursing homes is contemptuous. It is impossible to take up an adaptation place as a direct result of NMBI delays in processing applications and issuing NMBI ‘decision letters’. NHI is committed to working with the Department of Health and its Chief Nursing Officer to seek rapid solutions to this escalating crisis.” The Irish Independent and Daily Mail reported on a nursing home unit in Dublin lying idle due to inability to staff it because of registration issues. Both newspapers also spoke to nursing candidates awaiting registration a prolonged period of time. Nursing home units lying idle as key staff await State approval read a Daily Mail headline. An Irish Times headline read Nursing home owners criticise delays in registration of nurses, Irish Examiner heading Varadkar must solve nursing crisis and Irish Independent headline read Varadkar told to take control of nursing crisis. A separate Irish Independent article was headlined Backlog of nurse registration threatens a hospital crisis. The coverage was derived from sustained NHI engagement with media and NHI continues to keep media briefed of issues arising.
Royal College of Surgeons to provide addition to clinical adaptation programme For a prolonged period, NHI has been engaging closely with the Royal College of Surgeons in Ireland re provision of an addition to the clinical adaptation programme that is currently in place and the responsibility of the Nursing and Midwifery Board of Ireland. On Friday 18th September the RCSI announced approval for the programme had been secured from NMBI. Information for Applicants, including aspects pertaining to immigration requirements, is available to view via the RCSI website – www.rcsi.ie. Electronic applications for the RCSI aptitude test opened Wednesday 28th October 2015. In preparation, a potential applicant must ensure that she/he considers the most up-to-date version of the information for applicants’ document.
19 — NHI NEWS
NHI NEWS — 20
ANNUAL CONFERENCE REGISTRATION Opportunity to Visit Exhibitors.
08.15am - 09.00am
MORNING SESSION Conference Chair
John Bowman Broadcaster & Historian.
09. 00am - 09.15am
WELCOME - Tadhg Daly - CEO.
09.15am - 09.30am
OPENING ADDRESS Kathleen Lynch T.D. Minister for Primary Care, Social Care (Disabilities/Older People) & Mental Health. Thomas Kearns Executive Director of Faculty of Nursing & Midwifery, RCSI.
09.30am - 10.00am
A Competence Assessment (Aptitude Test) for Overseas Nurses wishing to Register and Practice in Ireland.
11.15am - 11.45am
Lesley Palmer Chief Architect Dementia Services Development Centre, University of Stirling
11.45am - 12.15pm
Questions & Answers Chairman John Bowman.
12.15pm - 1.00pm
BREAKOUT SESSIONS
1.00pm - 2.15pm
LUNCH Sponsored by Unilever Food Solutions. Opportunity to Visit Exhibitors.
AFTERNOON SESSION 2.15pm - 3.15pm
KEY NOTE SPEAKER Norah Casey Broadcaster and Publishing Entrepreneur.
3.15pm - 3.45 pm
Questions & Answers Chairman John Bowman.
3.45pm
Conference Close.
David O’Flanagan Corporate Finance Partner, Deloitte.
10.00am - 10.30am
Nursing Home Support Scheme – Review of Pricing Processes. TEA/COFFEE Opportunity to Visit Exhibitors.
10.30am - 11.15am
BREAKOUT SESSIONS
Session 1 Dr. Kevin Moore, NHI Researcher
12.15pm 1.00pm
The lived experience of nursing home residents in the context of the Nursing Home as their own home
To register for this year’s conference, please complete ONE registration form per delegate, and return with Conference fee to:
Fire Precautions in Nursing Homes
REGISTRATION FORM
Session 2 Philip Daughen Inspector Estates/Fire Safety HIQA
Name:
BOOK EARLY TO AVOID DISAPPOINTMENT
Nursing Home:
T: +353 0 1 429 2570 F: +353 0 1 429 1845 E: admin@nhi.ie
Address:
2015 Annual Conference, Nursing Homes Ireland, Unit A5,Centrepoint Business Park, Oak Road, Dublin 12. Please select the Breakout Session which you would like to attend by ticking the appropriate box. Breakout Session 1
Kevin Moore
Please Note the closing date for booking is Friday 6 th November 2015 Email: Member
Non Member
( Please Tick Box )
Breakout Session 2
Philip Daughen
CONFERENCE FEE: €40 Members
You can refer to Conference Agenda for Breakout Session topics.
€180 Non Members
I enclose payment for member of
€40
or payment for non member of
€180 €
€
There is no refund for cancellations advised of less than two days before conference date.
ANNUAL CONFERENCE SPEAKERS Lesley Palmer
Lesley Palmer is the Chief Architect for the Dementia Services Development Centre at the University of Stirling. Lesley is an experienced architect and a confident leader of cross disciplinary design teams. She has extensive experience of working closely with housing associations, communities, charitable bodies and third sector organisations, helping them realise their capital design projects; advising on funding, procurement and construction processes. In addition to architectural practice, Lesley has been a guest critic at several acclaimed schools of architecture and previously held the position of Studio Director for the BSc Honours year at the Department of Architecture, University of Strathclyde. Lesley is currently responsible for the delivering the DSDC Architecture & Design consultancy service, design training and advising clients throughout their build project on the importance of and practical application of dementia design principles.
NHI NEWS — 24
NURSING HOMES IRELAND CARE AWARDS 2015 Thursday 12th November 2015 | Double Tree by Hilton Hotel, Burlington Road, Dublin 4
Congratulations to the NHI Care Awards 2015 Finalists NURSING HOME DIRECTOR OF NURSING/PERSON IN CHARGE AWARD
NURSING HOME REGISTERED NURSE OF THE YEAR AWARD
NURSING HOME CARER OF THE YEAR AWARD
Eimear Carney TLC Centre, Maynooth, Co. Kildare
Marta Nowakowska Bartosik Ferndene Nursing Home, Blackrock, Co. Dublin
Jackie Edwards Moorehall Lodge, Ardee, Co. Louth
Veronica Birchall TLC Centre, Maynooth, Co. Kildare
Laura Sheridan Maypark House Nursing Home, Maypark Lane, Waterford.
Lynn Keyes, Esker Lodge Cathedral Road, Co. Cavan
NURSING HOME CATERING AND NUTRITION AWARD
NURSING HOME ANCILLARY WORKER AWARD
Catering & Hospitality Team Knightsbridge Nursing Home, Trim, Co. Meath
Fergal Dunne Knightsbridge Nursing Home, Trim, Co. Meath
Pascal Desmet Brindley Healthcare, Convoy, Co. Donegal
Mary B McMahon Ennis Nursing Home, Ennis, Co. Clare
Marie Gaynor Sonas Nursing Home, Cloghanboy, Athlone, Co. Westmeath
Ollie Stapleton Maypark House Nursing Home Maypark Lane, Waterford
NURSING HOME COMMUNITY INITIATIVE AWARD
NURSING HOME INNOVATIONS IN DEMENTIA CARE AWARD
NURSING HOME END OF LIFE CARE AWARD
Breege Conlon & Michelle Watters Moorehall Lodge, Ardee, Co. Louth
Shirley Larkin Sonas Nursing Home Cloverhill, Cloverhill, Co. Roscommon
Physiotherapy Department TLC Centre, Maynooth, Co. Kildare
Social Care Team Oaklodge Nursing Home, Cloyne, Co. Cork
Katie Uí Chúlain Áras Chois Fharraige, Spiddal, Co. Galway
Viva Life Team TLC Centre, Santry, Co. Dublin
Carol McLoughlin Moorehall Lodge, Ardee, Co. Louth Maura O’Sullivan St. Gobnait’s Nursing Home, Ballyagran, Co. Limerick Rizalyn Silacan Ferndene Nursing Home, Blackrock, Co. Dublin
NURSING HOME SOCIAL & RECREATIONAL PROGRAMME AWARD Maria Brady St. Elizabeth’s Nursing Home, Athboy, Co. Meath Ann Crowley St. Luke’s Home, Mahon, Co. Cork Kathleen Hanrahan Clarenbridge Nursing Home, Craughwell, Co. Galway
Sinead Beirne Annabeg Nursing Home, Ballybrack, Co. Dublin Dr. Eileen Courtney Hamilton Park Care Centre, Balbriggan, Co. Dublin Kiri Mulqueen Beechlodge Care Facility, Bruree, Co. Limerick
WINNER - NURSING HOME RESIDENT ACHIEVEMENT AWARD 2015 Henry Delaney Powdermill Nursing Home, Ballincollig, Co Cork
NHI Care Awards 20 15 MC Grainne Seoige 25 — NHI NEWS
A prestigious celebration of Excellence in Care! To book your tickets
Contact Olivia at (01) 4292570 | www.nhicareawards.ie
OFFICE OF THE OMBUDSMAN
Remit of Ombudsman extended to private & voluntary nursing homes As of 24th August, the remit of the Office of the Ombudsman has been extended to accept complaints from or on behalf of residents in private nursing homes. Jennifer Hanrahan, Sectoral Lead for Private Nursing Homes in the Office, writes that in dealing with and resolving individual complaints, the Ombudsman strives to bring about improvements in administration based on the lessons learned. Under the terms of Statutory Instrument 300/2015, the remit of Peter Tyndall, the Ombudsman, has been extended to allow him independently examine individual complaints about private nursing homes in receipt of public funding. Almost all private nursing homes are in receipt of some form of public funding either under subvention or through the Nursing Home Support Scheme (Fair Deal). The Ombudsman already accepts complaints about publicly run nursing homes and from 24th August 2015 he can also accept complaints from or on behalf of residents in private nursing homes, but only regarding events that occur on or after that date. In the case of residents in publicly contracted beds in private nursing homes, the cut-off date for making a complaint to the Ombudsman does not apply. In essence the role of the Ombudsman is to examine complaints about the administrative actions of the bodies under his remit, known in legislation as “reviewable agencies”. The Ombudsman is seen generally as a means of dispute resolution and as an alternative to the courts. If the Ombudsman finds in any given case that the complainant has been treated unfairly or improperly and has been adversely affected as a result, he will then suggest an appropriate redress to remedy, mitigate or alter the adverse affect suffered. In dealing with and resolving individual complaints, the Ombudsman strives to bring about improvements in administration based on the lessons learned from these individual complaints. The Office of the Ombudsman recently hosted a number of information seminars across the country for private nursing home representatives. The independence of the Office was highlighted, as were the Ombudsman’s powers and his complaint handling processes. The Ombudsman’s approach, while generally informal, has the option of a formal investigation also at his disposal. In 2014 the Office of the Ombudsman examined over 3,500 complaints from the general public. Only 32 of these complaints related to the public nursing home sector. The issues raised in these complaints ranged from missing laundry to failing to meet basic needs or to respect patient privacy and dignity. To illustrate type of complaints received and to provide a balanced view, a number of interesting case studies from the public nursing home sector were presented at the information seminars. It should be noted that reviewable agencies can sign up, through the Ombudsman's website, to receive the Ombudsman's quarterly casebook which outlines the outcome of many of the cases dealt within the reporting period. This helps to give reviewable agencies a good understanding of the issues and types of complaints arising in their sector. RESOLVING A COMPLAINT The Ombudsman will only accept a complaint if the complainant has made a reasonable effort to resolve their complaint with the private nursing home in the first instance.
27 — NHI NEWS
Where a complaint is not resolved locally, the public then has the option of referring their complaint to the Ombudsman for independent examination. Signposting to the Ombudsman via the nursing home website, by signage in common areas or in the complaint reply letter is of particular importance so that complainants are made aware of their right to take the matter up with the Ombudsman if they feel the need to do so. For his part, the Ombudsman looks at each complaint on its individual merits. The Ombudsman is prevented by legislation from looking at complaints against private nursing homes where, in the opinion of the Ombudsman, the action complained of relates solely to a clinical judgement decision. This replicates a similar exclusion which applies in the case of public nursing homes and hospitals. Attendees at the information seminars received an information pack containing a model complaints system for nursing homes, which included a sample ‘complaint form’. These documents, available at www.ombudsman.gov.ie, are designed to complement and to underpin the statutory framework, as set out in SI 415/2013, which is already in place for local complaint handling in private nursing homes and to streamline the existing process. The Ombudsman plans to roll out this model complaints system to other sectors over time. HOW DO YOU DIFFER FROM HIQA? A frequently asked question is how the role of the Ombudsman differs from that of the Health Information and Quality Authority (HIQA). The Ombudsman and HIQA have separate but complementary roles in the health and social care area. The role of the Ombudsman mainly involves examining individual complaints from patients, their family or representative about the care they have received from a private nursing home. HIQA is the independent authority established to drive continuous improvement in Ireland’s health and personal social care services by regulating and monitoring the safety and quality of these services. A memorandum of understanding has been signed between the two agencies which will ensure that individual complaints which are submitted to HIQA will be passed if appropriate to the Ombudsman for examination. Further information on the Ombudsman’s role in relation to private nursing homes is available on the Ombudsman’s website www.ombudsman.ie
What actions will the Ombudsman investigate or not investigate?
Complaint Examination Process
The Office of the Ombudsman may investigate any action taken by or on behalf of a reviewable agency in the performance of administrative functions if that action has or may have resulted in adverse affect. The maladministration checklist encompasses actions which have been: P taken without proper authority P taken on irrelevant grounds P the result of negligence or carelessness P based on incorrect or incomplete information P improperly discriminatory P based on an undesirable administrative practice P a failure to provide reasonable assistance; or P otherwise contrary to fair or sound administration.
There are four stages outlined for the complaint examination process: enquiries, assessment, examination, investigation.
The Ombudsman may decide not to investigate if: P the action complained of is trivial and vexatious P the complainant has insufficient interest P the complainant has not taken reasonable steps to seek redress P satisfactory measures to remedy, mitigate or alter the adverse affect have been or are proposed to be taken.
The role of the Ombudsman Liaison Officer The Ombudsman Liaison Officer acts as the initial point of contact between the Ombudsman and the nursing home and ensures: P that any written or verbal communication from this Office is directed to the appropriate person P time limits for responses are met P all relevant documents requested are forwarded to the Ombudsman P that site visits by Ombudsman staff are facilitated
The enquiries unit will: P
Screen all enquiries and complaints in the first instance
P
Ask has complaint been through agency’s internal complaints procedure?
P
Establish that the issue complained of is in remit of Ombudsman
P
Deal with complaints that relate to non-reply to correspondence
P
Advise people how to make a complaint, redirect complaints outside remit, deal with premature complaints and close straightforward cases.
The assessment unit will: P
Ensure private Nursing Home is notified of the complaint
P
Ask the Nursing Home to acknowledge receipt of the complaint
P
Obtain resident’s consent for complaint to go forward
P
Request report/file/medical notes for complaint to proceed (3 week deadline)
P
Finalise complaints that do not require detailed examination
The examination and investigation stages encompass: P
Engaging with the nursing home and focusing on the issues
P
Case worker may wish to visit and speak with the staff or resident involved in the complaint.
P
If serious issue not resolved through examination process or if the issue is systemic or significant, the Ombudsman may decide to formally investigate the case (Only a small number of formal investigations are carried out)
P
There are two types of formal investigation – case-based or own initiative
P
During the investigation stage further information is gathered if necessary - documents, reports, interviews
P
Formal interviews are recorded if necessary
P
Subsequently a draft report with findings is issued to the nursing home and a formal response is sought
P
If an adverse finding or criticism of an individual is made, they will be afforded an opportunity to consider and make representation to the Ombudsman in this regard
P
The draft report is subsequently finalised and will include recommendations based on findings for redress/remedy where appropriate
P
The Ombudsman makes recommendations to reviewable agency and if appropriate, in general terms, to other reviewable agencies. The recommendations are not binding, but generally accepted.
Appeals process The internal appeals process: Appeals Manager or Senior Investigator will considers validity of appeal/decision P The target for completion is 4-6 weeks
Complaint Closing Categories P
Upheld: Complaint substantiated P Partially Upheld: Some aspects of complaint substantiated P Assistance Provided: Better explanation/other benefit as result of complaint P Not Upheld: Complaint not substantiated
NHI NEWS — 28
OFFICE OF THE OMBUDSMAN
What should your complaints handling procedure entail? Underpinning the guidance should be the ethos of ‘Investigate Once, Investigate Well’. Emphasis should be on:
P
Investigation- completed within 30 working days
P
A complaint recording system
P
Quicker, simpler and more streamlined complaint handling
P
Written response to a formal complaint
P
Local early resolution
P
Redress - an appropriate remedy
P
The most appropriate outcome for both complainant and the nursing home
The characteristics of a model complaints handling procedure should entail: P
Easy and convenient access
P
Timeframes set out
P
Frontline resolution- completed within 5 working days
A model complaint handling procedure will: P
Provide broad direction and support in improving your complaint handling procedures
P
Lay out the essential components of an effective complaints handling procedure
P
Focus on simplifying and streamlining
A NEW VENUE!
NHI Annual Conference & Care Awards 2015 Thursday, 12th November 2015 Double Tree by Hilton, Burlington Road, Dublin 4
Further details in this issue
29 — NHI NEWS
DEMENTIA CARE
Fairfield recognised for butterfly project A West Cork nursing home has adopted a globally recognised culture change in dementia care. Fairfield in Drimoleague was recently awarded Level 1 Dementia Care Matters accreditation.
A
West Cork nursing home has adopted a globally recognised culture change in dementia care. Fairfield in Drimoleague was recently awarded Level 1 Dementia Care Matters accreditation. Entitled ‘ The Butterfly Project,’ the programme’s ethos lies in recognising the whole person and joining the personal and professional in a way that brings out the best in people and where feelings matter most. “By developing peoples emotional intelligence and practical skills, they become more confident, more responsive, more at home in their environment and the result is a total culture change which transforms lives,” Sean Collins, provider of care at the 49-bed nursing home stated. “We are pleased to receive Level 1 accreditation. Only a handful of nursing homes in Ireland and the UK have managed to achieve such a standard in dementia care. The 12-month training programme undertaken by the home necessitated a radical culture change. Key deliverables Fairfield has fulfilled to meet the accreditation include: P The home should look more like a home – not a hospital; P ‘Matched’ households with people experiencing a similar
point of dementia are created to foster genuine love and friendship with common interests;
P Visual murals and rummage boxes with reminders of
former lives lived are there in abundance. P Rooms are just like home – with photographs, furnishings,
and the comforts of home. P Residents are encouraged and facilitated to bake, garden,
sing songs. “The group living approach makes sense to the people living and working here, providing a specialist approach for people which is appropriate to their experience of dementia and their personality and life experiences,” Sean Collins stated. Fairfield is divided into three ‘Houses’ that are named after local townlands: Rockmount House, Deelish House and Dromusta House. People are matched together to decrease stress and to enhance the social aspects of group living. Each house is self-contained with sitting rooms, kitchenette and dining room, making for a warm, homely environment. Minister with Responsibility for Older Persons Kathleen Lynch TD congratulated Fairfield. “Prioritising Dementia patients’ emotional care where feeling matter most means they engage more with their carers and their surroundings, and this contributes to wellness and a positive outlook in their own world.” she stated.
P Staff dress in normal ‘family’ attire. P Lounges and public areas are designed to encourage
interaction amongst residents – no large spaces with people sitting on the periphery.
Sean Collins, Fairfield Provider of Care, pictured with Minister Lynch and staff at the awarding of the accreditation.
31 — NHI NEWS
Further information re the Project is available from www.dementiacarematters.com
BEST PRACTICE
Bringing the outside world in Knightsbridge Nursing Home in Co Meath was the recipient of the innaugural Nursing Homes Ireland Innovations in Dementia Care Award at the 2014 NHI Care Awards. Jackie Kay advanced the nursing home’s Memory Lane programme by introducing a series of features to stimulate memories and bring memories of the outside world and times past into the nursing home. Her focus on a person-centred care approach seeks to ensure residents in her care have best quality of life and to enable these persons communicate through their feelings. She writes further in respect of the programme here.
M
y innovation came from my own personal belief to create a home away from home - a home that I would want to live in, a home I would feel safe in, and a place where people would know and respect who I am. I was able to achieve this with the help of the Memory Lane Program, which was created by Barchester (UK) in collaboration with David Sheard, the founder of Dementia Care Matters. The ‘blue-print’ was in place to enable me realise what I wanted to accomplish – dedicated Memory Lane settings within the nursing home. My innovation is a practice that derives from these core values: tenacity, belief in humanity and, above all, feelings. When I first read about the butterfly effect from David Sheard it sounded as if I was reading about myself - how I feel and what I do; I was so excited. Using my energy, passion and the freedom afforded to me by the management of Knightsbridge and with the assistance of my husband, we designed a poster around the theme of butterflies. This depicted butterflies in a cornfield moving from flower to flower. The poster highlighted the continual movement and interaction of butterflies, who move from moment to moment. The poster generated considerable interest and discussion in what we were seeking to achieve with Memory Lane. It was the platform to generate interest amongst residents, staff, volunteers and visitors to the nursing home in the program. The next step in the process was the creation of murals to begin the creation of the Memory Lane settings. Within one part of Memory Lane you pass a street image mural that shows old shops and pubs. On another you pass a farm scene, which depicts cows, sheep, a tractor, old stone wall. In another part of Memory Lane, a mural of a clothes line with old clothes 33 — NHI NEWS
is passed by residents, staff and visitors. Our murals trigger memories and are the source of much discussion for those who pass by them. Their creation brought a lot of fun and smiles all round; everyone feeling good and that’s what matters. Within Knightsbridge we have also created a nursery – a room with a cot, dolls, and children’s clothes. This room has a particular resonance for female residents. An school setting is also within Memory Lane. This features a blackboard and old school desks. A public house has also been replicated. This features an old-style bar, with stools and a Guinness pump. A number of our residents come from publican families and when they became aware of what we were creating they donated old pictures, mirrors, barrels and other memorabilia to support its creation. Memory Lane triggers memories and brings the past back into the nursing home. We have brought the outside-into our Memory Lane community. This innovation creates a comfortable, familiar environment for people to express themselves and their feelings. Dayto-day this innovation allows for residents and staff to open-up. The empathy shared encourages our community to care for each other in a very personal way, allowing for all emotions, happy or sad. Person-centred-care requires an understanding of each unique individual and, where possible, their life history. The innovation is dynamic and sustainable. Two of my future projects are: ‘The Men’s Shed’ and an arts and craft room. Continuously recognising the individual and the shifts and change in the people who join us is important going forward. Part of my responsibility involves training staff in dementia care. This includes staying up to date on the latest information, attending conferences and workshops
We have brought the outside-into our Memory Lane community. This innovation creates a comfortable, somewhat environment for people to express themselves and their feelings.
throughout Ireland and the U.K. All of these have given me invaluable insight into the needs of someone lost within. Working with and training staff has also helped me identify colleagues with that special touch and clear understanding of how feeling matters most and who will drive the innovation on. The support and encouragement given to me by my colleagues and management has allowed me to explore new programmes and implement new ideas. The innovation is inexpensive to implement. All you need is someone with a lot of passion, freedom and support. As per the bar, I have been inundated with gifts and items for developing ideas in Knightsbridge. These have come from the families of residents, the staff, and local businesses who are more than willing to help out. As previously stated, the
Our murals trigger memories and are the source of much discussion for those who pass by them.
innovation is not a rigid structure; it is dynamic and it allows for the uniqueness of each person in our home. It is not only a care programme for dementia, but it is a program for the development and care of the person. Everything I do revolves around one word – feelings - and how I can make people feel good.
Best Practice is a feature in NHI News that focusses on best and innovative practices in nursing homes. Nursing Homes are invited to make us aware of practices the wider public should be aware of and can contact michael@nhi.ie if interested in contributing an article P NHI NEWS — 3 4
THERAPY DOGS
Irish Therapy Dogs - Bringing Special Moments to Special People
I
rish Therapy Dogs is a registered charity that offers comfort and reassurance to those who need it most. Its Mission is to provide physical, therapeutic and educational benefit to people, young and old, fit and frail, alert and impaired. It provides these services in hospitals, nursing homes, day care centres, schools and other places where people may be restricted from having pets. The presence of dogs and their owners in these settings add comfort and support to the people within them. Those individuals who may not otherwise react to an external stimulus will often engage with a therapy dog. The benefits are impossible to measure and there to be seen, even in something as simple as a smile. An explanation for these therapeutic effects is that a dog fulfills our most basic human need to touch. Stroking, holding and enjoying the company of a dog can soothe the most stressed of us. A warm soul with a beating heart helps ease our sense of isolation and loneliness. One simple statement sums it up beautifully, ‘My dog understands me’.
35 — NHI NEWS
Every Irish Therapy Dogs’ volunteer knows what a positive difference their visits make and the enormous joy their dogs bring. Amongst the many inspiring stories, one volunteer states re their role: “…it puts me in the privileged position of being a friend, and I get to hear thoughts that might not be expressed to someone else. One lady told me she wanted to have ‘one more holiday’ – a thought that was shared with me because my dog was sitting between us, bridging the gap.” A Nursing Home resident describes how valuable the weekly visits are: “I feel at peace and very much loved during their visit. They are so cute and cuddly. For that hour, I pretend that the dogs are mine. They are one of my dreams come true and they make me feel very, very special.” You can learn more about the pet therapy provided by Irish Therapy Dogs, and registering a Care Centre, at www.irishtherapydogs.ie