NHI Statement 11th December re Nursing Home Care


The allegations at the centre of the Prime Time Investigates programme broadcast Tuesday, 9th December, were unacceptable, shocking, and appalling. It is critical media are accurate in their reporting surrounding these very serious allegations. Áras Attracta is a HSE residential, respite and day service for adults with an intellectual disability and not a registered long-term residential care provider. Erroneous statements or references that associate the allegations with nursing home care can lead to unwarranted, unnecessary and  significant distress and upset being caused to nursing home residents, their families, and staff in nursing home care.


The nursing home sector is subject to robust independent regulation and inspection and is arguably the most heavily regulated element of the Irish health sector. In 2013 HIQA carried out 814 inspections of 565 centres, with the vast majority, 78%, being unannounced. There is strict legislative requirement for private and voluntary nursing homes in respect of management of complaints. The Care and Welfare of Residents in Designated Centres Regulations 2013 and National Quality Standards for Residential Care Settings for Older People stipulate clear and robust regulatory requirements for all nursing homes (public, private and voluntary) in respect of receipt and management of complaints. They stipulate the nursing home complaints procedure must be accessible, effective, and ensure all complaints are investigated promptly, fully and properly recorded. They also stipulate any resident who has made a complaint must not be adversely affected. The complaints procedures are structured, highlighted and provide for an open, transparent, non-discriminatory and strictly confidential procedure.


It is important to note HIQA provided the following clarification today, Thursday 11th December: “When HIQA receives primary complaints the procedure for dealing with those complaints is that they are passed to the relevant service provider to investigate through its own complaints procedure. It is on the basis of non-resolution of that complaint that it would be referred to the Ombudsman by the provider. It is not correct that there are 400 unanswered complaints. Recent comments have confused information we receive with complaints. In 2013 HIQA received 355 pieces of information in relation to nursing homes; this included unverified information as well as complaints. All of these were assessed carefully and all relevant information was acted on.”


In its Annual Overview Report on the Regulation of Designated Centres for Older People – 2013 (published May 2014), HIQA states: “The Authority’s approach to responsive regulation ensures that those providers who are persistently non-compliant with the [national] standards and regulations , and who place service users at risk of harm, are identified quickly and face proportionate and meaningful enforcement action.” HIQA Guidance for Designated Centres: The Inspection Process states: “In some instances an inspection will be required to focus on a single or specific issue. Single-issue inspections arise from a number of events including receipt of a complaint, concern or notification to HIQA of a significant event affecting the safety or wellbeing of residents. The inspection allows the inspector to focus (but not exclusively) on the area of concern indicated by the information the Authority has received. The type and frequency of inspection is based on knowledge of the centre, the provider’s history of compliance, whether information indicates that there is a risk to residents, and whether, in line with a proportionate, risk-based model of regulation, another monitoring intervention is more appropriate, such as a requirement for the provider to provide more detailed information or to carry out a provider-led investigation.”


Debate surrounding care provision standards should be conscious of  requirement for evidence-based cost of care models that support care providers and staff to meet the significant responsibly entrusted to them to provide complex and multidisciplinary care. This is a recommendation endorsed by the Oireachtas Health Committee.


Staff in the nursing home sector care deeply about the residents they care for and, as per the Regulations and National Standards, are subject to rigorous regulation and inspection that is undertaken independently by HIQA. NHI and our Members are committed to the highest standards of quality care delivery in a professional environment.


Note for the Editor

Extract from Health Act 2007 (Care and Welfare of Residents in Designated Centres for Older People) Regulations 2013.


Complaints procedure

34. (1) The registered provider shall provide an accessible and effective complaints

procedure which includes an appeals procedure, and shall—

(a) make each resident and their family aware of the complaints procedure

as soon as is practicable after the admission of the resident to

the designated centre concerned,

(b) display a copy of the complaints procedure in a prominent position in

the designated centre,

(c) nominate a person who is not involved in the matter the subject of the

complaint to deal with complaints,

(d) investigate all complaints promptly,

(e) assist a complainant to understand the complaints procedure,

(f) ensure that the nominated person maintains a record of all complaints

including details of any investigation into the complaint, the outcome

of the complaint and whether or not the resident was satisfied,

(g) inform the complainant promptly of the outcome of their complaint

and details of the appeals process,

(h) put in place any measures required for improvement in response to

a complaint.

(2) The registered provider shall ensure that all complaints and the results of

any investigations into the matters complained of and any actions taken on foot

of a complaint are fully and properly recorded and that such records shall be in

addition to and distinct from a resident’s individual care plan.

(3) The registered provider shall nominate a person, other than the person

nominated in paragraph (1)(c), to be available in a designated centre to ensure


(a) all complaints are appropriately responded to; and

(b) the person nominated under paragraph (1)(c) maintains the records

specified under in paragraph (1)(f).

(4) The registered provider shall ensure that any resident who has made a

complaint is not adversely affected by reason of the complaint having been



Michael McGlynn, NHI Communications & Research Officer, facilitates Media requests. He can be contacted at (01) 4292570 or 087 9082970. 





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