Minister Butler introduces further safeguards for Older People

• new provisions being debated in the Dáil this week include enhanced powers to collect and publish data from nursing homes to allow for more integrated national planning across the sector, and new enforcement powers for HIQA’s Chief Inspector of Social Services
• additional family members, including cousins, to be considered as a ‘family successor’ to a family farm or business assets under the Nursing Homes Support Scheme (Fair Deal) also being debated this week
• new legislative measures will also introduce a licensing framework to regulate home support providers as part of the Programme for Government commitment to deliver a statutory home support scheme

Minister for Mental Health and Older People Mary Butler has secured Cabinet’s approval to publish the General Scheme of the Health (Amendment)(Licensing of Professional Home Support Providers) Bill 2024. The Bill introduces a new licensing framework for home support providers.

When enacted, the Bill will amend current legislation and introduce a licensing framework for home support providers. This means that service users who receive home care in their own home can be assured of this safeguarding of the quality and consistency of care across the country. Providers – whether public, private or voluntary - will be required to meet minimum requirements in order to provide a home support service in Ireland.

This framework will be supported by National Quality Standards which will be developed by the Health Information and Quality Authority (HIQA). HIQA’s Chief Inspector will be responsible for independent monitoring and assessing compliance of registered home support providers.

For those that receive home care supports in their home, they will be assured of the same minimum standard of care wherever they live. Today in Ireland, approximately 57,000 people will receive home care which enables them to live in their own homes and communities for as long as possible. Last year, 22.1 million hours of home care were delivered the length and breadth of the country, providing this vital wraparound support to help older people to age well.

This Bill will now be referred to the Office of the Attorney General for priority drafting, and the legislation will be progressed as a priority by Minister Butler through the Houses of the Oireachtas in the coming months.

Government approval has also been granted to publish the Health (Miscellaneous Provisions) (No.2) Bill 2024 which provides for amendments to the Health Act 2007 and the Nursing Home Support Scheme Act 2009.

These new amendments are in response to key recommendations in the COVID-19 Nursing Home Expert Panel Report, which called for the enhancement and modernising of the regulatory framework governing nursing homes. It also provides an obligation on all nursing homes – public, private and voluntary – to provide key data to HIQA which will help oversight and future planning of the nursing home sector in Ireland.

The amendments to the Nursing Homes Support Scheme Act 2009 (Fair Deal) will widen the definition of those eligible to be considered as a ‘family successor’ to a family farm or productive business assets to include cousins, great-nephews and great-nieces, and great-grandchildren. Under the Nursing Homes Support Scheme (NHSS) (Amendment) Act 2021, contributions from farm and business assets can be capped after three years in care, as long as the family successor that is appointed will continue to run the asset for a period of time.

Minister Butler said:

The Health (Amendment) (Licensing of Professional Home Support Providers) Bill provides for:

• on 27 April 2021, Government gave approval to the Minster for Health to draft a General Scheme and Heads of Bill to establish a licensing framework for home support providers
• the Health (Amendment) (Licensing of Professional Home Support Providers) Bill seeks to amend the Health Act of 2007 to provide for a licensing framework for home support providers while making it an offence to operate a home support service without a licence and incorporating transitional arrangements for existing home support providers
• the regulatory framework consists of primary legislation for the licensing of home support providers, regulations for home support services which will set out the minimum service requirements that a provider must meet to obtain a licence, and HIQA National Standards
• the Bill will provide for independent oversight by conferring on HIQA’s Chief Inspector the authority to grant, amend, and ultimately revoke a licence if a home support provider fails to meet the minimum requirements set out in regulations or contravenes a provision of the Act
• the Chief Inspector will be responsible for monitoring and assessing compliance of Home Support Providers against Regulations and HIQA standards. This regulatory framework and inspection process will ensure quality standards are met and will help build public confidence in the expanding provision of Home Support
• following publication of the General Scheme, officials from the Department of Health will work with officials in the Department of Children, Equality, Disability, Integration and Youth, Department of Public Expenditure, NDP Delivery and Reform, and the Office of Parliamentary Council to finalise priority drafting of the legislation and publication of the final text of the Bill at the earliest opportunity. The General Scheme and Regulatory Impact Assessment will be published on the Department of Health’s website shortly

The Health (Miscellaneous Provisions) (No.2) Bill 2024 provides for:

Amendments to the Health Act 2007 to:

• introduce new powers for the Chief Inspector of Social Services to issue compliance notices to provide a more agile and proportionate tool for intervention to support compliance in residential centres for older people and people with disabilities, complementing the current Section 51 processes under the Act. The provisions are similar to compliance notice models in other legislation
• provide a new function for the Chief Inspector to collect, share and publish key operational data in relation to nursing homes
• reduce timelines for existing enforcement provisions initiated under Section 51, to expedite the current system of imposing conditions on registration or cancelling registration and to maintain consistency with the current District Court Rules to bring motions to appeal
• provide a clear legal basis for the Chief Inspector to enter and inspect a premises which is unregistered, if he or she has reasonable grounds to believe that the business of an unregistered designated centre is being carried on
• providing an express power for the Chief Inspector to remove a condition attached to registration of a designated centre without an application from the registered provider. Provide explicitly that the Minister can prescribe, in regulations, certain requirements to be included in complaints processes for residential centres

Amendments to the Nursing Homes Support Scheme 2009 to:

• extend the definition of those eligible to be considered as a ‘family successor’ to a family farm or business assets to include cousins, great-nephews and great-nieces, and great-grandchildren
• provide for further technical amendments to the 2009 Act

The Health Act 2007 established the Health Information and Quality Authority (HIQA) and the Office of the Chief Inspector of Social Services. It also provides the regulatory framework for residential services for older persons (nursing homes), persons with disabilities and children in need of care and protection. The Chief Inspector of Social Services monitors compliance with this regulatory framework.

The Nursing Homes Support Scheme Act 2009 established the Nursing Homes Support Scheme under which financial support is provided to those availing of long-term residential care services.