Rural areas worst affected as 14 nursing homes close

Almost 1,000 nursing home beds were lost last year through the closure of centres or reductions in bed numbers, according to a report from the State’s health watchdog.

Fourteen nursing homes closed during the year, with the loss of 414 beds, the Health Information and Quality Authority (Hiqa) said in the report, an overview of the regulation of nursing homes in 2022. A further 473 beds were lost as 69 homes reduced their capacity, generally to provide residents more space.

However, the overall number of beds in the sector has declined only marginally due to the registration of new nursing homes and extensions to others. Rural areas were most affected by nursing home closures, Hiqa said, especially in the west.

The total number of beds available in seven counties increased, with the greatest rises seen in Meath and Louth. Sixteen counties saw bed numbers fall, with the greatest decreases in Galway and Roscommon.

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The report highlights the “significant impact” a closure can have on residents and people looking for a nursing home. “For example, it can result in people having to travel out of communities that are familiar to them, and it can be further for families and friends to travel to visit,” Hiqa said.

It points to a trend of declining individual ownership of nursing homes and an increase in “provider groups” operating in the sector. The average size of nursing homes is also growing.

Of the 14 nursing homes that closed, 12 ceased voluntarily, one closed when the provider did not renew registration and one was closed because of regulatory issues. Among the reasons given for closures were financial viability, staffing difficulties, regulatory costs, burnout, “and a recognition that operating a nursing home was not an attractive career proposition for the next generation”.

By last December, there were 557 nursing homes providing 31,674 beds. Most – 77 per cent – were operated by private providers; 20 per cent were operated by the HSE.

“Nursing homes faced great challenges over the past few years due to the impact of the Covid-19 pandemic,” said Carol Grogan, Hiqa’s chief inspector of social services. “In 2022, we found that providers and staff were able to begin to return to pre-pandemic arrangements for the benefit of residents.”

Overall compliance was judged to be high, with nursing homes found to be either compliant or substantially compliant with 88 per cent of the regulations assessed. The report identifies a number of areas for improvement such as premises, fire safety, and infection prevention and control arrangements.

Ms Grogan said Hiqa continued to identify that “where there are effective governance and management arrangements in place, nursing homes have higher levels of compliance with the regulations and better outcomes for the people who live in them”.

The level of non-compliance on residents’ rights increased. This included issues like not having access to activities and occupation, lack of privacy in multi-occupancy bedrooms and, in some cases, residents not being able to make choices either in relation to their daily routine or wider life decisions.

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