How big is NHQI?
Currently, our group has six members with counties Dublin, Cork, Clare and Tipperary represented. We plan to recruit new committee members to grow and develop into a national organisation. We particularly want to attract members who have the time and energy to get actively involved from areas such as the South West, South East, North West, North East and the Midlands.
With six members, can you credibly say you represent the voice of relatives and residents at this point?
We are not aware of any other group in Ireland with the same mission and goals. To drive change in society, we decided to stand up and get the ball rolling. We see this as a starting point to something bigger. All of NHQI currently have or had loved ones in nursing home care and understand the issues involved. The majority of the group previously worked over a 10 year period as part of a Relatives’ Group within HIQA. In short, we are knowledgeable in the area. We want to support residents and relatives in voicing their concerns in the public domain.
Should relatives contact you with issues and complaints?
Yes, However, while we welcome all relative and resident contact, we are not qualified or resourced to resolve complaints. Our goal instead is to drive systemic change, provide information on processes and lobby for a proper complaints resolution process, which is missing from the current regulatory framework. Under existing arrangements, if relatives have concerns, they should raise them directly with the nursing home provider, escalate to HIQA and the Ombudsman as necessary and also consider communicating the issue to Sage, the professional advocacy organisation, which can mediate and support resolution.
If relatives have complaints or concerns, we suggest the following steps.
- Speak directly to the person in charge. Beforehand, write down your points. Have details of the incident, the date it occurred and what member of staff you spoke to at the time. Ask for it to be logged as an official complaint. Stay calm. Good nursing homes are open to feedback and will be keen to resolve your issue. Do not apologise for raising the issue – you are within your rights to do so. Your relative is entitled to a high standard of care. If you are nervous about the direct approach, speak to the advocate attached to your relative’s nursing home and ask them to either speak to the person in charge on your behalf or accompany you on a joint telephone call, which could be organised on WhatsApp or Zoom. Say your piece, stop and then listen to the response. Do not feel under pressure to respond straight away. It is fine to say that you would like some time to reflect.
- If you are not happy, we recommend that you put your complaint/concern in writing. If the concern is serious and you feel based on the previous outreach that resolution is unlikely, copy NHQI, HIQA, the Ombudsman and Sage (the latter can mediate and support resolution on your behalf). Clearly describe the issue/incident, what you observed, when it occurred and what steps you have already tried to take to resolve the issue in advance of escalation.
What is your current relationship with HIQA?
HIQA has a key role in the regulation of quality care in nursing homes and in informing the public. We set out to develop regular dialogue with HIQA along with other key stakeholders and be consulted in advance of the development of any new standards and the publication of corporate reports that relate to residential care for older persons. We expect to participate in service user panels, focus groups and national patient experience surveys, where relevant. This includes making submissions to expert groups regarding relatives’ input to issues such as medicines management, use of restraints, staffing levels, skills mix etc. We have views to share on topics like the promotion of best practice, the presentation and formatting of inspector reports, the introduction of annual online compliance training by nursing home managers plus the introduction of mandatory relative questionnaires as part of HIQA inspections.
What about the nursing home provider groups?
Likewise, we will reach out to the provider panel to exchange views, discuss new developments and issues of mutual concern as well as showcasing best practice.
Why are you now not working under the HIQA umbrella?
Originally established in 2010, the group came together as volunteers in response to an invitation from HIQA to nursing home residents and their relatives to join a service user forum. At that time, the establishment of the Forum was cited by HIQA as a first step towards the creation of a wider network of service user contributors in relation to both nursing homes and other social service sectors within their remit. However, this has not happened and HIQA is apparently now following a different engagement strategy
Why did HIQA change strategy?
That is a question is for HIQA to respond to.
What did you achieve over that 10-year period?
We watched developments and best practice in nursing home care and regulation in other jurisdictions and shared our views and concerns with HIQA at our quarterly meetings. In turn, our views were canvassed by HIQA on developments and initiatives such as the revised Standards. We produced a newsletter around twice per year to help inform and guide relatives. We spoke to the Nursing Home Providers at regional sessions for the launch of New Standards and participated in focus groups for relatives held regionally. More recently, we have submitted our views to both the Law Reform Commission and the Expert Nursing Home Panel.
Do you believe HIQA has made a difference?
Yes, undoubtedly progress has been made but there is still much to be done.
Why go public now with your group?
Ireland is at an important juncture in developing new models of care for older people in Ireland. We believe going public and attracting more voices will be beneficial to that debate.
How do you differentiate NHQI from Sage?
Sage is an organisation focussing on advocacy work for older people, dealing with complex issues that require mediation. In contrast, we are a grass roots movement made up of ordinary volunteer citizens, who represent the voice of relatives and residents and are campaigning for systemic change in the care and quality of life of all older people in nursing home care in Ireland. We have no funding and are volunteering our time and expertise. We would describe our work as complementary but different.
Are you prepared to work with groups like Sage?
Yes, of course, we have already reached out to Sage. We are open to all collaborations, which advance our core goal – improvement in the care and quality of life of all older people in nursing home care in Ireland.
Are you planning a broader membership model?
We certainly want to attract additional members who support what we stand for. The level of interest that emerges will influence the way NHQI develops over time.
Would you describe your organisation as a response to COVID?
No, while the COVID-19 situation has certainly been a catalyst for change, this group originated ten years ago. We are looking beyond COVID-19 to longer-term care and quality of life. There are a multitude of untold, small things every day that collectively add up to unfulfilled lives.
How do you hope to get your message out there?
Though the support of traditional and social media. We would ask for the media’s support in communicating the broader message.
Why should people who do not have loved ones in nursing homes, care about your priorities?
We all have parents, grandparents, aunts and uncles. We all grow old. This is an issue that will affect us all. By 2041, it is estimated that at least one in four people in Ireland will be over the age of 60 – we need to establish the right models of care now.