Action needed to safeguard the rights of older people

Action needed to safeguard the rights of older people

Age Action calls for urgent response to RTE Investigates revelations on failings in care

The appalling practices revealed in last night’s RTE Investigates programme are an indictment of our care system for older people, and indicative of the growing challenge in that sector.

Age Action knows that the poor practices revealed, some of which are explicitly harmful, will be deeply upsetting to older people living in, or who anticipate living in, long-term residential care, and to those who love them. It is not reassuring that 17 weeks elapsed following protected disclosures to HIQA before a further inspection was undertaken.

These fundamental failures occurred in two homes operated by the largest provider of long-term residential care in the State. Persistent non-compliance had been found by HIQA. Both of these homes continued to increase their resident numbers, without penalty for repeated failure to meet regulatory standards. HIQA notes that the two facilities in the documentary were among 36 homes which had three or more inspections in response to “persistent non-compliance” and that new admissions to one of the homes have now been stopped.

“The practices revealed by RTE Investigates represent a fundamental failure to respect the rights of older people, and of our societal duty of care. Our system of regulatory enforcement is failing vulnerable older people. The case for more robust action in the face of persistent non-compliance seems clear.” Age Action’s Head of Advocacy Camille Loftus said.

Almost 24,000 older people live in long term residential care – 2.9% of those aged 65 or over. For most, living in long term residential care is not their choice, but a consequence of the lack of viable alternatives. People want care in their own home, around their family and friends.

The revelations are shocking, but reflect challenges which have been evident for some time. Staffing shortages and inadequate training are endemic. Facilities are increasingly developed as real estate investments, rather than to provide care to people who need it. The funding model is not person-centred, taking no account of each resident’s level of care needs.

“These revelations show an intolerable level of institutional abuse of the rights and dignity of older people. Older people must be given the choice, control, and quality care they need to age in their own homes, rather than being treated as units for the generation of profit” said Camille Loftus.

Action needed now

The Minister for Older People, Kieran O’Donnell TD has said that his priority is to put in place a statutory homecare scheme. This is a welcome and long overdue development. Post Covid, there have been some positive changes in the model of care for older people, with more funding going to home support. This is the correct direction of travel, but the pace of change is inadequate to need: while nearly 24,000 older people were supported under the Nursing Home Support Scheme in September 2024, only 69 people had access to an Intensive Home Care Package.

The Commission on Care will make recommendations for the future development of the health and social care system,  but Government now needs to take urgent action to ensure that older people’s rights to dignified and safe care are respected:

• Statutory provision for adult safeguarding is now an urgent priority. This was recommended in the wake of the Leas Cross scandal 20 years ago. The Programme for Government commits to a national policy, but this must be underpinned by robust legislation, as recommended by the Law Reform Commission.
• A whole system review of the current funding model for long-term residential care to ensure that it is adequate and centred around the care needs of residents is a further priority.
• The capacity of the regulatory oversight system also requires examination. A strong regime of sanctions for persistently non-compliant homes needs to be put in place as a matter of urgency. Repeated failure to comply needs to be clearly flagged to prospective residents and their loved ones to support informed choice about care providers.

Ends.

[i] HIQA Statement on Nursing Homes, 5^th June 2025: https://www.hiqa.ie/hiqa-news-updates/statement-nursing-homes

[ii] HSE Performance Report, September 2024: https://www.hse.ie/eng/services/publications/performancereports/management-data-report-september-2024.pdf

[iii] A statutory homecare scheme was a recommendation of the Citizen’s Assembly in 2017

[iv] Walsh & Connolly (January 2024) Long Term Residential Care in Ireland. ESRI: https://www.esri.ie/system/files/publications/RS174.pdf

[v] Intensive Home Care Packages (IHCP) are provided by the HSE to support individuals with complex care needs to remain at home, offering a broader range of services than the standard Home Support Service, including additional home help, nursing, and therapy services. They are particularly targeted towards older people and those with dementia, aiming to provide individualised care plans and reducing admissions to hospital and long-term residential care.