Martin Daly demands answers on nursing home failings
Martin Daly pressed regulators over nursing home failures exposed by RTE Investigates, naming AMACE, Beneva and a private residence, and questioned whether current powers are adequate. He sought answers on regulation, staffing, facility safety, closures and financial penalties.
Martin Daly asked how to "put this right" after footage and reports that many described as elder abuse. He listed specific lines of inquiry: adequacy of regulatory powers, reliance on private provision of nursing homes, funding, staffing levels, facility standards and the threshold for closing a home.
He questioned whether the regulator's existing framework is sufficient and whether it can compel large corporate entities to act rather than relying on cooperation. He asked if there should be stronger powers to require actions such as restricting admissions and to hold corporate owners to account when behaviour only changes after media exposure.
Daly highlighted the interim report's findings of numerous complaints and serious premises issues, including around infection control, record keeping, residents' rights and fire regulation non-compliance. He noted examples from the residence and Ben Evan where many complaints were recorded between 2022 and 2024, and asked what it would take to close a nursing home judged unsafe.
He probed whether there is adequate funding and a standardised staffing framework for assessing safe staffing. The regulator responded that current powers allow action with providers but not to direct corporate entities, that most providers cooperate, and that the Safe Staffing Framework and work by the Chief Nursing Officer should provide a more objective basis to challenge providers and bind owners. Daly also asked about the use of financial penalties for corporations whose behaviour appeared unchanged until public exposure.
Key questions raised
Martin Daly asked how to "put this right" after footage and reports that many described as elder abuse. He listed specific lines of inquiry: adequacy of regulatory powers, reliance on private provision of nursing homes, funding, staffing levels, facility standards and the threshold for closing a home.
Regulatory powers and corporate providers
He questioned whether the regulator's existing framework is sufficient and whether it can compel large corporate entities to act rather than relying on cooperation. He asked if there should be stronger powers to require actions such as restricting admissions and to hold corporate owners to account when behaviour only changes after media exposure.
Facility failings and safety concerns
Daly highlighted the interim report's findings of numerous complaints and serious premises issues, including around infection control, record keeping, residents' rights and fire regulation non-compliance. He noted examples from the residence and Ben Evan where many complaints were recorded between 2022 and 2024, and asked what it would take to close a nursing home judged unsafe.
Staffing standards and enforcement options
He probed whether there is adequate funding and a standardised staffing framework for assessing safe staffing. The regulator responded that current powers allow action with providers but not to direct corporate entities, that most providers cooperate, and that the Safe Staffing Framework and work by the Chief Nursing Officer should provide a more objective basis to challenge providers and bind owners. Daly also asked about the use of financial penalties for corporations whose behaviour appeared unchanged until public exposure.
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Transcript
Thank you for attending today. We really appreciate it, but it is critical that we not only get answers to what has happened both in the AMACE nursing homes, both in the Beneva nursing home and in the residence that was exposed by RTE Investigates, and I suppose rather than rehash the actual emotional horror that a lot of people felt from watching and in the words of one of the specialists in elderly care, elder abuse was the word he used, and I don't think anyone has disagreed with that analysis. So rather than rehash that I suppose the questions really are how can we put this right, how can we reflect on what has happened and what has been exposed to improve things going forward. So I have a series of questions and rather than hearing me speak about this, I would prefer to get some answers if we could. One, do you think that your powers under the regulatory framework for nursing homes is adequate? How do you think that that can be strengthened? Is there an over-reliance on the private provision of nursing home care which would become dependent upon? An ever-increasing congregation of elderly people in these private nursing home facilities which I am told is the only way that they are viable? Is there adequate funding going into the nursing homes to provide adequate care? Have you a role around the whole area of staffing levels there? And I suppose one of the big things that have come out looking through your interim report is that there are really serious concerns about not just the care of patients, but the facilities in which they were being provided. So in the residence there were something like 40 abuse complaints. There was an issue around fire regulation and control. I mean most other buildings in this country would be closed down by the fire officer if there was 100% non-compliance with fire regulation. In Ben Evan, that was in the residence, in Ben Evan 198 a lot of complaints of elder abuse between 2022 and 2024. Non-compliance with the rights of residents, both personal care, record keeping premises, infection control, the list goes on. What does it take to close down a nursing home? And then finally, have you any powers around financial penalties for these corporations who are, I would say, feel that they are unencumbered by HICWA to provide the services they are providing? Because it does not look like their behaviour changed until they were exposed by RTE Investigates. Thank you Deputy Daly. First of all, I think just to say in relation to our powers, I think there are two points to make. Firstly, the powers we have allow us to take action with the provider and I think Susan and Finbar can speak to how we execute those powers. I think in relation to your question around the move towards large corporate entities, we would agree that that is a shift. We do not currently have powers to direct or require them to do anything. We work on the basis of cooperation and I do want to put on record today that the vast majority of those corporate entities as well as individual providers cooperate and work with us. But regulation is there to provide both action and a deterrent. And I think it is important that when there is a changing landscape that we pause and look at whether we need additional regulatory powers to deal with, in circumstances such as this, that there are additional powers where we can hold the entity to account. I think the action by the entity itself, based on discussion with us, to restrict all admissions to all units is an action that we welcome, but it might be an action that we would require of a corporate entity and that is an example of where having those powers would be very important. In terms of the staffing, you can see in all of our inspection reports we comment on staffing, but we do not have a standardised frame for looking at what is good staffing and what does it look like. The work being done by the Chief Nursing Officer, which he has done in relation to healthcare, will give a much more objective lens and will allow us to comment much more forcibly where we need to. More importantly, it will require those providers and the owners to be bound by those staffing frameworks in a way that they are not currently. I think the Safe Staffing Framework has two roles, both in terms of giving the power to us to be able to appraise and critique and then, secondly, being able to challenge the provider. Thank you very much. That is the end of our time slot there. Maybe I might just ask. Yes, we will come back in. There will be another stop. We will come back on the EU's complaints. Thank you very much. Thank you very much. Thank you very much. Thank you very much.