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Rules:

Definition of a Nursing Home

A “Nursing Home” is an institution for the care and maintenance of more than two dependent people (i.e., people who need assistance with the activities of daily living by reason of physical or mental ill health). Various institutions are excluded from this definition, including mental hospitals, maternity homes and institutions where the majority of patients are priests or members of religious orders.

At present, convalescent homes operate under the nursing homes legislation but it is likely that they will be specifically covered by law in the near future when regulations are made under the Health (Miscellaneous Provisions) Act, 2001.

Minimum standards

Detailed requirements concerning minimum standards for nursing homes are set out in legislation. There is also a Code of Practice for Nursing Homes, which has been agreed by a group of people representing owners of nursing homes, Health Services Executive (HSE), the National Council on Ageing and Older People, carers and other people with experience in the care of older people. This Code is available from the Governemnt Publications Office.

The purpose of the Code is to set out best standards of care to which all nursing homes should adhere. It covers a range of issues in relation to the provision of nursing home care, including:

While the Code is not legally binding, it does set standards for high quality care and encourages nursing homes to achieve these standards. The Department of the Environment and Local Government has also produced a “Guide to Fire Safety in Nursing Homes”, which is available from the Government Publications Office, priced 6.60 euro.

Some of the main issues addressed in the legislation and the Code include the following:

Suitable and sufficient care – Nursing Homes must ensure that suitable and sufficient care is provided to maintain the welfare and well-being of the residents, having regard to the nature and extent of their dependency.

Nursing and medical care and treatment – a high standard of nursing care and appropriate medical care by a doctor of your choice (or acceptable to you) must be provided. There are detailed provisions in relation to medical treatment and physiotherapy, drugs and medicines, chiropody, occupational therapy and other health services.

Occupational and recreational facilities – the nursing home must provide facilities for the occupational and recreational needs of residents.

Accommodation and facilities – there are detailed rules about accommodation, facilities and minimum heating standards.

Safety and design – there are provisions in relation to the design of the nursing home so as to ensure maximum safety for residents. Nursing homes must also, of course, comply with the building regulations and with general fire and safety rules. Nursing homes are required to ensure that residents are adequately insured against injury while being maintained in the home.

Kitchen facilities – each home must have a separate kitchen with suitable and sufficient facilities and equipment and must have provision for food storage in hygienic conditions.

Hygiene and sanitary facilities – there are detailed rules about hygiene and sanitary facilities.

Nutrition – nursing homes must ensure that suitable, sufficient, nutritious and varied food is provided. Dietary restrictions on medical or religious grounds must be respected. Meal time should be at the normal time of family meals and residents should be involved in menu planning and choice of food.

Privacy and Respect – residents must be able to undertake personal activities in private

Freedom of Choice – residents should be able to exercise freedom of choice (to the extent that this does not infringe on the rights of other people)

Religious facilities – the Nursing Home must provide adequate arrangements to facilitate you in the practice of your religion.

Safety of personal possessions – there are detailed provisions for the protection of the personal possessions of residents

Information on current affairs, – you must be provided with information about current affairs and similar issues.

Visits – the nursing home should encourage residents to maintain contact with family and friends of their choice and allow visits at reasonable times.

Discharge – if you are being discharged, the Nursing Home must tell you or your representatives of the date of the proposed discharge, the reasons for the discharge and give at least 14 days notice to people to make alternative arrangements.

Terminally ill patients and death – the Nursing Home must provide adequate arrangements for the care of terminally ill residents and provide for their special needs. The Nursing Home must also ensure respect for the remains of the deceased person, make arrangements for the removal of remains and notify the Medical Officer for Health of the death within 48 hours.

Records – each Nursing Home must keep a register of all residents, setting out basic personal, medical and other details. All personal records must be treated with confidentiality and should be retained for not less than 5 years after the person ceases to live in the home. Residents should have access to personal records, subject to certain restrictions in limited cases.

Information – each home must have a brochure setting out information about the home, including the name and address of the proprietor, the admissions policy, accommodation provided and special facilities and services.

Contract of care

A contract of care is agreed between you and the nursing home. This contract sets out the terms that are to govern your care and welfare and must include details of the services to be provided and the fees to be charged. It must be provided to every resident within two months of admission to the nursing home. The Code of Practice for Nursing Homes states that the contract should cover:

A comprehensive nursing review of the care of each resident should be undertaken by the nursing home at least every six months.

You may not be charged any more than the amount as agreed in the contract of care. This means that there can be no further separate charges for bed and board, nursing care appropriate to the level of dependency, incontinence wear and bedding, laundry service and aids and appliances necessary to assist a dependent person with the activities of daily living. A special service or item of equipment must be the subject of a separate agreement between you and the nursing home and must be set out in the contract of care.

Nursing home complaints

You or somebody acting on your behalf can make a complaint to the Health Services Executive (HSE) in relation to any matter concerning the nursing home. The complaint should normally be in writing but the Health Services Executive (HSE) can accept an oral complaint if it is not possible to put it in writing. The Health Services Executive (HSE) must investigate the complaint and the proprietor or the person in charge of the nursing home must be notified and given the opportunity to respond to the complaint. If the complaint is upheld, the Health Services Executive (HSE) can direct the Nursing Home to take specified action in relation to the complaint and the proprietor must comply with this.

The Health Services Executive (HSE) must notify the complainant of the outcome of the complaint. The Code of Practice for Nursing Homes also recommends that each nursing home should have an in-house procedure to deal with complaints (this in-house procedure will not affect the formal procedure set out above).

Where to apply

Copies of the “Code of Practice for Nursing Homes”‘ and the “Guide to Fire Safety in Nursing Homes” are available for purchase from: