Regrettably, the national standards and regulatory process are not robustly enforced. There is no apparent evidence that they assist service providers to develop a real culture of quality care and continuous improvement. We are not aware of any efforts made by HIQA to have the quality standards improved or updated. We believe that the existing regulation governing care plans need to be strengthened while the terms of nursing home contracts of registration could be made more effective through inducements to adhere to better practices.
We call for additional oversight by local clinicians and the addition of new expertise to HIQA inspection panels, for example, gerontologists, psychologists, infection control specialists and management assessment skills. The group also wants to see the introduction of annual online compliance training by nursing home managers plus the introduction of mandatory relative questionnaires as part of HIQA inspections.