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 | Web: www.nhi.ie
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NURSING HOMES
THE HEART OF COMMUNITY CARE CARDI PLAN NOW FOR SIGNIFICANT GROWTH
HSE SERVICE PLAN
NHI CARE AWARDS 2012
NHI’S CONCERNS FOR 2013
NURSING HOME LIFE RECOGNISED
COMMENT
HSE plan forecasts reduction in persons supported by Fair Deal in 2013 HSE plan for increased waiting lists for Fair Deal funding in 2013
Tadhg Daly, Chief Executive Officer, Nursing Homes Ireland
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arly into 2013, concern is increased once again concerning our commitment as a society to meet the needs of our population requiring nursing home care.
HSE plans for the Nursing Home Support Scheme (Fair Deal), as outlined in its Service Plan 2013, are cause for serious worry and concern, given the projection that the Fair Deal scheme will financially support 110 less people this year than were supported at end of December. Indeed the HSE is forewarning of problems with Fair Deal as one of its risks to the implementation of the 2013 Service Plan. It states, within the document,“impact of potential insufficient capacity of the NHSS” as one of 11 potential risks to the delivery of the Plan. It also states “there will be challenges in responding to the need for residential care and it is anticipated that a placement list will be in operation and new places offered under the NHSS as funding becomes available in line with the legislation”. The fact remains that inadequate provision of long term care is a significant risk to the delivery of the entire Service Plan because people requiring nursing home care will remain, inappropriately, in the acute system and the resultant challenges this will pose to the broader delivery of health services to the wider population. All of the positive developments that Minister for Health Dr Reilly constantly speaks of in respect of reductions in A&E waiting times, trolley count and the activity of the Special Delivery Unit will be negated overnight by the shortsighted restrictions on Fair Deal funding for 2013. The HSE Performance Report for year end 2012 (December) illustrates the growing requirement for nursing home care and the financial support provided by Fair Deal. At the end of the year, 22,871 persons were Fair Deal approved. The HSE assessment is 22,761 persons will be Fair Deal supported by year end 2013, so the HSE is forecasting to financially support 110 less persons in 2013 despite the fact that there are increasing numbers of applicants for Fair Deal funding. The planned reduction in numbers supported under Fair Deal is illogical and shortsighted. It negates against the growth in demand for the scheme and will have wider implications for the health sector. We are well aware our population is growing older and living longer. This edition of NHI News reports upon recent research conducted by the Centre for Ageing and Research Development in Ireland (CARDI), which projects growth in demand for nursing home care will rise by 12,270 (59%) from 2006 to 2021 – an average growth of over 800
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persons a year. The December Performance Report states at the end of the year 575 people had completed their acute phase of their care and were medically fit for discharge. The ESRI* recently reported 22,004 persons were discharged from acute hospitals to long-stay accommodation in the year 2011 and 40% of the beds ‘occupied’ within such settings during the year were by persons aged 65+. Reducing the numbers supported by Fair Deal will have a significant impact upon the acute hospital sector. Older persons will remain in hospital awaiting approval on the scheme or will remain at home with inadequate care provision. NHI is concerned what will come into effect in 2013 will be in effect a ‘one resident out – one resident in’ scenario, whereby persons will be required to wait for a person to leave the scheme before another person can be approved for Fair Deal funding. Fair Deal was designed to ensure nursing home care is “accessible, affordable and anxiety-free”, but the Service Plan negates against the core principles of the scheme. The HSE Service Plan 2013 will have a significant affect upon older persons and is likely to cause many distress, angst and worry. NHI’s concerns are echoed by Age Action Ireland, and other organisations representing older persons. Age Action Ireland has stated it is concerned that many older people will await a place on the Fair Deal scheme in an acute hospital bed at a far greater weekly cost to the State than that of being cared for in a nursing home. It has expressed concern older people who are sick, frail, or no longer able to live at home, will be left waiting for somebody to vacate a nursing home bed before they can receive the care they need. Fair Deal is a key component of the Irish health system and this is evidenced through the increasing numbers supported by it since its inception. At year end 2011 22,327 persons were approved and at year end 2012 22,957 persons were approved. NHI’s very real concern is a seismic storm is brewing. Requirement for nursing home care and the support of Fair Deal is increasing significantly and continually growing, as backed-up by CARDI and other research and projections. Policy stakeholders and the wider public should heed the warnings emanating from the recent CARDI research: “Even with greater emphasis on care at home and more resources provided to realise it, the demand for residential care is going to increase significantly in the next decade.” The December 2012 Performance Report advised of 7,953 public beds at year end 2011 and 7,329 at end of 2012, a reduction of 624. Contrary to last year’s HSE Service Plan, the 2013 document does not advise of bed closures for the public sector this year. The issues outlined arise as the NTPF, on the State’s behalf, is refusing to appreciate, recognise and negotiate fees that reflect the true costs associated with the provision of the specialist care nursing homes provide. The NTPF, which fails to bring gerontological or nursing care clinical experience to negotiations, is seeking unjustified and unwarranted reductions that ignore the true cost requirements placed upon nursing homes. As well as bringing severe pressures upon such homes in their delivery of care, the NTPF’s actions are negating against the ability of the sector to secure required investment to meet ongoing and growing demand for such care. Because of the limitations of the current funding model, private and voluntary nursing homes are not in a position to expand or deliver new builds to meet ongoing and growing demand. NHI members cannot invest in future requirement for long-term residential care because of their concerns surrounding the limitations of the Fair Deal scheme and the failure of the State, through the NTPF, to recognise the cost of care. So key issues presently impacting upon the long-term residential care sector include:
CONTENTS NHI NEWS News from Nursing Homes Ireland, the representative organisation for the private and voluntary nursing home sector. READ ALL ABOUT US! Emotions run high in a Co Cork nursing home as a resident gives his bridal daughter away, an alzheimer café opens in one Dublin home as another rolls out the red carpet for film screenings, residents and staff of a Tipperary home raise funds to benefit a children’s hospital, and a home’s athletic chef enjoys international success. Find out activities of NHI members in Read All About Us!
DATES FOR YOUR DIARY An NHI Education Day in March and the organisation’s AGM in April are two forthcoming dates for your diary.
NEWS UPDATE New pertaining to the nursing home sector
CARDI STUDY A huge increase in growth in demand for care of older people has been identified in research funded by the Centre for Ageing Research and Development in Ireland (CARDI).
HSE SERVICE PLAN 2013 The HSE Service Plan 2013 signals further cuts in the numbers that will be supported by the Nursing Home Support Scheme (Fair Deal). NHI has warned the Plan will inevitably have a significant impact upon the numbers of older persons awaiting the support of Fair Deal.
NHI ANNUAL CONFERENCE 2012 The NHI Annual Conference 2012 highlighted the critical role of nursing homes in community care. Economist Moore McDowell warned of significant implications if Fair Deal fails to move beyond short-term budgetary concerns and Ombudsman Emily O’Reilly encouraged nursing homes to ensure their complaints handling service is very real, very honest and very responsive. NCPOP REPORT A report by the National Centre for the Protection of Older People recommends all agencies that have an interest in the protection of older people should continue to be involved in the further development of strategies to prevent and identify abuse and neglect of older people receiving residential care.
NHI CARE AWARDS 2012 Gala night celebrates the excellent care in NHI homes across the country.
BEST PRACTICE A Co Cork Care Centre has led the way in turning its local community into a Positive Ageing Town.
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.
P Reduction in numbers supported by Fair Deal; P Substantial reduction in the capacity of public nursing home units, with costs to provide care in such homes rising substantially; P No negotiations or transparency re cost of public nursing home care and the costs merely published by the HSE; P Escalating growth in demand for long-term residential care, even with greater emphasis placed upon care at home; P HIQA standards are pushing up the cost of care while the NTPF mission is to reduce the fees provided, with inevitable consequences; P Failure of the NTPF to recognise the true cost of care in the private and voluntary nursing home sector; P The incapacity of private and voluntary nursing homes to invest in ongoing and growing demand for long-term residential care because of current failure of Fair Deal to recognise true cost of care and uncertainty surrounding the Fair Deal scheme. The issues outlined all pose significant challenges within their own right but in tandem they are of considerable cause for concern. NHI has previously warned the Government cannot bury its head in the sand in respect of its requirements to plan for the growth in demand for our ageing population. Issues such as those outlined are facing us at present and addressing them cannot be put on the long finger. The Government must plan now, in consultation with NHI, to meet present and ongoing future requirement and failure to do so will leave us with a considerable crisis that will impact directly upon some of society’s most vulnerable – older persons. We are in a precarious position and issues surrounding the provision of nursing home care cannot be ignored and must be addressed. On the horizon is the Fair Deal review, which is projected to be complete this year. This must address the current inequities of the scheme and introduce an evidence-based cost of care model that recognises the complex care requirements of persons requiring nursing home care and facilitate the private and voluntary nursing home sector in maintaining and developing high quality services to meet existing and projected future demand. The issues we are faced with at present help outline the critical importance of the Fair Deal review. They also thrust responsibility upon the Government to take a leadership role and engage in a meaningful way with the private and voluntary sector to plan to ensure we meet the care requirements of an accelerating number of persons who are growing older and requiring care.
Tadhg Daly, NHI CEO
*Activity in Acute Public Hospitals in Ireland Annual Report 2011
NHI NEWS — 02
NHI UPDATES Committed to excellence in care
Tenders to be sought “shortly” for Fair Deal review: Department of Health
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Minister for Older People Kathleen Lynch: It is envisaged Fair Deal review will be completed 2013
he Department of Health will shortly be seeking tenders through the public procurement process to carry out the review of the Fair Deal scheme, NHI has been advised. Writing to NHI in a letter dated 18th January, Minister for Older People Kathleen Lynch stated: “The Department will shortly be seeking tenders through the public procurement process for the carrying out of the review. It will process within the constraints of available staff and other priorities. It is envisaged that the review will be completed in 2013.” The Department states companies will be asked to submit a methodology for conducting the review as part of the tender process. In late December, the Department published a review of the submissions to inform the review of the scheme. A total sixty-one submissions were received from representative/professional organisations, statutory bodies, nursing homes, groups representing the interests of older
Nursing home life profiled in Irish Independent
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people, private/commercial bodies, organisations in the community and from the voluntary sector. On 9th January, NHI advised the wider public of publication of the submissions and reiterated its call for the Department of Health to publish the Fair Deal review timeline. “Nursing Homes Ireland once again calls upon the Department of Health to confirm the specific timeline in respect of the review and to confirm when it is expected to complete,” Tadhg Daly, NHI CEO stated. “The review process commenced last June and indications from the Government advised it would be completed early in 2013. This review is a key moment in the delivery of care for our increasing ageing population and it is important there is certainty and transparency surrounding the process. NHI looks forward to engaging with the external party chosen by the Department of Health to undertake the review and availing of the opportunity to bring our experience and knowledge to the review.”
The Irish Independent’s Health & Living supplement has provided readers with an insight into nursing home life. In its 28th January edition, it featured interviews with three residents from NHI member homes: Merrial Davis, Glendale Nursing
Home, Co Carlow, Julia Thurmann, Hamilton Park Care Facility, Co Dublin, Sylvia Maloney, St Luke’s Home, Co Cork. The three residents, who are all winners of the NHI Care Awards Resident Achievement Award, spoke of friendship and activity
that is part of nursing home life and the happiness it brings to their lives. The article informed readers of the NHI Care Awards and advised of choosing a nursing home. The article can be read under the news section of the NHI website www.nhi.ie.
Department considers bringing stakeholders together following NHI representations in Oireachtas
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Minister for Older People Kathleen Lynch TD is to raise with Department of Health officials NHI’s recommendation stakeholders involved in the delivery of care to older persons meet on a regular basis to share information and bring issues to the table. Minister Lynch committed to bringing the matter to officials attention during a debate in the Seanad on 19th December on Care of the Elderly. NHI has consistently made representations to Senator Colm Burke and other politicians calling upon the Department of Health to bring key stakeholders such as the Department, HSE, HIQA and nursing homes together for a ‘Forum on Long Term Care’ to address the challenges associated with the provision of long-term residential care. Speaking during the debate, Senator Burke stated: “Nursing Homes Ireland, several other organisations representing the elderly and health agencies are anxious to facilitate a longer-term planning strategy to be developed for caring for the elderly.” He went on to state: “While the Health Information and Quality Authority is calling for certain standards in nursing homes, it is not providing the necessary support and sharing of information to assist them in meeting those standards. Many nursing homes feel it would be helpful if there were more consultation with all groups involved in the care of the elderly. A comprehensive long-term programme for care of the elderly is necessary. A recent report pointed out that 49% of people occupying hospital bed spaces are over 65. We must ensure the appropriate services outside of hospital are available to these people when they are well enough to leave hospital. We can only achieve this if we have more consultation on the matter.” Minister Lynch advised of “close co-operation” between statutory and non-statutory organisations in the area of services for older people”. Senator Burke said: “The nursing home organisations are aware of the Department’s consultations with the various groups but believe more could be achieved if the groups met together with the Department as opposed to individually. Even if such meetings were held every six months, it might provide an opportunity to find out what they may be missing or needs to be improved.” Minister Lynch responded: “I recognise the benefit of the Senator’s suggestion and I will raise it with my officials. If representative groups were invited to sit around a table to discuss the same issues they might offer solutions that we have not thought of heretofore.”
Senator Colm Burke: More could be achieved if the groups met together with the Department as opposed to individually
Excellence in Care – Nursing Homes Ireland dedicated Irish Independent supplement Readers of the Irish Independent were provided with a copy of the dedicated Nursing Homes Ireland supplement Excellence in Care on Thursday, 29th November. The supplement: Informs a national audience of NHI and its stated aims and commitments, Commemorates the NHI Care Awards 2012, Advises persons of nursing home life and the activities and excellent care provided in homes, Provides valuable information and advice on availing of nursing home care, Delivers NHI commentary on the importance of the review of the Fair Deal scheme and the critical opportunity it presents the Government to implement a sustainable plan to address the health and social care requirements of our ageing population, Informs readers of issues of pertinence to the private and voluntary nursing home sector that NHI is working towards. Nursing homes, citizens information centres and elected representatives were provided with copies of the supplement to advise persons considering nursing home care. Limited copies of the supplement are available by contacting NHI at (01) 4292570 and it can be downloaded via www.nhi.ie under the publications section of the site.
Sunday Business Post article: Fair Deal ‘mark two’ must address changing demographics While the public has embraced Fair Deal, there is a requirement to fix operational issues and for the scheme to be included in the long-term budget for healthcare provision. Tadhg Daly, NHI CEO, made such points in a Sunday Business Post feature that focussed upon the review of the Fair Deal scheme. Mr Daly was quoted: “The challenge in respect of the review of the Fair Deal – and the design of Fair Deal mark two – is to ensure that Ireland’s changing demographics and the reduction in public capacity are addressed.” The article also quoted from Economist Moore McDowell’s presentation at Nursing Homes: The Heart of Community Care, the NHI Annual Conference 2012. The Business Post advised Mr McDowell is undertaking an NHI-commissioned study on the economic and policy environment for the nursing home sector. "The State has signalled its intent to reduce its provision so we know that the required increased supply can only come from an expanded private and voluntary sector,” Mr McDowell is quoted. "Price setting, fixing and capping are not compatible with a market-driven supply response to demand changes and is not necessary in a competitive market."
NHI Care Awards highlights on Youtube Highlights from the NHI Care Awards 2012 are now available for the world to view on Youtube. A nine minute TV report from the awards night features interviews with: NHI Care Awards 2012 winners; Professor Brendan McCormack, Chair of the NHI Care Awards judging panel; Tadhg Daly, NHI CEO; NHI representatives; Marty Whelan, NHI Care Awards 2012 Event MC John Doyle, Homecare Medical Supplies, event sponsors. The glitz and glamour of the event at Citywest Hotel is evident for all to see. You can view the report by visiting Youtube and searching for “Nursing Homes Ireland Care Awards”.
NHI NEWS — 04
NHI advises national audience of nursing opportunities
Nursing home life profiled
NHI recently featured on RTE Radio 1 advising a national audience of the rewarding and fulfilling employment for nursing graduates within the private and voluntary nursing home sector. Following poor uptake for the HSE’s nursing graduate scheme, Tadhg Daly, NHI CEO, encouraged nursing graduates to consider a career in private and voluntary nursing homes in an interview on Morning Ireland and informed of ongoing demand for nurses within the sector. Mr Daly told listeners our ageing population is placing greater demand upon nursing home services and the requirement for the speciality that is gerontological nursing. He advised of competitive salaries provided by private and voluntary nursing homes and excellent terms and conditions for nurses working within the sector, including excellent opportunity for advancement, the development of skills, and the chance for nurses to work within their local communities. He spoke arising from publication of an NHI statement, dated 2nd February, titled NHI encourages graduate nurses to look to private and voluntary nursing homes for fulfilling career opportunities. “It is important nurses are aware the private and voluntary nursing home sector has excellent opportunities available for nurses,” Mr Daly stated. “Nursing homes provide challenging and rewarding employment in local communities and bring together a wide range of professionals within specialist healthcare settings. The work provides care to our most vulnerable and delivers a high level of job satisfaction. Private and voluntary nursing homes offer very competitive pay rates and excellent terms of employment.” Listeners were advised of Rewarding Career Opportunities for Nurses – Working in a Nursing Home, the NHI brochure aimed at healthcare professionals that challenges myths and advises of the reality of working in private and voluntary nursing home settings. It promotes employment within the sector and is obtainable by contacting NHI at (01) 4292570. Other national media outlets, including Newstalk and Today FM, and regional radio featured an interview with Mr Daly concerning the opportunities. The Sunday Independent also informed readers of opportunities.
The Irish Independent of 28th January gave readers an insight into life in a nursing home. Reporter John Cradden spoke to three residents of NHI nursing homes who are winners of the NHI Care Awards Resident Achievement Award. Merrial Davis of Glendale Nursing Home, Co Carlow (2012 winner), Julia Thurmann, Hamilton Park Care Facility, Co Dublin (2011 winner), and Sylvia Maloney, St Luke's Home, Co Cork (2010 winner), spoke of life in their respective nursing homes. The three residents spoke of friendship, activity and the happiness nursing home life brings to their lives. The article informed readers of the NHI Care Awards and provided them with advice in respect of choosing a nursing home. It featured in the Health & Living supplement of the Irish Independent and the article can be read on the NHI website, www.nhi.ie.
NHI CEO outlines issues of concern to sector The review of the Nursing Home Support Scheme (Fair Deal), demand for long-term care and capacity provision, and concerns regarding the consistency of the Health Information and Quality Authority (HIQA) were all discussed by NHI CEO Tadhg Daly in a recent interview with the Irish Medical News (dated 4th February). The interview can be read in the news section of the NHI website, www.nhi.ie, and within it Mr Daly informs Fair Deal has, in many respects, been a very positive development and has addressed the myriad of schemes that existed prior to its introduction. He said NHI would like to see amendments around the operational side of it, stating from a providers point of view there are significant issues that need to be addressed; the narrow definition of goods and services and failure of the NTPF to look at the whole capital and future provision of the sector, being some. Development of the private and voluntary nursing home sector is being impeded in some respects by the NTPF because of its strong efforts to continually decrease fees to members, Mr Daly said, and he warned such actions could have a knock-on effect on standards of care. Irrespective of Minister James Reilly’s plans to enable older people stay at home for longer, there will still be a growing demand for nursing home care, Mr Daly advised, pointing to recent CARDI research that informs of this (see CARDI Study article). He reiterated NHI’s call for the Fair Deal budget to continue to be dedicated and ringfenced and for a sophisticated funding model to be introduced to support the complex care requirements of residents and to support providers in providing care and meeting ongoing and future demand. Mr Daly advised of persistent concerns surrounding the consistency of HIQA’s inspection of the private and voluntary nursing home sector, before adding: “One of the challenges for HIQA into the future, and I think they have acknowledged this in terms of new safety and quality improvement directorate, is about providing guidance and support and information to the sector so that it can respond more appropriately to issues as they arise. There is a distinct lack of guidance.”
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Actions recommended by Department Subgroup to reduce admin burden on nursing homes A Department of Jobs, Enterprise and Innovation Subgroup has recommended a number of actions to reduce administrative burdens upon nursing homes in respect of the registration and re-registration process. The recommendations follow on from NHI representations to the Department’s High Level Group on Business Regulation. Last June Tadhg Daly, NHI CEO, presented to the Subgroup and outlined unnecessary administrative burdens being imposed upon NHI members in respect of re-registration and advised of administrative duplication and overlapping between State authorities. The report by the Subgroup recommends the following actions in the short-term to reduce administrative burdens upon nursing homes: P Where operators have already established the accuracy of certain information and it has not changed it should be possible to make a declaration to this effect and have the original proof accepted as still valid; P It is recommended that HIQA consider generating more guidance for nursing home providers and it should consider working with other relevant bodies, for example fire services and environmental health officers, on guidance and standards. For the long-term, the Subgroup recommends completion of registration and renewal should be possible online. See the report in the publications section of www.nhi.ie
READ ALL ABOUT US! What activities are taking place in your home? How are residents fullling 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.
Alzheimer café launched in Dublin care centre
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loomfield Care Centre in Co Dublin has launched an Alzheimer Café, which will provide a safe venue for people with dementia and their loved ones. RTE personalities Derek Mooney, Brenda O’ Donoghue and Bláthnaid Ní Chofaigh were on hand to launch the Alzheimer Café South County Dublin on 7th November in the Rathfarnham-based Care Centre. “For the evening, our dining room was transformed into a café style room, with china cups, table-cloths, jazz music and pastries and cakes that delighted the crowd,” explained Catherine Keogh, Occupational Therapy Manager at Bloomfield Care Centre. “Up to 70 people attended to support the café, many of whom were people with dementia, and or relatives, friends or carers of people with dementia.” Damien O’Dowd, CEO of Bloomfield Care Centre, opened the event and welcomed everyone. Anne Kearney, Older People’s Services HSE, then spoke about the origins of the alzheimer cafes and expressed her hope that the South County Dublin café will support and provide a safe venue for people with dementia and their loved ones. Derek Mooney spoke from the heart about his experience in caring for his mother who has Alzheimer’s’ and the impact this has had on his family. Derek reminded all in attendance of the importance of patience and love when supporting someone with dementia. Volunteers that comprised of staff from all of the steering group organisations were on hand to listen, support and guide attendees as appropriate. Attendees provided feedback on future talks and information they wished to gain by attending the café. “Overall, the evening was considered a great success and we look forward to hosting the Café evenings here in Bloomfield, every second Wednesday,” Ms Keogh added. “The evening could not have happened without the support of the steering group member organisations – Bloomfield Care Centre, Age Action, Alzheimer Society of Ireland, Trinity College Dublin and the HSE.” The Alzheimer Café, Bloomfield Care Centre, Dublin 16, has a programme of presentations upcoming in March, April and May. Each of the presentations will discuss issues surrounding dementia, including communication, early intervention, and legal matters. The presentations will be taking place on 10th April, 8th May & 12th June. Persons interested in attending can contact the Centre at (01) 4950021 or visit www.bloomfield.ie P
Left: Pictured at the launch of the Alzheimer Café are, from left, Brenda O’Donoghue, RTE; Anne Kearney, Older People’s Services HSE; Derek Mooney, RTE; Frankie Barrett, eastern regional manager Alzheimer Society of Ireland; Bláthnaid Ní Chofaigh, RTE; Damien O’Dowd, CEO, Bloomfield Care Centre; Catherine Keogh, occupational therapy manager, Bloomfield Care Centre.
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Resident at Cork nursing home gives bridal daughter away on special day
Red carpet rolled out for film screenings in Dublin home
When daughters marry, it is their wish to have their Dad by their side, walking them up the aisle. One daughter’s wish was fulfilled in early January in St Luke’s Home, Co Cork, when her father, a resident of the home, was afforded the opportunity to give his daughter away. On Friday 4th January Audrey Healy, the second youngest of five and a last daughter to get married, walked up the aisle of the main corridor of St Luke’s and into the conservatory, on the arm of her much loved dad Michael Healy. Audrey wanted her Dad by her side for this special day and so it was agreed that Michael, who has Alzheimer’s, would give Audrey away to her fiancé Huw Hayes on their special day. In a re-enactment of her church ceremony that took place that morning and in the company of close family, friends and staff at the home, Audrey’s wish came true. “It was the most magical and emotional day of all our lives”, said Audrey.“It’s impossible to put into words how we all felt for the two precious hours of my wedding day spent with Dad, family, friends and staff at the home. Dad wished us every health and happiness for our future lives in a toast in the home that was complete with chocolates, champagne, flowers and décor that even matched the bridesmaids and flower girls! In true tradition, my first dance with my new husband Huw took place in the company of my gorgeous mum and dad and close family and as I danced with dad, there wasn’t a dry eye in the house.” “The transition to nursing home care, although difficult at the beginning, has been made infinitely easier by the ethos and care shown by all staff at St Luke’s. Dad would not have been well enough to take part in the whole day, but he did give me away and we spent quality time together, which he loved and which we will always remember. His ability to take on the role of father of the bride was facilitated in a reassuring and kind manner by the staff of St Luke’s and for that I am profoundly grateful.”P
A Co Dublin nursing home recently participated in the Picture House Outreach Programme of the Jameson Dublin International Film Festival. Ashford House Nursing Home, Dun Laoghaire, participated in the festival in February when it held a special screening of two Buster Keaton silent moves – One Week and Cops. The red carpet was rolled out for the screenings, as part of the nursing home was transformed into a cinema for the afternoon. The Festival provided the films, posters, programmes, tickets and ice-cream to co-incide with the home’s participation in the celebration of film. Residents greatly enjoyed the atmosphere the filming created and the cinema experience brought with it P
Left: Resident Imelda Saunders proudly displaying her Picture House cinema ticket. Middle: Ashford House Activity Co-ordinator Ann Moore introducing the Picture House Programme to residents. Bottom: Residents Raymond McCluskey and James Reilly enjoying treats at the Picture House screening.
The happy bride is pictured with her proud father Michael
NHI NEWS — 08
Athletic chef brings success to Cork home Athletic achievement has brought medals to a Co Cork nursing home. Skibbereen Residential Care Centre chef Maureen Glanton has celebrated a successful 2012 with residents and staff of the nursing home. Maureen won the discus event at the All-Ireland Masters’ Track and Field Championships for the sixth year in a row in August, and finished second in the hammer event. She also enjoyed success last Summer at the British Masters Championships, winning three medals – a gold in discus, silver in weight throw and a bronze in the hammer category. Maureen has been competing in the over 45 category at masters’ level since returning to the athletics world in 2005. She is pictured with some of her medal haul.
Willowbrook fundraiser assists Children’s Hospital Things went a little purple in a County Tipperary nursing home last September, but it was all for a good cause. Residents, staff and visitors to Willowbrook Lodge, Fethard, participated in ‘purple day’ to raise funds for Our Lady’s Children’s Hospital, Dublin. The day involved all residents and staff wearing something purple to collect money for the hospital. The home ran an open day and a series of activities to coincide with the day that was held during Positive Ageing Week. Activities included an old sayings quiz, a sing-song and pass-the-parcel. Visitors to the home generously rewarded the efforts of residents and staff, with €700 being raised for the hospital P
Enjoying ‘purple day’ in Willowbrook Lodge are, from left, Sona Wilfred, staff nurse; Grace Ryan, senior care assistant; Noelle Killeen, manager; and Andrea Matisz, senior care assistant.
DATES FOR YOUR DIARY Upcoming events of interest March
6 April
NHI Education Day Data Protection and Information Governance: What you need to know, the NHI national education day for staff in member homes will take place in Dublin on 6th March. The event will take place in the Red Cow Moran Hotel, Naas Road, and NHI Members will be provided with a full line-up of speakers in the lead up to it. Book your place by contacting Olivia Slater at 01 4292570 or emailing info@nhi.ie.
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Optimising Health & Well-Being in the Frail Nursing Home Resident – a Joint Approach is the title of Irish National Extended Care Medicine Association (INECMA) 2nd national conference. The event will take place at Killashee House Hotel, Naas, Co Kildare. NHI will be provided with further details in the lead up to the event.
16/ 17
Sonas APC: 5th International Dementia Care Conference Innovation, Inclusion and Empowerment is the theme for Sonas APC’s 5th International Dementia Care Conference & Exhibition Event, featuring international, US, UK and international expert speakers. The main conference will take place 16th April and be followed by a Masterclass Day on 17th April. Both events will be held at the RDS, Dublin 4. Further information is available at www.sonasapc.ie.
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NHI AGM The NHI AGM and a Members Seminar will take place in Hotel Kilkenny, Co Kilkenny. NHI Members will be provided with a full schedule and listing of speakers in the lead up to it. Important issues pertaining to the private and voluntary nursing home sector will be discussed at the AGM and the Members Seminar will provide informative presentations to Members. NHI encourages all members to mark the date of this important event in their diary.
May
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All Ireland Gerontological Nurses Association 5th Annual Conference The conferencewill take place in the Crowne Plaza Hotel, Dundalk. Keynote speakers will include Noel Mulvihill, HSE; Professor Barbara Bowers, University of Wisconsin; Claire Keating, Northern Ireland Commissioner for Older People.
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NHI NEWS — 10
NEWS UPDATE
THE LATEST HAPPENINGS IN THE CARE SECTO R
Minister advises re Fair Deal waiting list All applicants who are approved for Fair Deal funding are put on the placement list in chronological order by the date of determination of their application. Dáil Éireann was advised of this on 17th January after Deputy Caoimhghín Ó’Caoláin (Sinn Féin) asked the way in which the waiting list for Fair Deal will be administered. The HSE’s National Service Plan 2013 states potential insufficient Fair Deal capacity poses a risk to the delivery of the plan and advises there will be challenges in responding to the need for long-term residential care. NHI has raised significant concerns in respect of Fair Deal waiting list for 2013. Responding to Deputy Ó’Caoláin, Minister for Older People Kathleen Lynch stated: “The HSE operates a national placement list to enable it to operate within the Budget for the Scheme. All applicants who are approved for funding are put on the placement list in chronological order by the date of determination of their application. Funding issues to applicants in this chronological order to ensure equity nationally. Funding is currently being released on a weekly basis.”
Bealtaine 2013: call for nursing homes to participate Grow Happy – a call to celebrate growth, spring and positivity for ourselves and our communities is the theme for this year’s Bealtaine festival. Age and Opportunity are once again encouraging nursing homes to participate in Ireland’s national celebration of creativity as we age. Bealtaine is a month-long programme that runs every May and offers opportunities for people aged 50+ to engage with arts and culture as audience member, artist, critic or participant. Visit www.feilenabealtaine.ie for further information or contact 01 8057709.
Dawn Chorus in Ringsend, Co Dublin: Part of last year’s Bealtaine festival activities.
Ombudsman’s remit extends HIQA and the NTPF are among the bodies that will come under the remit of the Office of the Ombudsman because of the passing of the Ombudsman Amendment Act 2012. The Act passed its final stage in the Dáil in October and both organisations are part of 140 bodies that will come under Ombudsman oversight from April. The Ombudsman is not empowered to examine retrospective complaints. Right - Ombudman Emily O’Reilly 140 additional bodies, including HIQA & the NTPF, will come under the remit of the Ombudsman Emily O’Reilly
11— NHI NEWS
New model of care for older people in hospital to be rolled out A new model of care for how older people are cared for in hospital has been launched by the Department of Health. The HSE said the initiative is aimed at significantly improving the access for frail older patients to specialist geriatric teams, day hospitals, specialist inpatient beds and rehabilitation beds. The report detailing the model sets out the following reforms: m The establishment of specialist geriatric teams within hospitals, m A comprehensive geriatric assessment for all those identified as frail older people to fully assess their individual needs and the range of services they require, m Dedicated in-patient specialist geriatric wards, m In-patient rehabilitation facilities, m Improved links with community-based services (residential care and home support). The HSE advises the model of care will: m Provide rapid access to specialist geriatric teams in hospital, m Provide a standard comprehensive assessment of their needs by a multidisciplinary team, m Improve access to inpatient care through the establishment of geriatric wards, m Improve access to rehabilitation through the establishment of specialist geriatric teams/wards. The model has been developed by nurses, doctors and therapists working in frontline services, in consultation with patients and HSE Services for Older People as part of the National Clinical Programme for Older People and will commence transitioning towards implementation this year. Hospitals identified for phase one are in the Dublin Mid-Leinster and Dublin North East Regions. Dr Diarmuid O’Shea, Clinical Lead for the National Clinical Programme for Older People, said the initiative is designed to ensure the needs of the older person are assessed when they are admitted to hospital and their care will be delivered in a coordinated and focussed manner. Below - Dr Diarmuid O’Shea: The initiative is designed to ensure the needs of the older person are assessed when they are admitted to hospital
Signifi ficcant rise in growth of long-term residential care to 2016: WHO & European Health study More than 31,000 persons in Ireland will require long-term residential care in 2016, a World Health Organization and European Observatory on Health Systems and Policies report states. The report entitled Health System Responses to Financial Pressures in Ireland: Policy Options in an International Context has been presented to the Department of Health. The report states: “The difficulty of discharging patients who no longer need hospital care is a constraint on effective use of hospital beds.” It adds: “There is some uncertainty about the exact level of nursing home care but between 2006 and 2011 the numbers in nursing homes appear to have increased at a rate of around 3% per year. The numbers for 2016 have been projected using the assumptions that the level of community care support does not decrease (or increase) and that age standardised disability rates continue to fall. The pure demographic effects lead to a significant rise in the need for long-term care and on the basis of current patterns of community provision this will require increased places in nursing homes at around 3% per year. The shift towards private provision of nursing home care, with a marked fall in the number of public beds, is only significant if there is a difference in the
Review of public nursing homes
services provided in public and private homes and in their ability to deal with complex needs.” The report projects the numbers in longterm residential care in 2016 will be 31,725. The projected numbers in such care for 2011 was estimated at 26,269 (the numbers supported under Fair Deal at the end of the year was at 22,327: HSE Performance Monthly Report December 2011). The Department of Health commissioned the European Observatory on Health Systems and Policies to prepare the report, authored jointly with the WHO Regional Office for Europe. “The main aim of this report is to review in a concise but rigorous way the main policy options available to the Irish Government in responding to the effects of the financial crisis on the Irish health system,” the publication states. “It attempts to assess the response of the Irish health system to budget cuts in recent years and to explore future options in light of relevant international evidence drawn from experiences in European and OECD countries facing similar challenges. In contrast to the narrow time frame that fiscal pressures sometimes impose on policy makers, the analysis here takes a longer term approach to addressing the challenges generated by austerity.”
The HSE recently completed a review of its 129 public units providing residential care. Minister for Older People Kathleen Lynch advised the Dáil on 19th December and 11th December the review will provide the basis for discussions between the Department of Health and HSE with a view to developing an overall set of proposals for the future delivery of residential care. The review focussed on a number of areas, she stated, including each unit’s ability to meet HIQA standards in terms of staffing availability, environmental matters such as the age & structure of the home, and factors including location and stock. Speaking in the Dáil on 11th December, Minister Lynch said the review aims to identify the maximum number of beds and public residential units that could be retained in each region, within existing financial and staffing resources. “The HSE is working closely with the Department to develop an overall sets of proposals for the Minister,” she added. In her 11th December response, Minister Lynch advised up to the end of October, a total of 504 public beds had closed and it was not envisaged the figure of 555 beds, which was earmarked in the HSE Service Plan 2012, would be reached. She was responding to a question from Deputy Robert Troy (Fianna Fáil) who asked the Minister for Health to reconsider his policy for closing public nursing home beds.
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NHI NEWS — 12
CARDI STUDY
Growth in demand for nursing home care to rise 12,000+ by 2021 A huge increase in demand for care of older people has been identified in research funded by the Centre for Ageing Research and Development in Ireland (CARDI), writes Paul McGill, Strategic Research Officer with the Centre
Pictured at the launch of the report on 25th October are, members of the research team, from left, Dr Maev Ann Wren, TCD; Prof Charles Normand, TCD; Prof Davis Coakley, CARDI; Dr Caitriona Murphy, TCD; Prof Bob Stout, CARDI; Dr Dermot O’Reilly, QUB. Photo by Brendan Lyon/Image Bureau.
Towards the Development of a Predictive Model of Long-Term Care D emand for No rthern Ireland and t he Republic of Ireland concludes that between 2006 and 2021, the number of people aged 65+ using residential long term care will rise by 12,270 or 59% in the Republic of Ireland (RoI). In Northern Ireland (NI), the rise will be 4,270, up 45%. However, the need for residential care could be greater if informal carers are unable to provide the same amount of care as at present; for example if more women enter the labour force or emigrate. The report, whose lead author was Dr Maev-Ann Wren from Trinity College Dublin, believes that 12,270 more people in the Republic of Ireland will use formal home care in 2021 by comparison with the year 2006 and
13 — NHI NEWS
23,500 more will use day or daily informal care, increases of 57% in both cases. In Northern Ireland an additional 4,200 older people are expected to use care from statutory providers (up 37%) with informal care rising by 11,000 (26%). Projecting the need for and utilisation of long-term care is not an exact science and the authors faced inadequate data sources and complex definitional issues. To simplify somewhat, the projections are based on the number of older people expected to be alive in 2021 with levels of disability that indicate a need for care. The research also identified many people who need care but are not receiving it. In Republic of Ireland, 11% of older people with limiting disabilities were receiving no care (8,020 people) compared with 2% in Northern Ireland (1,100 people) in 2006.
Many issues affect the ability of older people to live independently at home. These include: m Does the person live alone? m Is the home well equipped for a person with a disability? m Are family members living nearby? m Is there a voluntary organisation providing support? m Is the older person mobile inside and outside the home? Financial factors are also at play because people who own their own homes are less likely to enter residential care than those who rent. In part this is because older people or their children may wish to hold onto the asset of the family home. In addition, renting your
home indicates low wealth and research shows that low income people are more likely to have illness and disability than better off people. The researchers could not factor in all these variables but using the assumptions set out in the full report, they believe there will be a big increase in demand for both residential and domiciliary care, even if levels of disability among older people decline. The big driver is the ageing population, especially the older old, who are most likely to need care. In the decade from 2011 to 2021 the number of people aged 85+ will increase by 55% in Ireland as a whole. Moving beyond the time-frame of the report, the increase is even greater. By 2041, the number of people aged 85+ in Republic of Ireland is projected to quadruple (an additional 197,000) and in Northern Ireland to triple (up 68,000). CARDI believes that such dramatic ageing demands careful research to ensure that policies and services meet the future needs of a greatly increased older population. For example, government policy in both Republic of Ireland and Northern Ireland is that older people should be encouraged and enabled to continue living at home for as long as possible, which fits well with what older people prefer. It is not clear, however, that either Republic of Ireland or Northern Ireland is doing enough. Initiatives are needed to promote healthy and active ageing so that older people are less likely to need care. Greater support is required for people in their own homes, such as telecare, assistance with transport, activities to promote inclusion and services such as meals and personal care. In this context the authors of the report note that in Republic of Ireland the emphasis on resolving the funding of nursing home care has done nothing to address patchy provision of long-term home care. Even with greater resources for care at home, the demand for residential care will increase significantly in future. At a time when nursing home places are being cut, this has important implications for governments, private and voluntary providers of care and the planning and regulatory bodies involved P
NHI RESPONDED TO THE PUBLICATION OF CARDI’S REPORT WITH THE FOLLOWING STATEMENT: CARDI report reiterates NHI call for Government to plan now to meet growing demand for long-term residential care. Nursing Homes Ireland welcomes publication of the CARDI report Future demand for long-term care in Ireland, which reiterates the longstanding call by NHI for a national strategy to be developed as a priority to meet the growing demand for long-term residential care. The report projects the number of persons requiring nursing home care will increase by at least 12,270 by 2021, an increase of 59% from 2006, and the increasing numbers could amount to 14,502, an increase of 65%. CARDI’s findings come on the back of the ESRI’s projections that an additional 13,324 long-term residential care places will be required to meet demand up to 2021. Tadhg Daly, NHI CEO commented: “Following on from the ESRI research and the publication today of this very important body of work by CARDI, the Government and policy makers cannot continue to ignore the significant growing demand for nursing home care. CARDI and the ESRI’s projections come as the capacity of public sector long-term residential care is being continually and significantly reduced, further underlining the importance of NHI’s call to develop a long-term strategy. Private and voluntary nursing homes have the willingness and expertise to meet the significant challenges that will be presented in meeting our ageing population’s care requirements but must this be supported by policy to meet the care requirements of this generation and those succeeding them. A failure to act now will leave Irish society with a crisis in the coming years, as the sector may not have the capacity to meet the significant demands that will be placed upon it.” Mr Daly added: “The forthcoming review of the Nursing Home Support Scheme (Fair Deal) presents an opportunity to ensure the model of funding for long term care provides a sustainable basis for the delivery of quality care and also allows for on-going investment in future development by the private and voluntary sector.” NHI particularly welcomed the reports recommendation that “Further research is required into the exact costs of long-term care for older people and how the extra demand for care can be catered for in the most effective way”. The CARDI report underlines the critical role nursing homes will continue to play in meeting the healthcare requirements of our population, stating: “there will be a large increase in demand for long-term care by people aged 65+ even if rates of disability and rates of utilisation of care decline; the impact of these factors will be greatly outweighed by the very substantial rise in older population, especially those aged 85 and older”. It adds: “Even with greater emphasis on care at home and more resources provided to realise it, the demand for residential care is going to increase significantly in the next decade”. Funding for long-term care in Ireland also warns of “considerable unmet need” in the delivery of care, advising 14% of older people with limiting disabilities living in the community were receiving no care (8,020 people) in 2006. The warnings of CARDI echo those of the ESRI, which has projected a further 13,324 long-term care places will be required to meet demand up to 2021.
RESEARCH TEAM The lead author of the report was Dr Maev-Ann Wren, Trinity College Dublin. The project leader was Professor Charles Normand, Trinity College Dublin, and the main partner in Northern Ireland was Dr Dermot O'Reilly, Queen’s University Belfast. Other research team members were Dr Sharon Mary Cruise, QUB; Dr Sheelah Connolly, NUI Galway; and Dr Catriona Murphy, TCD.
NHI NEWS — 14
HSE SERVICE PLAN 2013
NHI critical of projected cut in numbers supported by Fair Deal for 2013 The HSE Service Plan 2013 signals further cuts in the numbers that will be supported by the Nursing Home Support Scheme (Fair Deal). It is in stark contrast to the projected numbers the HSE assessed at the start of 2012 that would be supported by Fair Deal for that year ahead. Subsequent to this, the HSE diverted funding originally allocated to the Fair Deal subhead and signalled 630 fewer persons would be supported by the scheme as a consequence of this action. The assessment in the HSE Service Plan 2013 is numbers supported by Fair Deal will be reduced further this year. The HSE assessment in the Service Plan 2013 is 22,761 persons will be supported by Fair Deal in the year ahead. This is in stark contrast with its assessment in the Service Plan 2012, which signalled 23,611 persons would be Fair Deal supported, though the subsequent revision reduced projected numbers to 23,061 persons. Contrasting the HSE’s projections, the 2013 assessment in the Service Plan is 850 fewer by comparison with that originally projected in the 2012 plan and 300 fewer by comparison with the revised assessment. The HSE Performance Report December 2012 reports the numbers supported by Fair Deal in 2012 fell short of the revised numbers the HSE projected to support by the end of the year. Some 22,871 persons were Fair Deal approved at year end 2012 and the 2013 assessment is 110 short of this number. The figures above signify continued reduction in the capability of Fair Deal to support persons requiring nursing home care. Requirement for such care continues to grow and recently published research by the Centre for Ageing Research and Development in Ireland (CARDI), projects demand for such care will rise by 12,270 (59%) from 2006 to 2021, warning even with greater emphasis on care at home and
more resources provided to realise it, demand for nursing home care will “increase significantly” in the next decade. Within the Service Plan, the HSE expresses concern re the capacity of Fair Deal to meet demand in the year ahead. It identifies “the impact of potential insufficient capacity of the NHSS [Nursing Home Support Scheme – Fair Deal]” as a risk to the delivery of the Service Plan. It states there will be challenges in responding to the need for long-term residential care and anticipates a placement list will be in operation and new places offered under the Fair Deal as funding becomes available in line with legislation. NHI is concerned people awaiting Fair Deal will have to wait for a bed to become vacant before they are accepted for the scheme. Speaking upon publication of the Service Plan, Tadhg Daly, NHI CEO stated: “This (HSE Service Plan 2013) will inevitably have a significant impact upon the numbers of older persons awaiting the support of Fair Deal for nursing home care. Indeed, the Service Plan is projecting a waiting list for persons seeking to avail of Fair Deal support. Fair Deal was designed to ensure nursing home care is “accessible, affordable and anxiety-free”, but today’s Service Plan negates against the core principles of the scheme. The HSE Service Plan 2013 will have a significant affect upon older persons and is likely to cause many distress, angst and worry. It will also have a detrimental impact upon the overall delivery of health services as those requiring the specialist care of nursing homes may be required to have their care requirements met in inappropriate settings such as acute hospitals.”
HSE Service Plan 2013 (Nursing Home care) at a glance j
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In respect of the Nursing Home Support j The service plan includes a projected Scheme the HSE assessment is 22,761 €6m of additional income to be persons will be supported by NHSS generated through the proposed increase (Fair Deal) by year end 2013. in asset contributions under Fair Deal (from 5% - 7.5% & from 15% to 22.5%). Fair Deal budget for 2013 is €997m. j It projects €1m being raised in 2013 Fair Deal Budget 2013 increased from through co-payment for respite care, a 2012 level of €994m to €998m (+0.4%) new proposal, but detail in respect of yet significant reduction in targeted this is not included. numbers expected to be supported j The service plan commits that “provision under the scheme. of intermediate care options and the Unlike the 2012 plan, there is no provision of clear pathways of care for reference to proposed public bed older persons accessing the health care closures. systems will continue to be developed in The plan states: “The HSE recognises 2013, with specific emphasis that in the absence of the allocation of on the provision of transitional / additional funding for the NHSS in Tadhg Daly, NHI CEO: intermediate type care to address the 2013, that there will be challenges in “The HSE Service Plan 2013 will issue of unnecessary admissions to responding to the need for residential have a significant affect upon older acute hospitals and the requirements for care and it is anticipated that a persons and is likely to cause long stay care. This will build on the placement list will be in operation and many distress, angst and worry.” work commenced in 2012 which saw an new places offered under the NHSS as investment of €11m in these types funding becomes available in line with of services”. the legislation.” j There is no specific budget identified in the service plan In respect of potential risks to delivery of the 2013 National for intermediate care. The budget allocation the amount Service Plan the plan highlights 11 potential risks, including for Older Persons Services (exc NHSS; Fair Deal) is the “impact of potential insufficient capacity of the NHSS”. reduced by 2.6% from €403m in 2012 to a budget of €392m in 2013.
15 — NHI NEWS
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NHI ANNUAL CONFERENCE 2012
ANNUAL CONFERENCE HIGHLIGHTS CRITICAL ROLE OF NURSING HOMES IN COMMUNITY CARE Nursing Homes: The Heart of Community Care the NHI Annual Conference 2012, proved to be an excellent success. Over 350 delegates listened to an excellent line-up of speakers in Citywest Hotel, Co Dublin, on 15th November discuss:
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Our requirement as a society to meet significant growth in demand for long-term residential care; Challenges faced by private and voluntary nursing homes in care delivery and meeting increased demand; The private and voluntary nursing home sector and the critical role it is playing in healthcare delivery; Challenges posed in meeting ongoing regulatory requirements; HIQA registration and renewal; Creating nursing homes as places to flourish and nursing homes roles in enabling residents to flourish in life.
The conference was chaired by broadcaster and historian John Bowman and speakers and their presentations included:
j Emily O’Reilly, Ombudsman: “Who Cares?” An Investigation into the Right to Nursing Home Care in Ireland and the NHSS (Fair Deal) j Dougie Beaton, HSE Health Intelligence Team: SAT (Single Assessment Tool) Pilot Report Niall Byrne, Deputy Director Social Services HIQA: First cycle of Independent Registration and Inspection Moore McDowell, Economist & Managing Director ECU Ltd, Market Analysis of the Irish Nursing Home Sector Professor Brendan McCormack, Professor of Nursing Research and Practice Development in the Institute of Nursing Research, University of Ulster: Creating Places to Flourish: A National Agenda for Residential Care In Ireland j Dr.Maureen Gaffney, Adjunct Professor of Psychology and Society, UCD: Learning to Flourish and Helping Others to Flourish Members can access the conference presentations via the Members section of the NHI website, www.nhi.ie
NHI Chairman Owen McGartoll addressed delegates.
NHI Chairman Owen McGartoll, Ombudsman Emily O’Reilly and NHI CEO Tadhg Daly in discussion
Conference chair John Bowman
19 — NHI NEWS
Dougie Beaton, HSE Intelligence Team, discusses the SAT Pilot Report
Significant implications if Fair Deal fails to move beyond short-term budgetary concerns: Moore McDowell overnment failure to ensure the Fair Deal scheme moves beyond its short-term budgetary concerns will have significant knock-on effect for Ireland’s healthcare services and Irish society, leading Economist Moore McDowell has warned. Speaking at the NHI Annual Conference, Mr McDowell advised the forthcoming review of Fair Deal must remove the current framework of price capping to ensure the private and voluntary nursing home sector can address the significant growth in demand for long-term residential care. Failure to do so will have very serious implications for acute hospital services and our wider health sector, he warned. Mr McDowell is currently undertaking an NHI commissioned study on the economic and policy environment for the nursing home sector. The study aims to provide the most comprehensive analysis ever undertaken of the sector. Speaking before his presentation, Mr McDowell warned of the consequences for Irish society of persisting with the present framework. “The nursing home sector is critical to a well-functioning health service. If the sector is not enabled to meet the huge growth in demand in the years ahead, this will have a serious impact upon our acute hospital services and health system. Persisting with the current framework will lead to large numbers relying upon acute hospital services to meet their care requirements and unable to access the specialist healthcare nursing homes provide in community settings throughout Ireland.” He stated: “We know that demand for long term care will rise dramatically over the next 10-15 years. The State has signaled its intent to reduce its provision and we know therefore that the required increased supply can only come from an expanded private and voluntary sector. “What is required for a market driven response to an environment that is undergoing significant change? The forthcoming review of the Fair Deal presents an opportunity to address the considerable challenges of increasing the capacity in the nursing home sector to meet the significant growth in demand. At present Fair Deal reflects a
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preoccupation with short term budgetary concerns rather than efficient operations of the long-term care market and negates against nursing homes increasing capacity to meet significant growing demand for long-term residential care,” he added. “The ability of the private and voluntary nursing home sector to finance development is the key to meeting increased growth in demand for long-term residential care. The current Fair Deal structure, designed to ensure equitable access to care, must be changed. I would recommend that, in tandem with the issue of the overall structure of payment for long-term care, the current framework of price capping must go.” “The market has two components: price setting through the NTPF negotiation of maximum fees and setting service quality standards, through HIQA’s inspection of the sector. These operate independently and are incompatible with an efficient market solution to the supply problem. Price setting, fixing and capping is not compatible with a market driven supply response to demand changes and is not necessary in a competitive market. The present framework for supporting the provision of long-term residential care is dysfunctional and the financial squeeze being brought to bear upon the private and voluntary nursing home sector is not sustainable. The principle of co-payment, already accepted, will have to become an instrument of finance rather than a matter of equity.”
Delegates listen intently at Nursing Homes: The Heart of Community Care
NHI NEWS — 20
NHI ANNUAL CONFERENCE 2012
OMBUDSMAN EMPHASISES IMPORTANCE OF COMPLAINTS SERVICE Owners, managers and staff of nursing homes can, on a day-to-day basis, demonstrate their respect for the dignity and wellbeing of all residents by ensuring they provide a “very real, very honest, very responsive complaint handling and advocacy service”. That is the view of Ombudsman Emily O’Reilly, who spoke at Nursing Homes: The Heart of Community Care, the NHI Annual Conference. Ms O’Reilly said providing such a service must encourage real engagement, real feedback, real listening and real change in service improvement as a result of complaints. Advising of the Ombudsman Amendment Act, which brought HIQA and the NTPF under the remit of the Office of the Ombudsman, Ms O’Reilly said the legislation affords the Minister for Public and Expenditure and Reform the authority to, by order, place services in receipt of significant public funding – even private agencies – under her office’s remit. “I hope shortly to know whether private nursing home residents, funded under the Nursing Home Support Scheme, will be enabled to complain to my office, but whether they will be able to or not, one thing is certain,” she stated. “A good complaint handling system at local level is not just a requirement of HIQA standards, it not only makes good sense for the proper governance of any nursing home, but it also demonstrates a respect for the rights of residents, a commitment to hearing residents views, to respecting their experiences and making every effort to ensure their wellbeing and happiness.” With regards to the Nursing Home Support Scheme (Fair Deal), Ms O’Reilly said the most common areas for complaint are with regard to the financial assessment and the exclusion of certain services from the basic package. “My Office made a submission to the NHSS
TOP TEN COMPLAINTS
review and highlighted our concerns regarding the insufficiency of the basic bed and board package, the possible inadequacy of the scheme for persons under 65, particularly those with acquired brain injuries and other serious disabilities, and the need to look more comprehensively at other alternatives to residential care,” she stated. The growth of the private nursing home sector brings responsibility with it, delegates were advised. She said the State has devolved responsibility to provide care to the vast majority of people in need of long term care to private nursing homes and it is an onerous one, and rightly so. “That onerous responsibility relates not only to the care of residents, but also to the creation of an ethos in a profit making sector that truly commits to the holistic and ethical care of citizens, that respects older people’s past and present contribution to society, and that commits to addressing the diverse and sometimes challenging needs of all residents,” she said. Ms O’Reilly welcomed NHI’s stated commitment to ensure that the lives of older people in member homes are enhanced and fulfilled and that residents are provided with the highest quality care and services. She acknowledged NHI’s stated goal of ensuring that everyone who chooses a nursing home for the next step in their lives experiences a safe, happy, caring and fulfilling environment. “I would urge you to show leadership in this sector, to live to those fine commitments, not just laminate them, and to seek out innovative ways on putting them into practice,” she stated. “It is not enough to get out the HIQA checklist and work your way through it; creating a home environment for people reaching the end of their lives demands far more than that and you have a moral duty, in my view, to continue to strive to achieve it.”
Ms O’Reilly advised of the top ten complaints to her office with regard to the provision of health or social care: m Poor verbal communication m Poor record keeping m Deficits in care and attention m Rude or inappropriate behaviour m Failure to ensure dignity and privacy for people who are dying m Poor admission or discharge planning m Poor needs assessment m Poor hygiene practices m Inconsistent and inequitable decision making m Poor complaints handling With regards to the Nursing Home Support Scheme (Fair Deal), Ms O’Reilly said the most common areas for complaint are with regard to the financial assessment and the exclusion of certain services from the basic package.
21 — NHI NEWS
ƐƐĞƐƐŵĞŶƚƐ ĂŶĚ DĞĚŝĐĂƚŝŽŶ ŝŶ ,/Y ͛Ɛ ^ƉŽƚůŝŐŚƚ ƐƐĞƐƐŵĞŶƚƐ ĂŶĚ DĞĚŝĐĂƚŝŽŶ ŝŶ ,/Y ͛Ɛ ^ƉŽƚůŝŐŚƚ Health Health CareCare Informed Informed (HCI)(HCI) has has compiled compiled a report a report on HIQA on HIQA findings findings fromfrom a sample a sample of ten of ten Nursing Nursing Homes Homes inspected inspected during during the the last last quarter quarter of 2012. of 2012. The The key key areas areas of non-compliance of non-compliance continue continue to be torisk be risk management, management, insufficient insufficient policies policies and and procedures procedures and and assessment assessment and and carecare planning. planning. The The HCI HCI report report was was completed completed against against the the six core six core domains domains of the of the Health Health Act,Act, 2007; 2007; Governance, Governance, Quality Quality of of Service, Service, Health Health and and CareCare Needs, Needs, Premises, Premises, Communication Communication and and Staffing. Staffing. The The following following provides provides a summary a summary of findings of findings in relation in relation to the to the Health Health and and CareCare Needs Needs presenting presenting apprehensions apprehensions in Assessment in Assessment and and CareCare Planning, Planning, and and Ordering, Ordering, Prescribing, Prescribing, Storing Storing and and Administration Administration of Medicines. of Medicines. Assessment Assessment and and CareCare Planning Planning raised raised concerns concerns in six in of sixthe of the ten ten centres; centres; fourfour displayed displayed insufficient insufficient or no or no consultation consultation withwith residentƐ͛ residentƐ͛ and and theirtheir relatives/representatives, relatives/representatives, and and no understanding no understanding or agreement or agreement of the of the implementation implementation of care of care plans. plans. &ŝǀĞ ŽĨ ƚŚĞ ĐĞŶƚƌĞƐ ůĂĐŬĞĚ ŝŶĐŽƌƉŽƌĂƚŝŽŶ ŽĨ ƚŚĞ ƌĞƐŝĚĞŶƚƐ͛ ĂƐƐĞƐƐŵĞŶƚƐ ŽĨ ŶĞĞĚƐ &ŝǀĞ ŽĨ ƚŚĞ ĐĞŶƚƌĞƐ ůĂĐŬĞĚ ŝŶĐŽƌƉŽƌĂƚŝŽŶ ŽĨ ƚŚĞ ƌĞƐŝĚĞŶƚƐ͛ ĂƐƐĞƐƐŵĞŶƚƐ ŽĨ ŶĞĞĚƐ to inform to inform carecare planning; planning; in one in one centre centre this this was was specific specific to nutrition to nutrition and and wound wound care.care. Other Other indications indications thatthat exposed exposed unsatisfactory unsatisfactory application application of care of care plans plans consisted consisted of the of following: the following: x Resident x Resident assessments assessments onlyonly indicated indicated the month the month for review for review x One x One centre centre had had wound wound carecare and and challenging challenging behaviour behaviour policies policies in place in place but but not not usedused by staff by staff in the in the centre centre x Care x Care plans plans werewere not not in place in place for all forresidents all residents assessed assessed needs needs these these included included challenging challenging behaviour behaviour and and management management of falls. of falls. Non-compliance Non-compliance on Ordering, on Ordering, Prescribing, Prescribing, Storing Storing and and Administration Administration of Medicines of Medicines was was displayed displayed in six in six centres, centres, fourfour of which of which has has policies policies and and procedures procedures thatthat required required further further developments. developments. FourFour centres centres had had inappropriate inappropriate storage storage and and administration administration processes processes in accordance in accordance to best to best practice, practice, one one of which of which involved involved medication medication administration administration times times not not being being adhered adhered to. to. Medication Medication errors errors and and recording recording of verbal of verbal prescriptions prescriptions was was not not correctly correctly implemented implemented in three in three of the of ten the ten centres. centres. Findings Findings on medication on medication management management thatthat occurred occurred in centres in centres were: were: x Records x Records of drugs of drugs prescribed, prescribed, signed signed and and dated dated by the by GP thewere GP were not not maintained maintained x The x The maximum maximum amount amount of PRN of PRN (as required (as required medications) medications) to be toadministered be administered within within a 24ahour 24 hour period period was was not not stated stated x The x The space space to record to record when when a medication a medication was was refused refused on the on the administration administration sheet sheet was was limited limited and and not not clearly clearly legible legible in a in sample a sample reviewed reviewed by the by HIQA the HIQA Inspector. Inspector. The The HCI HCI report report highlights highlights the the continuing continuing trends trends in HIQA in HIQA findings findings in relation in relation to the to the Nursing Nursing Homes Homes meeting meeting the the Health Health Act and Act and HIQA HIQA standards. standards. The The centres centres exhibited exhibited vastvast improvements improvements in areas in areas suchsuch as fire as safety, fire safety, foodfood and and nutrition, nutrition, and and maintenance maintenance of resident of resident records. records. However However theythey continue continue to struggle to struggle in crucial in crucial areas areas suchsuch as risk as risk management management and and assessment assessment carecare planning. planning. For aFor fulla copy full copy of the of report the report or information or information on Care on Care Planning Planning Services Services contact contact Health Health CareCare Informed Informed (HCI)(HCI) on 093 on 093 36126 36126 or email or email info@healthcareinformed.com info@healthcareinformed.com
NCPOP REPORT
Pictured at the launch of the report in UCD are, from left, Dr. Amanda Phelan, Co-Director; Professor Gerard Fealy, Director NCPOP; Dr. Jonathan Drennan, UCD; Patricia Hall, NCPOP at UCD; Professor Pearl Treacy, Emeritus Professor, NCPOP; Dr. Attracta Lafferty, Associate Director, NCPOP
Report recommends development of strategies to prevent and identify abuse and neglect of older persons. The National Centre for the Protection of Older People (NCPOP) at University College Dublin is a national research centre funded by the HSE for the study of elder abuse and neglect and related aspects. In December 2012, the Centre launched the report of a major national survey on staff-resident interactions and conflicts in residential care settings for older people. Dr Attracta Lafferty, Centre Director (Associate) at NCPOP, outlines the main findings emanating from the survey.
L
ed by Dr Jonathan Drennan, the aim of the study was to measure the extent to which staff working in residential care homes experienced conflict with residents, observed conflict or themselves engaged in neglectful or abusive behaviours towards residents. A total of 1,316 registered nurses and healthcare assistants working in 64 public, private and voluntary nursing homes from across Ireland participated in the survey. Although findings indicated that the vast majority of older people in receipt of care in the residential sector in Ireland are cared for in high quality, safe and supportive settings, staff reported that they had both observed and had perpetrated acts of neglect and abuse. Approximately 57% of staff reported that they had observed one or more neglectful acts and 27% reported that they had engaged in at least one neglectful act within the preceding year. In addition, approximately 12% of staff reported
25 — NHI NEWS
that they had observed another member of staff physically abuse a resident in the preceding year, such as restraining a resident beyond what was needed or pushing, grabbing, shoving or pinching a resident. Approximately 3% of staff reported that they themselves had committed one or more acts of physical abuse on a resident. The study also found that approximately a quarter of respondents (27%) had observed another member of staff psychologically abuse a resident, which included shouting at a resident in anger, insulting or swearing at a resident and isolating a resident beyond what was required. Approximately 8% of staff reported that they themselves had engaged in psychological abuse, with shouting at a resident in anger being the most frequentlyreported behaviour. A very small minority of staff reported that they had observed or perpetrated financial abuse (take valuables or
property from a resident) or sexual abuse (engage in inappropriate sexual behaviour). The study also highlighted that the majority of respondents (91.8%) had experienced some form of abuse from residents in their care. A substantial majority (85%) of staff reported that they had experienced physical abuse from a resident in their care, including being slapped or hit, pushed, grabbed, shoved, pinched and/or kicked or hit with a fist, in the preceding year. The vast majority of staff (88.6%) reported that they had been insulted or sworn at by a resident or were shouted at by a resident in anger in the preceding year. Approximately a quarter of the respondents reported that they had experienced some form of inappropriate sexual behaviour by a resident. A number of factors were found to be associated with the risk of neglect and abusive behaviours. These included low levels of job satisfaction, staff experiencing emotional exhaustion and burnout, poor staff commitment to their organisation and experiences of stress in the organisation. The psychological and physical well-being of staff were other factors associated with the physical and psychological abuse of older people in residential care. In comparison to international research into staff-resident interactions and conflicts, this study found that the extent of staff-reported abuse in residential care settings in Ireland was lower than that reported in other countries. The report acknowledges that staff in the residential care sector are working in physically and psychologically demanding jobs, and while a number of initiatives and safeguards have been put in place to protect older people receiving care in the residential sector, there is evidence that older people do experience neglect and various forms of abuse. Therefore, there is a need to intensify efforts to protect older people through approaches such as giving older people receiving care a voice in relation to their care, educating staff and relatives about abuse and the consequences of abuse, and providing supports for staff working with older people. At a national level all agencies that have an interest in the protection of older people should continue to be involved in the further development of strategies that both prevent and identify the abuse and neglect of older people receiving residential care.
Full details of the study fi fin ndings can be found at: http://www.ncpop.ie/ncpopresearch and hard copies of the report are available by emailing ncpop@ucd.ie or calling (01) 716 6467.
NHI issued the following statement to co-incide with publication of the report: Nursing Homes Ireland today, December 6th, acknowledged publication of the report by the National Centre for the Protection of Older People (NCPOP) entitled Older People in Residential Care Settings: Results of a National Survey of Staff-Resident Interactions and Conflicts. Private and voluntary nursing homes played a lead role in informing this research. This report will contribute to the ongoing development and learning within the nursing home sector that is committed to best practice in the delivery of care for residents in nursing homes. In the context of the debate surrounding Older People in Residential Care Settings: Results of a National Survey of Staff-Resident Interactions and Conflicts, it is important to note the report states the prevalence of mistreatment of older people in the Irish nursing home sector was “substantially lower” than that reported internationally. The report states “the vast majority of older people are cared for in high quality environments,” and such behaviour, while completely unacceptable, was “on a limited scale”. “Elder abuse is utterly unacceptable in all settings and this report highlights the reported rates in Irish nursing homes were substantially lower by comparison internationally,” stated Tadhg Daly, NHI CEO. “Stakeholders responsible for the care and protection of older persons and wider Irish society must continually address the issue of elder abuse and insure the protection of older people in all settings. NHI Members have already implemented many of the recommendations within the report, which is likely to explain the comparatively low incidence of levels of abuse in Irish nursing homes by comparison internationally. Specifically the report states NHI and organisations such as the HSE, HIQA, social and health professionals, and advocacy bodies must engage for the protection of older people. This is already happening.” NHI and our members are committed to maintaining a safe physical and emotional environment for all residents in nursing home care. A number of the report’s recommendations to reduce and prevent the occurrence of mistreatment in residential settings in Ireland are already in practice in nursing homes. The recommendations already in place include: the implementation and adoption of HSE policies in relation to elder abuse, targeted education for health professionals working in the nursing home sector, resident councils to encourage residents and their relatives to discuss issues and concerns. The report states the vast majority of respondents (82.3%) had received training in the area of elder abuse, and states education and training is central to the recognition and prevention of the neglect and abuse of older people. The report in particular describes the Third Age National Advocacy Programme as “a welcome initiative that provides older people in residential care settings with a voice in their care.” NHI is a partner organisation of this initiative, part-funds this programme, provides representation to its steering committee, and supports its ongoing development and growth nationally. Older People in Residential Care Settings: Results of a National Survey of StaffResident Interactions and Conflicts states: “The regulation of the nursing home sector through HIQA, and the power invested in the authority through legislation, has changed the landscape in terms of the quality and standards of care in the nursing home sector.” NHI has worked closely with HIQA since its inception in the development and implementation of the national quality standards and continues to engage with the independent authority to enhance the inspection process and ensure that regulation and inspection continually improves the quality of care and life of residents in nursing homes. HIQA is the independent Authority that inspects all Irish nursing homes. The nursing home sector is subject to robust regulation and inspection and is the most heavily regulated health sector. HIQA implements comprehensive national standards, National Quality Standards for Residential Care Settings for Older People in Ireland, that are designed to protect the rights and ensure the provision of high quality care for persons in nursing homes. Older People in Residential Care Settings: Results of a National Survey of Staff-Resident Interactions and Conflicts acknowledges staff working in the residential care sector are in physically and psychologically demanding jobs. It also reports of pressures brought to bear upon staff in nursing homes as a result of mistreatment of staff by residents, stating 73% of staff suffered physical mistreatment, 80% of staff had been sworn at or insulted by a resident in anger in the preceding 12 months, and 88.6% of staff respondents had experienced one or more forms of psychological abuse in the preceding year. The report confirms neglect and abuse in such settings occurs on a limited scale. NHI states it is critical we recognise the vast majority of staff in nursing homes are unwaivering in their dedication and commitment in providing high-quality, professional care to residents in Irish nursing homes. It acknowledges staff working in nursing homes are in physically and psychologically demanding jobs. “The report acknowledges that working in nursing homes is physically and psychologically demanding but states the vast majority of staff reported being satisfied with their job (93.7%),” Mr Daly stated. “The report states: ‘The vast majority of healthcare assistants provide high quality care to their patients (Foner 1994) and, as identified in this study, hold positive attitudes towards older people.”
NHI NEWS — 26
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NHI Care Awards 2012
NHI Gala Night Celebrates Excellence in Care ursing Homes across the country celebrated Excellence in Care at the third annual NHI Care Awards in association with Homecare Medical Supplies, which took place in Citywest Hotel on Thursday November 15th. At the prestigious awards ceremony, 28 finalists went forward for eight award categories that incorporated excellence in nursing, care, social and recreational programmes, catering and nutrition, ancillary work, community initiative and innovation. Merrial Davis, a resident of Glendale Nursing Home, Tullow, Co Carlow, was honoured with the Nursing Home Resident Achievement Award.
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Over 300 nominations were received for the nine award categories from communities across Ireland. RTE presenter Marty Whelan was once again event MC and the awards brought great glamour and celebration to Citywest Hotel. Representatives from health and older person services and support organisations were among the 400+ attending the awards. Nursing Homes Ireland wants to take this opportunity to thank all the sponsors of the NHI Care Awards 2012 and we encourage members to embrace the NHI Care Awards 2013! Visit www.nhicareawards.ie for gallery of images
The NHI Care Award Winners 2012: Back row, from left: Deborrah Lynch, Brían McNamara, Geraldine Clinton, Paul McCoy, Sandra De Brú. Front row, from left: Terry Tiernan, Pat Finnegan, Frances Neilan (Carrigoran House), Prof Brendan McCormack (Judging Panel Chair), Marty Whelan (Event MC), Merrial Davis, Tadhg Daly (NHI CEO).
29 — NHI NEWS
NHI Care Award Winners 2012 Pictured with the winners are event MC Marty Whelan and Tadhg Daly, NHI CEO (left), and Prof Brendan McCormack, Chair of NHI Care Awards 2012 Judging Panel.
NURSING HOME DIRECTOR OF NURSING/PERSON IN CHARGE AWARD
NURSING HOME REGISTERED NURSE OF THE YEAR AWARD
NURSING HOME CARER OF THE YEAR AWARD
Sponsored by Ecclesiastical Insurance
Sponsored by Epic Solutions
WINNER: Brían McNamara
WINNER: Geraldine Clinton
Greenpark Nursing Home, Tuam, Co. Galway
Moorehall Lodge, Ardee, Co. Louth
Annabeg Nursing Home, Ballybrack, Co. Dublin
FINALISTS: Karen Lordan Haven Bay Care Centre, Kinsale, Co. Cork
FINALISTS: Ann Cahill Castlemanor, Drumalee, Co. Cavan
Yvonne Carpenter, St Mary’s Residential Care Centre, Shantall Road, Co. Galway
Caroline O’Reilly Innis Ree Lodge Nursing Home, Lanesborough, Co. Roscommon
Tano Dorag Annabeg Nursing Home, Ballybrack, Co. Dublin
NURSING HOME SOCIAL & RECREATIONAL PROGRAMME AWARD
NURSING HOME CATERING & NUTRITION AWARD
NURSING HOME ANCILLARY WORKER AWARD
Sponsored by Fresenius Kabi
Sponsored by Euron
Sponsored by AON & RSA
WINNER: Terry Tiernan
WINNER: Pat Finnegan
WINNER: Sandra DeBrú
Ashford House, Dun Laoghaire, Co. Dublin
Castleross, Carrickmacross, Co. Monaghan
FINALISTS: Jackie Flynn Lakes Nursing Home, Killaloe, Co. Clare
FINALISTS: Janice McNamee Beechtree Nursing Home, Oldtown, Co. Dublin
FINALISTS: Johnny Kelly Portumna Retirement Village, Portumna, Co. Galway
Carmel O’Flaherty Kilrush Nursing Home, Kilrush, Co. Clareway
Donka Nusheva Annabeg Nursing Home, Ballybrack, Co. Dublin
Naoimh McMahon Haven Bay Care Centre, Kinsale, Co Cork
NURSING HOME COMMUNITY INITIATIVE AWARD
NURSING HOME INNOVATION AWARD
NURSING HOME RESIDENT ACHIEVEMENT AWARD
Sponsored by Bank of Ireland
Sponsored by BDO
Sponsored by CPL Healthcare
WINNER: Carrigoran House
WINNER: Paul McCoy
WINNER: Merrial Davis
Co. Clare
Castleross, Carrickmacross, Co. Monaghan
Glendale Nursing Home, Tullow, Co. Carlow
FINALISTS: Deirdre Mullins Haven Bay Care Centre, Kinsale, Co. Cork
FINALISTS: Liam Deeney Brentwood Manor, Convoy, Co. Donegal
Tony Williams, Portumna Retirement Village, Portumna, Co. Galway
Viktoria Ptak / Szymon Fijalkowski, Newpark Care Centre, The Ward, Co. Dublin
Sponsored by Homecare Medical Supplies
WINNER: Deborrah Lynch Hamilton Park Care Facility, Co. Dublin
FINALISTS: Sinead Beirne
Glendale Nursing Home, Tullow, Co. Carlow
NHI NEWS — 30
BEST PRACTICE
Care Centre a Haven for Community A County Cork Care Centre has led the way in turning its local community into a Positive Ageing Town.
T
he importance of community cannot be forgotten, particularly when persons move from their own homes into a nursing home. Residents begin a new chapter in their lives and at Haven Bay Care Centre, Kinsale, Co. Cork we strive to ensure that they feel as involved in their local community as much as possible. Their involvement with the community has been acknowledged by a myriad of groups and individuals and has culminated in Haven Bay Care Centre being awarded the Nursing Home Ireland Community Initiative Award in 2011. Interaction with all members of the community, both young and old, is actively encouraged.
Positive Ageing Town Haven Bay spearheaded the campaign for Kinsale to become a Positive Ageing Town. This began as part of our involvement in Age Action Ireland’s Positive Ageing Week 2010, during which they hosted a coffee morning, inviting its local active retired group into the home. This spurred on interest and by the following year after a committee was established to work towards the goal of Kinsale becoming a Positive Ageing Town. The committee was chaired by Deirdre Mullins, Activities Coordinator at Haven Bay. It compiled an extensive week of events for Positive Ageing Week 2011. Events featured included history talks, tea dances and a school art competition. The week was an unrivalled success and would not have been possible without the support and involvement of the staff and residents of Haven Bay and their interaction with the entire community. Kinsale achieved its goal and was named a Positive Ageing Town in 2011. Positive Ageing Week 2012 proved even more eventful in Kinsale. It commenced with a Garden Party Launch at Haven Bay, opened by Paralympic Sailor John Twomey and Junior Minister Kathleen Lynch. Events included, but were not confined to: a movie afternoon, organised by the students of Kinsale Community School; a table quiz, an intergenerational Mass, an historic talking tour of Kinsale with local historian Dermot Ryan, followed by refreshments for all, a visit to the 17th Century Charles Fort, an art competition, and a pamper morning.
31 — NHI NEWS
Haven Bay residents participated in a huge array of events both at the Care Centre and in the community. The events brought the community together and they supported the week through generosity of time and volunteering, monetary sponsorship and sponsorship in kind.
Adopt A Granny Haven Bay initiated our Adopt a Granny Scheme over two years ago. Activities Co-ordinator Deirdre Mullins visited all the local primary schools in the area, where she explained the importance of nurturing relationships between older and younger generations. Many of the pupils live a distance from their grandparents and likewise some of Haven Bay’s residents do not have grandchildren living in the area. “We have found that children are delighted to be involved in this scheme and have forged wonderful friendships with their ‘adopted granny or granddad’,” Ms Mullins explains. “They visit on a weekly basis and this intergenerational relationship has been of huge benefit both to the students and to our residents. In addition, the transition year students of our immediate next door neighbour, Kinsale Community School, have incorporated a weekly visit to our residents as part of their social and community modules.” Highlights of 2012 included a garden party, dancing and singing performances. The school’s Spanish students love conversing in Spanish with one Haven Bay resident, a former Missionary in South America. Ms Mullins spoke at the school’s graduation ceremony, where she informed the attendees of the importance of intergenerational relationships and community involvement. This further highlighted to parents and teachers alike the value of interaction between generations. Haven Bay actively welcomes students to carry out their work experience within the Centre and the students carry out duties in assisting with the activities programme and care of the Centre’s community garden. The garden acts as a focal point within the centre, hosting garden parties, and bringing together groups such as the transition year students and the Kinsale Active Retired Association.
Network Haven Bay has developed a network with local groups and societies and they are frequent visitors to the Care Centre. For
example, Kinsale Community Singers perform for residents throughout the year, and the local Guides, Brownies and Ladybirds have also become involved in its life. Kinsale Active Retired Association often attends events such as Cookery and Floral Demonstrations in the home. “Volunteers provide contact with the local community and enhance the quality of life of our residents through chat, or a walk, or through a visit from Sadie, our Pet Therapy Dog,” Miss Mulluns explaines. Locals helping out in the Centre sometimes read a book/newspaper for a resident or help them play Bingo, resulting in a feel good factor all round.
Charity Offerings In 2011, Kinsale Lions Club were thrilled when Haven Bay presented them with a cheque for €2,221, the proceeds of the Care Centre’s first ever Sale of Work. Preparing for the sale, residents were beavering away, making cards and flower arrangements. This work combined with donations from relatives and friends, brought about a very successful fundraiser that enjoyed tremendous support from the local community. Haven Bay recently held its second fundraising sale of work and again this was a huge success. The proceeds of €2,109 were donated to Kinsale Youth Support Services. Both local organisations were thrilled and very moved by the involvement and dedication of Haven Bay’s residents in their preparation and participation in each sale of work. The community at large have huge admiration for the altruistic spirit displayed by Haven Bay’s residents and staff. Haven Bay is now busily preparing for the Kinsale St. Patricks Day Parade - its second year in attendance. Haven Bay’s entry last year was called ‘Vintage not Old’ and residents were bedecked in green, carrying flags and banners. The Care Centre had a bus carrying 28 residents and their relatives and
Clockwise from left: ...
Sadie, a pet therapy dog, takes centre stage in Haven Bay and is pictured with, from left: Margaret Daly, resident; Sally Thelon, Pet Therapy Association volunteer; Mary Healy, resident. Representatives of Haven Bay Care Centre participating in the St Patrick’s Day 2012 Parade, Kinsale. Pictured on stage at the NHI Care Awards 2011 with the Community Initiative Award is Deirdre Mullins, Activities Co-ordinator Haven Bay Care Centre, with Marty Whelan, event MC.
leading the float was four residents in their wheelchairs acting as Grand Marshals. Staff handed out green shamrock cookies, much to the delight of the spectators. “The excitement of the Parade was second to none and the reaction of the community at large was amazing,” Ms Mullins states. “The general consensus was one of huge admiration for our residents and their contribution to the local community. Some of the most important qualities that are necessary for interacting and contributing to the local community are enthusiasm, energy and support, which we are delighted to have in abundance here at Haven Bay Care Centre. Our residents and staff feel that they are an integral part of community life here in Kinsale and in turn the community of Kinsale embrace our involvement with them.”
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 — 32
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