Details of private nursing homes and care homes for the elderly in the Island and total number of residents licensed for each establishment

1240/5(6453)

WRITTEN QUESTION TO THE MINISTER FOR HEALTH AND SOCIAL SERVICES BY THE DEPUTY OF ST. JOHN

ANSWER TO BE TABLED ON TUESDAY 5th JULY 2011

Question

Would the Minister inform members of the name and number of private nursing homes and care homes for the elderly in the Island together with the total number of residents licensed for each establishment?

What are the total number of full time and part-time staff for each of the licensed establishments?

How often are the premises inspected by Health and Social Services, and would the Minister give details of number of inspections to each establishment in last 3 years?

Have any reports of ill treatment of patients/residents been reported to the Department in the last 3 years and, if so, how many, and what action is taken in response to such a report? Is the Minister or her department aware of any bullying of residents/patients in either private or public sector nursing/care homes and, if so, how is this being dealt with?

Does the Department monitor the food and beverage that patients/residents receive and, if not, why not?

Do the private nursing/care homes have to comply with the same standards as establishments operated by the Parishes and the States and, if not, why not? How do staffing numbers compare in the private sector and the Parish/States sector?

Answer

Numbers of private care homes

Please see table 1 for details of private care homes and total number of licensed residents.

There are currently 38 registered residential care homes, 3 nursing and 9 dual[1] registered homes making a total of 45 homes regulated by HSSD. They comprise private, voluntary and Parish homes catering for a variety of health and social care needs for a range of age groups.

Staff numbers

Independent homes are regulated under the Law and it is a requirement that:

• all nursing homes "employ by day and by night suitably qualified and competent professional technical ancillary and other staff in numbers which are adequate to ensure the well being of patients".
• all residential homes "employ by day and where necessary by night suitably qualified and competent staff in numbers which are adequate for the well being of residents"

To support these requirements, HSSD issues staffing standards which require both nursing and residential homes to ensure that:

• The number of staff employed is sufficient to ensure that individual members of staff do not, on a regular basis, work in excess of 48 hours per week.
• Sufficient staff are employed to cover holiday and sickness absence.
• Any member of care staff must not work anymore than 12 hours in a 24 hour period unless this includes an overnight break.
• For residential homes the minimum ratio of care staff to residents is 1:10 by day and 1:15 by night." In units for high dependency residential care the ratio is 1:7 by day and 1:12.5 by night.
• For nursing homes the minimum ratio of non-registered care staff to residents is 1:5 by day and 1:10 by night.
• For nursing homes the minimum qualified nursing staff to resident ratio is as follows:

• Up to 10 residents there is one registered nurse by day and by night,
• Between 10 and 20 residents there is one registered nurse by day, except where the home takes acute cases where there are two registered nurses by day and one by night.
• Between 20 and 40 residents there are two registered nurses who can demonstrate the necessary competencies, by day and one by night.
• Over 40 residents there are three registered nurses who can demonstrate the necessary competencies, by day and two by night."

• The person registered as in charge of the home, has adequate periods of supernumerary time, not counted as part of the staff ratio, to carry out their management duties.
• Domestic staff are employed in sufficient numbers to ensure that the standards relating to food, meals and nutrition are fully met and that the home is maintained in a clean and hygienic state, free from dirt and unpleasant odours. Ancillary staff numbers are calculated on the following basis:
  • 3.5 hours per resident per week for laundry and domestic staff
  • 2.5 hours per resident per week for kitchen and catering staff.

Number of inspections

HSSD's registration and inspection team has responsibility for the statutory inspection of registered care homes and nursing agencies. An inspection schedule has been developed based on size of home and an associated risk assessment. High risk services are fully inspected twice a year and more often if required, medium risk homes are fully inspected at least once a year with a second limited follow up inspection. Low risk homes may only have one full inspection once a year.

Reports of ill treatment and departmental response

When HSSD receives complaints the complainant is advised to contact the home in writing requesting an investigation and response. This letter should be openly copied to HSSD.

If the response is not satisfactory, HSSD will investigate to establish whether the complaint constitutes non-compliance with statutory requirements. In cases where a complaint is serious or indicates a risk to an individual resident/s – whether through bullying or maltreatment - HSSD will directly investigate. Such cases are usually part of a safeguarding process conducted jointly with Social Services.

In 2009 the team was involved in 12 adult protection investigations and 4 complaints.

In 2010 the team were involved in 3 adult protection investigations and 4 complaints.

In 2011 to date, the team has been involved in 6 adult protection investigations and 9 complaints.

Monitoring of food and beverage

Inspections, which are usually unannounced, involve assessing whether the home complies with the statutory requirements for standards of care: These include: resident choice; staffing;; record keeping; infection control management; medication management; quality of the environment; compliance with fire and safety requirements and food.

This includes an assessment of the quality of food and drink provided, plus the quality of support provided with feeding and fluid intake.

A detailed list of inspection standards is available on request.  

Parity of standards across sectors

As present care homes provided by HSSD fall outside the Law and are therefore not regulated under the law. HSSD is currently working with Law Officers to develop a Regulation of Care Law which will bring HSSD Care Homes under the same standards as private sector homes. It is envisaged that phased implementation of the Law will commence in 2013/14.

A comparison of staffing levels across States, Parish and private homes is not available.

TABLE 1

DUAL REGISTRATION HOMES – 2011

* Denotes charity or Parish-run Homes  # denotes respite care facilities