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NEWS NHI News published by: nursing Homes ireland, unit a5, centrepoint Business Park, Oak road, Dublin 12. tel: 01 4292570 | Fax: 01 4291845 | e-mail: | Web:


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Nursing Homes Week 2013 quality living, quality care




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Tadhg Daly, Chief Executive Officer, Nursing Homes Ireland


n the previous edition of NHI News I wrote of our national public affairs campaign to bring to policy, stakeholder and public attention issues of critical concern for our sector and the key actions required. During the first phase of the campaign, our members briefed in excess of 90 TDs nationwide to ensure that they, as policy makers, understood the role of the private and voluntary sector and the requirements to ensure that as a society we maintain and develop sustainable high quality residential care services for our ageing population. Our public affairs campaign continues and in the last number of weeks we have presented to the members of the Labour Parliamentary Party and presented to the Joint Oireachtas Committee on Health and Children. We will, in the coming weeks, take the opportunity to brief other political parties including Fine Gael, Fianna Fáil and Sinn Féin. It is vital that we maintain this activity and take every opportunity both locally and nationally to highlight the critical issues facing our sector and the challenges of providing and funding the residential care needs of our ageing population. Our pre-budget submission, advised of in more detail in this edition, calls for a number of immediate actions including: P An enhanced framework to support the increasingly complex care requirements of nursing home residents; P Adequate resourcing of Fair Deal to eliminate waiting lists for funding and to ensure persons requiring nursing home care can access it in a timely manner. This ensures appropriate placement of persons together with considerable cost benefits for our health sector. P Policymakers need to ensure that the system strikes a 01 — NHI NEWS

balance between achieving ‘value for money’ and ensuring the sustainability of the private and voluntary sector. Our submission also outlines immediate initiatives amongst others required - to provide the sector with a necessary immediate stimulus to ensure that the sector can expand and deliver new capacity to meet demand. In August/September we celebrated the inaugural Nursing Homes Week and I want to thank all the members and communities that embraced it. The week celebrated the quality living and quality care that is embedded in NHI member homes. Nursing Homes Week provided NHI Members with an opportunity to celebrate and promote the resident and the staff and all that’s best about nursing home life. Nursing homes hosted a wide array of activities and events to celebrate the Week, including parties, music, barbeques, talks, drama, performance, fitness activities, pampering, arts and crafts, and outings. Residents, staff, families, visitors, local representatives and the wider community participated. One of the strengths of Nursing Homes Week was to promote the many and varied activities and events that already take place within nursing homes. It provided us with an opportunity to highlight this to people outside of the nursing home setting with a ‘calling’ that enabled national celebration and promotion of nursing home life at local and national level. Feedback from Members arising from the Week has been very, very positive and it received national and extensive local media coverage. Members informed NHI it afforded very valuable opportunity to promote their role within the community and persons who would not be familiar with such settings visited to participate in the celebrations and learn of nursing home life. Thank you again to all Members who supported this important initiative and we are already looking forward to the 2014 celebrations! Our sector is constantly challenged by misperceptions and NHI is proactive in seeking to promote the reality of nursing home life, change perceptions and highlight its positivity. During Nursing Homes Week we launched Quality Living, Quality Care, a NHI gloss booklet that promotes nursing home life and addresses misperceptions head on. We recognise the move to a nursing home understandably carries with it anxiety, apprehension and uncertainty, both for the prospective resident and their family and friends. Our booklet is designed to provide comfort and reassurance in this respect. It features valuable advice on healthcare provided in nursing homes, the facilities available, activities, food and nutrition, complaints procedures, choosing a nursing home and Fair Deal. Within the booklet staff of

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CONTENTS NHI NEWS News from Nursing Homes Ireland, the representative organisation for the private and voluntary nursing home sector. READ ALL ABOUT US International recognition for a Cork nursing home, All-Ireland Champions visit with the Liam McCarthy Cup, a busy summer of activity in a Kildare home, a 32 county cycle, sports day in Waterford and Leopold Bloom celebrations: all feature in this edition’s Read All About Us. NEWS UPDATE Minister commits to ring-fencing of Fair Deal as outsourcing of its administration is ruled out. Read about the latest happenings in the nursing home care sector. NHI ANNUAL CONFERENCE 2013 Shaping the Future of Nursing Home Care, NHI’s Annual Conference 2013, will focus upon the future of our sector and the expansion and development of nursing homes and the services they provide. The event schedule is listed and speakers are profiled. International speaker Dr Sarah Kagan, who will speak at the Conference, writes in this edition of NHI News, informing of her experience of disconnect between cancer and aging in American long-term care and endeavors to advance quality care. NHI CARE AWARDS 2013 The prestigious celebration of excellence in care returns for its fourth year with finalists now announced and our resident achievement award winner named. MY NURSING HOME LIFE My Nursing Home Life, a new feature to NHI News, profiles a person working or living within a nursing home. Michelle Curtin, a Registered General Nurse at Oaklodge Nursing Home, speaks about her role and the emphasis that is placed upon continuous professional development. NURSING HOMES WEEK 2013 It celebrated the quality living and quality care that is embedded in NHI member homes. The inaugural Nursing Homes Week 2013 proved a great success as NHI Members celebrated and promoted nursing home life. See images of the celebrations that took place across the country. SILVER STREAM CELEBRATES Silver Stream Healthcare adopt a holistic approach to care which is centred upon the fulfilment of the individual. Founded in 1993, Silver Stream now operates six nursing homes in Counties Dublin, Meath and Tipperary and recently celebrated ten years of providing care. MEMBER RESEARCH Oral health amongst persons with intellectual disabilities and perceptions of HIQA inspection were the focus of NHI Member research supported by the NHI Bursary.

Thanks to all supporters of NHI, many of whom are featured in this newsletter. Please note, NHI is not responsible for third party services advertised in this publication. Inclusion in this newsletter does not endorse, recommend or imply any approval of the suppliers listed in this publication.

nursing homes speak of their dedication to care and residents speak of the positivity of nursing home life. As well as to nursing homes, the book has also been circulated to citizens information centres, libraries, acute hospitals, TDs, and to organisations working within the health and older persons sectors. Feedback thus far has been extremely positive, with further copies of the booklet being requested regularly. I encourage you to utilise this material to promote nursing home life and your home. I’ve referred to the proactive approach NHI takes to changing misperceptions surrounding nursing home care. For four years, the NHI Care Awards have shone a light on the excellent care that is intrinsic within NHI member homes. The awards promote best practice within the nursing home sector and pay tribute to residents and staff in the nursing home community who demonstrate excellence in care. Such excellence is promoted in national and local media and the Awards play a lead role in enabling NHI highlight the excellence in care that is integral to nursing homes. Congratulations to the NHI Care Awards 2013 finalists, who were chosen from high calibre of entry for each of the award categories and I look forward to welcoming the nominees, their family, friends and colleagues to Citywest Hotel on the night. On the day of our Care Awards, we host our 2013 Annual Conference: Shaping the Future of Nursing Home Care. As its title indicates, the event will focus upon the future of our sector and the expansion and development of nursing homes and the services they provide. As ever, our conference should provide plenty of thought and consideration for nursing home providers and offer insight as to the future development of this critical component of the health sector. NHI recommends you book early to avoid disappointment for both the Annual Conference and Care Awards. I look forward to welcoming Members to Citywest Hotel on 7th November.

Tadhg Daly, NHI CEO


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NHI UPDATES Committed to excellence in care


NHI launches new booklet promoting & informing re nursing home life


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HI’s Nursing Homes Week 2013 coincided with the launch of Quality Living, Quality Care – Living in a Nursing Home, NHI’s new gloss booklet that promotes nursing home life and deals with misperceptions surrounding it head on. The booklet promotes excellent care that is intrinsic to nursing home life and informs of the new world of opportunity nursing homes open to persons moving to a home. It features advice on healthcare provided in nursing homes, facilities, activities, food and nutrition, complaints procedures, choosing a nursing home and Fair Deal, and features testimonials from staff of nursing homes and carers working within such settings. The book is designed to inform the following, amongst others, re nursing home care and life: older persons, relatives & friends of older persons considering nursing home care, health professionals, older persons’ representatives, elected representatives, persons considering employment in a nursing home. Tadhg Daly, NHI CEO commented: “NHI recognises the move to a nursing home brings with it uncertainty, anxiety and apprehension. This booklet is designed to provide very valuable and important information in respect of nursing home life and provide comfort and reassurance for persons moving to a nursing home and their family and friends.” Quality Living, Quality Care can be downloaded via the publications section of the NHI website,



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Quality Living, Quality Care Living in a Nursing Home


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NHI appears before Oireachtas Health Committee Nursing Homes Ireland appeared before the Oireachtas Joint Committee on Health & Children on 26th September to outline its 2013 Pre-Budget Submission. NHI’sopeningstatementtothecommitteestatedFairDealmustremain aring-fencedbudget,beadequatelyresourcedandfuture-proofed.“Adequately resourcingtheschemeisthehumanitarianthingtodo,”NHIstated,pointingto 777personsassessedarerequiringnursinghomecareat9thJulybutawaiting fundingapproval. NHIwelcomedMinisterKathleenLynch’scommitmentbeforetheHealth Committeetoring-fenceFairDeal.Theorganisationalsoinformedofdisconnect betweenNTPF,aspurchaser,andHIQA,asregulator,andoftheconsiderable challengesfacedbythepublicsectorintheprovisionoflong-termresidential care.“Public,privateandvoluntarynursingareregulatedtothesamestandard, yetourmembersareaskedtoprovidecareforafeeupto50%belowfees affordedtopublichomes,”NHIstated.“Itisclearthatthepublicandprivate andvoluntarysectorneedstoandcanworktogethertomeetthegrowing requirement for long-term residential care,” the statement said. “This is evident from the successful Ballincollig Community Nursing Unit public build/privaterunmodel.”


NHI’sprebudgetsubmissioncallsforimmediateactionsandstimulus,outlined inNHI Budget Submission 2013 article,wereoutlined. SpeakingtotheCommittee,TadhgDaly,NHICEOsaiditiscriticala continuumofcareisbroughttogetherforolderpersons,aswemustlookat howwedevelopandfundtherangeofservicesrequiredforolderpersons. PreviouslyMichaelHarty,ChairofHomeandCommunityCareIrelandcalled forFairDealfundingtobeopenedupforhomecare,statingpersonsaremoving tonursinghomesunnecessarilyduetoaccesstothefinancialsupport.MrDaly againwelcomedMinisterLynch’scommitmenttoring-fenceFairDeal,stating itistransparentandreiteratinghercommentsthatitistheultimate‘money followsthepatient’model.Thosemovingtonursinghomesmovebasedupon acomplexhealthcareassessmentthatiscarriedoutbydifferingHSEmedical personnelandthepeoplemovingtosuchsettingshavehighcomplexmedical andsocialcareneeds,hesaid.HereiteratedNHI’sviewtheFairDealfunding modelshouldbereplicatedforhomecare. AskedinrespectofcapacityofthesectorbyDeputyPeterFitzpatrick, FineGael,MrDalypointedtotheHSEServicePlan2013,whichwarnsofa significantnationaldeficitoflong-staycarebedsandcurrentshortfallsinDublin andotherurbanareas.


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Government must immediately publish report on viability of public homes NHI has called upon the Government to immediately publish the report on the viability of public long-stay residential units to ensure a full public debate concerning the provision of nursing home care can be given the important and long overdue consideration it requires. It followed media reports only ten public nursing homes will comply with HIQA’s 2015 physical environment deadline and 109 presently would not meet the standard. Only 720 residential beds out of an existing complement of 7,449 would subsequently comply with the standard and a significant proportion of public long-stay residential units are over 120 years old. Tadhg Daly, NHI CEO, said the reports outline the crisis that is facing our population in respect of the provision of long-term residential care. “NHI is aware the HSE has previously publicly stated a capital investment of €1.7 billion is required to maintain public sector provision at current level,” he stated. “The private and voluntary nursing home sector provides care to more than 75% of the country’s long-term care residents, and has invested up to €2bn developing necessary capacity, undertaking infrastructural improvements and transforming nursing home care. Last year 79% of new persons supported by Fair Deal chose private and voluntary nursing homes. An Taoiseach Enda Kenny has previously stated the Fair Deal initiative has brought about a whole new era in respect of nursing home care, with persons now choosing under the Fair Deal to live in private nursing homes. “Even with the massive capital costs to bring public units up to the required regulatory standards, the nursing home sector will still face a shortfall of up to 11,000 long-term care places. New units and significant investment are required to meet the increase in demand for this specialist care. We urgently require meaningful engagement with our sector to ensure a framework is implemented to meet the increased growth in requirement for long-term residential care. The Government and Ministers for Health and Older Persons cannot continue to ignore our call for the establishment of such a forum. The Department of Health must bring those who play a role in the provision of long-term residential care and older people’s representatives around the table to map out the future of nursing home care and implement an appropriate framework to meet the significant growing requirement for it. Failure to engage with our sector in respect of immediate and long-term planning is creating great uncertainty for this and forthcoming generations. The National Economic & Social Council has previously recommended the establishment of such a working group. “The scale of the challenge is immense. It is backed up by ESRI & CARDI forecasts. However the challenge is surmountable. Our sector has the capability, expertise and commitment to meet the care requirements of an ageing population but it must be supported by appropriate public policy.” NHI has written to Minister for Public Expenditure Brendan Howlin and Minister for Finance Michael Noonan urging them to engage with our sector in respect of a public private partnership stimulus package to meet long-term residential care requirements and create thousands of sustainable jobs.

Adaptation issues brought to attention of Minister NHI has written to Minister for Health James Reilly to outline concern of Members in trying to access a nurse adaptation programme, a stipulation of nurse registration with Bord Altranais agus Cnáimhseachais na hÉireann for some nurse applicants. The correspondence follows a NHI Nurse Registration Adaptation Programme survey that highlighted serious difficulties members are encountering in respect of accessing the programme. “Many nursing homes reported difficulties in recruitment and retention of nursing staff and accessing a work permit which is dependent on securing a date for adaptation placement,” NHI’s letter to Minister Reilly states. “NHI suggests that there is an urgent requirement for an extension of the adaptation programme to ensure appropriate workforce planning in our health service and to address the current recruitment crisis for private and voluntary nursing homes.”

NHI Budget Submission 2013 The private and voluntary nursing home sector has the potential to create 10,000 sustainable jobs over the next decade if supported with an appropriate framework to meet the growing requirement for long-term residential care, Nursing Homes Ireland’s 2013 Pre Budget Submission states. It puts forward three actions that can provide the sector with a necessary immediate stimulus to enable it start expanding to meet demand: P For a period of five years the rate of VAT applied to the construction and associated costs of any new residential care project should not be applicable for VAT payment or marginally rated, P Planning contribution fees should be waived during an agreed time defined period on such developments, P Operators of new builds should be afforded opportunity to agree in advance the Fair Deal rate for residents that will be supported within a new facility. The submission outlines the significant contribution the sector makes towards the Exchequer and contribution of Residents supported by the Nursing Home Support Scheme (Fair Deal) to the State. It points to the body of independent evidence that is outlining the considerable growth in requirement for nursing home care that is arising.For every 100 new beds provided within the sector, 100-full time sustainable jobs are created, the submission states. It adds: “The challenges to ensure our older population can avail of the specialist care nursing homes provide are considerable. They cannot be ignored and must be addressed and embraced. Government, the Department of Health and policy stakeholders must develop a coherent policy framework to meet the significant growth in requirement. Doing so will bring considerable benefits to the health service, the national economy and the economies of local communities. The private and voluntary nursing home sector can, with the right conditions, meet the required expansion over the next decade and in doing so create thousands of jobs within the construction sector and up to 10,000 direct sustainable jobs within the healthcare sector.” The Submission also calls upon the State to engage with the private and voluntary nursing home sector to ensure the specialist care it delivers is utilised and enhanced. “Private and voluntary nursing homes, as specialist care providers within communities that are subject to independent robust regulation, can play key roles in fulfilling our population’s healthcare requirements in respect of respite, intermediate, rehabilitation and home care, and independent and assisted living,” it states. The submission is available to read in full in the publications section,


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Public Affairs Campaign 2013 Media Coverage The Irish Times carried an extensive feature 9th August informing of the very real crossroads long-term residential care finds itself at. Though our ongoing public affairs campaign, NHI has engaged extensively with media to inform re pressures being brought to bear upon the private and voluntary nursing home sector in meeting continued and growing requirement for long-term residential care. Within the Irish Times article, Tadhg Daly, NHI CEO, informed private nursing homes have “throttled back” investment in the uncertain environment we now find ourselves in, while the public sector requires large sums to renovate its ageing structures to meet HIQA Standards. “There have been too many reports, too much talk and not enough action. A forum is an absolute necessity to address the growing healthcare demands of our ageing population and to plan accordingly,” Mr Daly stated within the article. “The sector has stepped up to the plate and met the challenge of the new, robust inspection process.” He went on to state: “We accept the State has to get value for money but this shouldn’t be confused with a downward spiral.” The article informed one in five public nursing homes is housed in buildings over a century old. “The cost of maintaining these relics is already huge and it is questionable whether they will pass muster when HIQA imposes new, higher standards from 2015,” it stated, referring also to a cost of €1 billion-plus to renovate existing HSE facilities.

On 11th July the Irish Independent carried a feature detailing the significant challenges being brought to bear upon the private and voluntary nursing home sector, advising of NHI’s push for better planning policy. The article featured an extensive interview with Mr Daly. He informed of the significant growth in our ageing population and increased demand for nursing home care. “Given the public nursing homes are obviously more expensive to run, there is no doubt the State needs private homes if it wants to keep costs down,” he stated. “When there are nursing home shortages, people end up in hospitals and a hospital bed costs around €1,000 a day.” He cited poor access to finance and policy uncertainty within our sector and referred to the “massive” administrative burdens being imposed upon homes because of the new regulatory regime. “We have regulations pushing us to spend more, but at the same time the State is stifling the prices we can charge,” he said. Other media to recently cover issues surrounding the pressures being brought to bear upon our sector and NHI’s Public Affairs Campaign 2013 included Morning Ireland (RTE Radio 1), RTE Nuacht, Sunday Business Post, Daily Mail, Daily Mirror, Both the Irish Times and Irish Independent carried further articles in respect of the issues affecting the provision of long-term residential care. You can access NHI’s media coverage by visiting the news section of the NHI website,

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NHI commissioned research to shape & inform public policy HI has engaged BDO to conduct independent research that will be used to shape and inform public policy in the area of provision of long term residential care and the funding of aged care in Ireland. Two successful focus groups were facilitated by BDO during September to identify key challenges facing nursing home operators and wider issues impacting upon the sector. NHI members participated in the focus groups that also aimed to identify and explore opportunities for the nursing home sector to play a greater role in the overall Irish healthcare system and contribute to the long-term sustainability and viability of the sector. BDO is engaging with key stakeholders in the health and long-term residential care sectors to inform in respect of its report. At the Shaping the Future of Nursing Home Care, the Nursing Homes Ireland Annual Conference 2013, Derry Gray, Managing Partner of BDO, will present the preliminary findings of BDO’s research. His presentation will be delivered at Citywest Hotel, 7th November, and is titled Towards a Future Strategy for Residential Care Requirements of Ireland’s Ageing Population. “This research is taking place during a time of significant reform and


challenge, not just for the nursing home sector, but the wider health sector,” Tadhg Daly, NHI CEO stated. “This report will ensure that we have the independent research and evidence to engage actively and lead the debate on public policy in respect of current and future requirements for long-term residential care. The evidence is clear. Demand for nursing home care will soon supercede the capacity of the sector to meet future requirements. The significant growth in demand for nursing home care, coupled with the continued reduction of public sector capacity, means Ireland is facing into a significant shortfall of capacity to meet the long-term care requirements of our ageing population.” Census 2011 revealed over a five year period to 2011 the number of persons aged 65+ grew by 14.4 per cent. The ESRI projects an additional 13,324 long-term care places will be required from 2007 – 2021 for persons aged 65+, a 53% increase. The Centre for Ageing Research and Development in Ireland (CARDI) projects the number of persons requiring nursing home care will increase by at least 12,270 by 2021, an increase of 59% from 2006, and the increasing numbers could amount to 14,502. One of the critical issues for the demand for long-term residential care

is the increase of the older old; that is the demographic aged 85+. The population aged 85+ is forecast to increase by 57,830 between 2006 and 2021, an increase of 120%. “The residential care requirements of an ageing population will have significant implications for the health service and if not addressed will exacerbate the existing difficulties in the acute hospital system,” Mr Daly stated. “There has been significant slowdown in new developments and extensions in the private and voluntary sector in tandem with reductions in public sector provision. There is an urgent need for Government to address and develop public policy that creates the necessary environment for the investment required to meet current and future residential care requirements of our ageing population. This, together with the increased dependency levels of residents together with increased specialisation in the nursing home sector, and the potential expansion of the traditional role of the sector must be addressed.” The full line-up of speakers for Shaping the Future of Nursing Home Care, the NHI Annual Conference 2013, is detailed in this edition of NHI News. Visit to download a booking form or contact (01) 4292570 to book your place.

Nursing Homes Ireland Partnership with First Choice Purchasing New Strategic Contracting and Group Procurement Partner Exclusive to NHI Members NHI has formally announced it has agreed a procurement partnership with First Choice Purchasing.Thepartnershiphasthepotentialto transform the business environment of NHI membersandbringsignificantsavingsandvalue formoneyatnoextracosttomembers. FirstChoicePurchasing’scoreobjectiveisto ensure that the partnership delivers the most competitive market price for all goods and services for NHI members, combined with optimum quality and service. First Choice Purchasinghasextensiveexperienceinstrategic contracting,servicelevelagreementdesignand smartprocurement.

TadhgDaly,NHICEOstated:“Thisisavery excitingdevelopmentforourmembership;NHI is taking a leadership role in driving value in procurementformembers.Thispartnershipcan deliver excellent returns on membership fees and effective savings, together with optimum qualityandservicesthatcanbenefitmembersin theday-to-dayrunningoftheirbusiness.” NHI members can sign up to the partnership by contacting Eoghan Donnellan, First Choice Purchasing, at or at 086 2295638.

“I have been working with First Choice Purchasing (FCP) and Jason Finnegan for the past six months and we have achieved fantastic savings in the process without affecting the quality of the Group’s purchases. Highfield Healthcare has reaped the benefits of being part of a group purchase scheme with in excess of 160 properties.. Once the purchasing audit comparison analysis was completed this highlighted areas we can improve our purchasing power. I would highly recommend working with FCP. They are a great safety net to ensure Highfield Healthcare has the best possible purchasing power” Stephen Eustace Chief Executive, Highfield Healthcare


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READ ALL ABOUT US! What activities are taking place in your home? How are residents fullling their lives? What celebrations are taking place? Read all about us! offers NHI Nursing Homes the opportunity to publicise the wide-ranging activities that are taking place in homes across the country. It provides an excellent opportunity to publicise nursing home life in the positive light it should be seen in and members are encouraged to make us aware of what is going on. You can send any articles or pictures of interest to

Summer of activity at Craddock House

An annual garden party that brought 300 people together, a Hollywood Fair, a series of outings, live music, antiques, flower arranging and baking classes; just some of the activities residents of Craddock House Nursing Home, Co Kildare, participated in during summer months, writes Mary Darker, Activity Coordinator. Summer kicked off in Craddock House Nursing home with our Bealtaine Festival Arts and Crafts Fair in May where our residents had the opportunity to showcase their work and participate in a range of activities. This included art classes, flower arranging, knitting, and arts and crafts. June kicked off with fantastic weather and our annual garden party was a great success, with over 300 visitors enjoying the day. It’s true to say that putting out the reliable Infant de Prague statue pays off! July 21st saw our ladies and gents take to the floor in celebration of National Live Music Day when a lovely two piece band called Shine visited and entertained with songs from the past & present. The month coincided with the mega celebration of Mai Tyrell's 100th birthday and boy did that very special lady party. To say she is amazing is an understatement. Not only were there great celebrations with us, but Mai partied for weeks celebrating the event with her family. Trips to our local Straffan Steam Museum and walled garden were also enjoyed and for those less able visits to our local lakes for picnic and ice cream took place.

Third Age was invited to the home and came with an abundance of antiques, from old washboards to double-sided glass baby bottles for displaying to our residents. The day went down a treat and many a memory was shared. Our activity coordinators treated our residents to an afternoon tea party in the Parlor where they enjoyed tea in real china cups and enjoyed the sweetest fancies imaginable. This day proved a great success and it was lovely to listen to stories of when the good china was taken out - most definitely a day to repeat. In August our flower arranging ladies enjoyed a trip to their teacher Hazel’s house and were given a tour around the farmland and beautiful gardens. Baking classes continue to be a success in Craddock House, with the most delicious brown bread being turned out by our ladies, who tell me the secret of the bread making is all in the way you mix it. The Hollywood Fair was delighted to welcome a group of residents where displays of vintage tractors and bicycles and trashing machines enthralled all. It was a very busy Summer in Craddock House!

Above: Jane Bagnall, Care Assistant, waltzes with resident Lilly Kirwan in the summer sun Left: Residents swing and jive on National Live Music Day Right: Mai Tyrell celebrates her 100th birthday at Craddock House with daughter Marjorie


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Green hands in International Millhouse as Missy recognition for settles into new home Brídhaven A loyal and friendly companion has joined the residents of Millhouse Care Centre, Co Wexford. Missy is a five year old golden retriever who was recently adopted by the nursing home’s Director of Nursing Audrey Molony on behalf of the residents. Prior to moving to Millhouse, Missy was a rescue dog. “Missy is an absolutely beautiful dog who was shy and timid when she first arrived in Millhouse but she has now settled in very well and she has a perfect temperament for our nursing home,” Audrey explains. “She is loyal and friendly and with so many residents loving her Missy is never short of companionship or a playmate to throw a ball for her to fetch”. Activities Coordinator Pam Rossiter accompanies Missy on her daily visits to residents in the home. Pam has seen first-hand the benefits pet therapy has to offer the residents of Millhouse and reports that Missy brings companionship to residents and aids social interaction within the home. Millhouse is a very lively setting. A recent addition to the activities programme is gardening. Thanks to Derek Butler, its head of maintenance, a recently purchased greenhouse is now producing its first season of fruit and veg. Residents have also grown a wide selection of flowers for display in window boxes to brighten up the home. Audrey is delighted that residents report a high level of emotional satisfaction from harvesting their home grown fruit and veg. She believes that the garden stimulates the residents of Millhouse by engaging all of the senses, not just the sights, sounds and smells but touch also, as the texture of the soil tells a story.

Left: Millhouse Care Centre resident Seamus Jones is pictured with Derek Butler, Head of Maintenance, in the nursing home’s new greenhouse.

The first nursing home to achieve the prestigious Joint Commission International Accreditation in Ireland and outside the USA is Brídhaven Nursing Home, Co Cork. It took two years to achieve the accreditation and the Mallow-based nursing home satisfied criteria set out by a team of international experts in a range of areas, including infection control and medication management. “We wanted to work to a standard that was recognised internationally as being the leader in our industry and, in turn, we wanted that to become the way we worked in Brídhaven,” Paul Rochford, Registered Provider stated. “Accreditation provides a culture that is open to learning from adverse events. It has increased our awareness of infection control, preventing harmrelated falls and enhanced more effective communication across the health care team. It has further developed our culture of transparency and openness to learning and clinical development; and it also demonstrates that our organisation is concerned that we deliver the best care possible.” Arising from the accreditation, paperwork is now audited on an ongoing basis to ensure that it delivers the safest possible outcome and training and recruitment procedures are at the highest level. The maintenance of machinery and buildings has become much more professional and every piece of equipment is now traceable. Minister for Older People Kathleen Lynch congratulated Brídhaven upon its achievements. “The concerted effort and hard work undertaken by those in Brídhaven Nursing Home to fulfil this international accreditation standard is to be commended,” she said. “The JCI evaluation process is intense, to say the least, and it is gratifying to see a care facility such as this go to all that trouble in order to go above and beyond normal standards of care and foster best practice in a culture of openness and efficiency. Simple measures like strict attention to hand washing and general hygiene, data and medicine audits, detailed accident reports and dietary requirements are so crucial in the care of the older person and continuous auditing is most definitely core in best practice.” P

Pictured at the announcement of the accreditation are, from left, Donna McNamara, Person in Charge; Minister Kathleen Lynch; Paul Rochford, Registered Provider; Helen Morley, HR Manager. Photo Donagh Glavin

Right: New resident Missy takes centre stage with Director of Nursing Audrey Molony, Resident Mary Stafford and Activities coordinator Pam Rossiter.


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Medals awarded as Maypark community comes together for sports day When we think of the life and activities in a nursing home we can quite often picture small groups of older people sitting in the day room playing bingo or listening to music, maybe having a cup of tea, writes Patricia O’Sullivan, HR Manager. Staff busily going to and fro, providing good care in an efficient manner, with visitors popping in with flowers to have a chat. At Maypark in Co Waterford we’ve really sought to throw tradition to the four winds and do something different. But what? It had to be something which residents and visitors would enjoy and something which the staff could participate in and get involved with. The weather being good, we started to think of an activity which we could go ahead with in the garden. Then some of the carers had a thought. What about a sports day just like everyone had during their school days! Some of us were unsure how the residents would react to such an idea. Then more carers started to expand on what the day could bring. Slowly a plan was formed; volunteers came forward, from face painters to sporting participants. Posters went up early and we spoke to lots of families encouraging them to come along. The day arrived on 9th July and everyone really had fun. Residents played bowls and other outdoor games. Staff and families did the traditional wheelbarrow races, egg and spoon and tug-ofwar. There was live music, strawberries and cream, plus lots to drink as it was a hot day.

Right: Cait Daly, Kevin Walsh, Ella Halley, Tess O'Sullivan enjoy the activities Below: Maypark’s Sports Days egg & spoon race


Liz Martin, Director of Nursing says it benefitted the home in so many ways, for example: P Residents got to be part of something their family and friends participated in and residents got to see children in their natural state of play. P

The element of competition was introduced and residents really got a kick out of winning and receiving medals, but also were amused when a member of staff won or lost. It was a great team building exercise for the staff. They worked very closely together to ensure the day went well.


The staff also really enjoyed a day at work that was different

Staff and relatives enjoyed great interaction, with staff entering races with residents in team events. The residents are still talking about their day. As it went so well, we are going to make it an annual event, something else to add to our calendar of life at the home. P

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Residents on their bike to raise money for charity The community of CareChoice Montenotte remarkably replicated a 32 county charity cycle within the home in May. Clodagh Whelan, Director of Recreation, writes further. When the residents of CareChoice Montenotte heard their House Doctor Dr. Tom English was doing a charity cycle in aid of Console they wanted to get involved. The CareChoice Recreation team worked with Fit for Life (the exercise therapists who visit the Home three times weekly) and came up with a plan: using a Motomed (an adapted exercise bike), the residents would cycle a minute for every kilometre covered by Dr English. To ensure staff and visitors could be part of the fun, there was also a spinning bike. The plan captured the imagination of visitors to the Co Cork home; for a week we had sons, daughters and grandchildren cycling with their relatives. Even the man who delivers the newspapers hopped on for a spin! We followed the progress of Dr English and his group each day on our giant map of Ireland and had great fun emailing and texting our progress between both cycles. Dr English and the Hardy Bucks cycling squad cycled across 32 counties, departing 4th May. There was a race to Crookstown on Day Two which the residents are certain they won! As well as raising money for charity and supporting a good cause, the social benefit was immense. There was a hum of chat and laughter at the bikes throughout the week. Visitors and staff learned about the health benefits of using the Motomed and the residents became the teachers. Dr English and the team were delighted with the support. He commented: “We raised €22,000 but more importantly we increased awareness of suicide prevention and the services provided by Console both nationally and locally. The support and effort of all at CareChoice Montenotte contributed greatly to our success. The commitment of the residents really spurred the outdoor cyclists on, particularly on the wet days! Their enthusiasm was inspiring and will live long in the cyclists memories”. Sometimes the residents of long term care are viewed in a way that is not particularly empowering or positive. This cycle showed that the residents of CareChoice Montenotte continue to contribute to society in a meaningful way and have great fun doing so! P

Period costumes for Bloomsday celebrations in Co. Dublin home


champagne brunch, musical entertainment and readings from James Joyce classic Ulysess, were all part of the Bloomsday celebrations at a Co. Dublin Nursing Home. Residents, family members and staff of Ashford House Nursing Home, Dun Laoghaire, celebrated the day on Sunday 16th June by dressing in period costume for the occasion. It created a wonderful Joycean atmosphere. The day is celebrated in the Co Dublin town and Ashford House residents, staff and visitors participated this year. It was such a success it was decided it will be an annual event at Ashford House. The activities within Ashford House are diverse, wide-ranging and varied. In July it undertook a visit to Dublin Zoo, pictured below, and a trip to the seafront in Bray was also a recent outing. P

The Hardy Bucks cycling group whose 32 county cycle was mirrored by the nursing home community of CareChoice, Montenotte. Picture from left to right are: Kieran Fields, Val Collins, Dr Michael Crotty, Drew O’Brien, Paul French, Dr Tom English.


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Beautiful gardens graced by visit of Cairnhill residents Lisa Fitzgerald, Activities Co-ordinator, at Cairnhill Nursing Home, Co Dublin, recounts a visit to Powerscourt Gardens on a warm summers day. The sky was blue, the air was fresh and the sun was shining gloriously. There was a sense of excited anticipation amongst residents that seemed almost tangible. The day for our trip to Powerscourt Gardens had finally arrived. When we reached Powerscourt we walked down a narrow, poorly lit corridor and accessed the gardens through a small door. This somehow made it feel like we were about to enter this secret, enchanted place. Everyone gasped with wonder when we opened the door. Before us was a great open space, sloping gently down to a beautiful lake. Beauty flowed from every corner of the garden. It featured an abundance of flora in nature’s most simple form, the chirping of birds, the deep green grass and the smell of the fresh air. The sights and sounds of the garden calmed the heart and brought a smile to everyone’s face. We walked around the immaculately kept gardens, up and down hills, in and out of forested areas admiring the bright colours and smells of the flowers. We took lots of pictures to remember the moment. One resident commented “this is how life is supposed to be – no troubles, no stress, just myself and nature”. Many of the residents

were keen gardeners – their gardens were their sanctuary, their hobby and a great pleasure in their life. Stories were shared among them about their own gardens and they reminisced about their much loved hobby and experiences. After our walk we went to the cafe that overlooked the gardens. It had a welcoming atmosphere and was buzzing with the chatter of customers. The warm breeze blew in from the open doors. We relaxed while enjoying a hot cup of tea and a slice of delicious cake. Afterwards, we went to the shop in Powerscourt and we browsed through the various craftworks, clothes, books and other items. We laughed as someone read aloud the funny anecdotes or phrases written in some books. We tried on the scarves and shawls and admired ourselves in the mirror. We examined the different food products and talked about our favourites. In Cairnhill we are proud of the care and attention we give to our residents. Social activities can help keep older people engaged in the world around them and to remain close to other people. Taking part in group activities and social events help older people maintain a sense of meaning and purpose in life, which can boost emotional wellbeing. Although our trip to Powerscourt may seem quite simple, it brought great joy to residents and our staff. It brought a smile to their faces; something we try to do everyday! P

Pro f


Nu M


m a

Liam visits Carrigoran All-Ireland Hurling Champions Clare paid a very special visit to the residents of Carrigoran House Nursing Home on their journey home from claiming the Liam McCarthy cup. The hurlers visited the nursing home prior to their homecoming parade. Team manager Davy Fitzgerald said members of the team expressed an interest in visiting the Newmarket on Fergus nursing home. Excited residents and staff met with the victorious players and held aloft the Liam McCarthy. P



Clare hurler Colin Ryan and the Liam McCarthy are pictured with resident Jimmy Hanrahan

Below: From left, player Colin Ryan, Sr Christina Murphy, Mary Donnelly, Paudge Collins and Emily Crimmins hold the Liam McCarthy.

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HIQA new complaints procedure The Health Information and Quality Authority has published a new Policy and procedure for the management and handling of complaints about the Authority policy document. The document outlines four stages for dealing with differing types of complaints and is for use by persons lodging a complaint concerning an employee or how the Authority conducts its business. Timelines are defined in respect of each stage. Stage 1: Immediate resolution (timeframe: within three working days of verbal complaint being received) Stage 2: Early resolution (timeline: within 21 working days of written complaint being received) Stage 3: Formal resolution (timeline: within 40 working days of formal resolution being requested) Stage 4: Review panel (timeline: within 48 working days of review panel being requested) NHI is of the view the publication of the new policy and procedure is a welcome development, providing definitive timelines and guidance in respect of bringing complaints to the Authority.

Fair Deal budget will remain ‘ring-fenced’: Minister Lynch Minister for Older People Kathleen Lynch has informed the Oireachtas Health Committee she gets “very worried” when she hears people talk of extending the Fair Deal scheme to the community. Minister Lynch praised the scheme for its fairness, describing it as the only scheme that follows the “money follows the patient” mantra. Minister Lynch said the model should be replicated for community care and the Fair Deal budget should remain exclusive for nursing home care. Speaking at the Oireachtas Health Committee debate 25th July she said: “We are reviewing the Fair Deal scheme. It is working very satisfactorily for nursing homes. I know that there will be problems with waiting lists from time to time, but it is still the fairest of all the schemes introduced. It is the only scheme in Ireland that has a "money follows the patient" concept and we should look at this in other areas. We are looking at how to extend it into the community in the same way as we deal with people in long-stay care. We are not talking about the fund as it now exists being used for community care. The fund needs to be used as it is now being used. There already exists an extensive budget for community care anyway, and it is about how people access that. It is about how the fund is delivered. I get very worried when I hear people talking about extending the Fair Deal scheme into the community, and I know they assume that the fund will be extended as well.” Later in the debate she added: “We have a specific budget for home care packages. I made this point earlier in respect of extending the Fair Deal scheme. We are not suggesting that we will distribute the pot of money set aside for long stay care throughout the community. It is a question of how we access the budget and the process we put in place to ensure it is as fair and transparent as the Fair Deal scheme. The review has been delayed slightly because of the various issues that arose during the year but we are still continuing with it.”

HSE elder abuse report 2012 The older persons own home remains the most common setting for the majority of elder abuse cases referred to the HSE. The Executive’s Open Your Eyes, its elder abuse report for the year 2012, informed 79% of the complaints referred to it emanated in respect of an older person living in their own home. Private nursing homes accounted for 9% of referrals, 3% emanated from public and continuing care settings and 6% from relatives home. In the year 2012, 2,750 cases were referred to the HSE and the breakdown in respect of the abuse category was as follows: P

Psychological 36%


Financial 25%


Neglect 19%


Physical 13%


Self-neglect 4%


Sexual 2%


Other 1%

46% of the complaints were in respect of abuse being allegedly perpetrated by a son/daughter, 17% by a partner/husband/wife, 5% by a neighbour, and 5% by carer/staff. In 2012, the HSE received 2,460 referrals of elder abuse to its service, an increase of 7% from 2011.

No specific proposals to outsource Fair Deal administration: Minister Reilly The Government has no immediate plans to outsource the administration of the Fair Deal scheme, Minister for Health James Reilly has stated. The Health Amendment Bill 2013, enacted 24th July, contains a clause that affords HSE opportunity to enter into an arrangement with a separate party to perform the administration of the scheme. During a debate concerning the Bill in the Dáil on 4th July, Minister Reilly said the programme for Government commits to the carrying out of a review to identify and eliminate non-priority programmes and to outsource, where appropriate, non-critical functions. “With this in mind, a provision enabling outsourcing is being inserted into the Nursing Home Support Scheme Act 2009,” he stated. “However, no specific outsourcing proposals are under consideration at this time.” Deputy Caoimhghín O’Caoláin, Sinn Féin Health Spokesperson, questioned where the proposal has come from, before calling for the scheme to be “simplified, streamlined and better fitted to the needs of the citizen who require this service.” He said he would strongly oppose any outsourcing of the scheme.

Right: Minister James Reilly: No immediate plans to outsource administration of Fair Deal


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HSE overturns Fair Deal rejection after Ombudsman intervention

Assisted Decision-Making (Capacity) Bill 2013 The Assisted Decision-Making (Capacity) Bill 2013 has been published by Minister for Justice Alan Shatter. The purpose of the Bill is to comprehensively update and reform the law governing decision-making by people whose capacity may be impaired. The Bill proposes: P The Wards of Court system will ultimately be replaced by the provision of a legal framework to support people in exercising their decision-making capacity so that they can better manage their personal welfare, property and financial affairs. P The existing law on capacity will change from the current "all or nothing" status approach to a functional one, whereby decision-making capacity is assessed on an issue and timespecific basis. P The Bill provides for a range of supports, on a continuum of intervention levels to support people in maximising their decision-making capacity, to include: j Decision-making assistance; j Co-decision making; j Decision-making representation; and j Informal support. The Circuit Court is intended to have exclusive jurisdiction in this area (excluding matters reserved for the High Court), giving court-backed protection to the options chosen by people. Currently the High Court has exclusive jurisdiction in this area. The Office of Public Guardian will be established within the Courts Service, with supervisory powers to protect vulnerable persons.

Right: Minister Alan Shatter has published the Assisted

The HSE rejected an application for Fair Deal support on the basis that a man who required nursing home care had expressed a wish to eventually return to his home. The Ombudsman reported of the case in her Annual Report for 2012. The man had a serious medical condition and needed respite care over a number of years. He passed away, however the family brought the case to the office of the Ombudsman after Fair Deal support was rejected. “I formed the view that the refusal by the HSE was at odds with the medical evidence on record,” the annual report states. “In particular, the evidence recorded that the man needed full-time supportive care and that he had lived in nursing homes previously under the Winter Beds Initiative. His application also followed several admissions to hospital in the previous months. In addition, it was clear from the application form for the Scheme that, while the man expressed a preference for staying at home, he also indicated that he was willing to stay in the nursing home for a few months.” Ms O’Reilly asked the HSE to review the decision and it accepted the application should not have been refused, making the appropriate payment of €5,043.90 to his estate.

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SHAPING THE FUTURE OF NURSING HOME CARE Shaping the Future of Nursing Home Care, NHI’s Annual Conference 2013, will take place Thursday 7th November in Citywest Hotel, Co Dublin. The conference will focus upon the required expansion of the nursing home sector to meet growth in demand for long-term residential care. We’re delighted Dr Sarah Kagan, a renowned Professor of Gerontological Nursing and international speaker, will travel to speak at the event. She specialises in examining the experience of cancer for older persons and offers advanced nursing consultation to patients, their, families, nurses and physicians on matters of symptom management. We’re also delighted to welcome Senator Feargal Quinn, whose expertise in the harnessing and development of brand and business should prove of particular interest to nursing home proprietors and staff. The Nursing Homes Ireland annual conference is a key date on the health sector calendar and brings together nursing home representatives, staff and professionals from the health sector. The conference schedule affords delegates opportunities to visit an excellent set of exhibitors informing of products and services offering benefits to nursing homes. Persons interested in attending Shaping the Future of Nursing Home Care are advised to book early to avoid disappointment. email: for further information or call (01) 429 2570


registration Opportunity to Visit Exhibitors

12.00pm – 12.30pm

MORNING SESSION Conference Chair

John Bowman, Broadcaster & Historian

09.15am - 9.30am

Welcome Tadhg Daly,CEO

09.30am - 09.45am

Marie Kehoe O’Sullivan, Director of Safety & Quality Improvement, HIQA Revision of the National Quality Standards and the development of guidance for providers

Opening address Minister Kathleen Lynch T.D. Minister of State for Disability,Equality,Mental Health & Older People

09.45am - 10.30am

Mr.Derry gray, Managing Partner, BDO Towards a Future Strategy for Residential Care Requirements of Ireland’s Ageing Population

10.30am - 10.45am

questions & answers

10.45am - 11.15am

tea/coffee, Opportunity to visit Exhibitors

11.15am - 12.00pm

Dr.Sarah Kagan,

12.30pm – 12.45pm

questions & answers

12.45pm - 2.15pm

luncH Sponsored by Unilever Food Solutions Opportunity to Visit Exhibitors

AFTERNOON SESSION 2.15pm - 2.30pm

eoghan Donnellan, First Choice Purchasing Introduction to NHI Group Purchasing Scheme and the benefits to NHI Members

2.30pm - 3.30pm

Key note Speaker Senator Feargal quinn

3.30pm - 4.00pm

questions & answers


close conference


nHi care aWarDS cereMOny

PhD RN, University of Pennsylvania

Caring for the Resident Diagnosed with Cancer - Leading with Skilful Assessment

i Delegates atteding the 2012 conference


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SPEAKER PROFILES Minister Kathleen Lynch TD AppointedMinisterofStateforDisability,Equality,MentalHealthandOlderPeopleintheDepartmentof HealthandDepartmentofJustice,EqualityandDefence,10thMarch2011.MinisterLynchwaselected toCorkCorporationin1985andfirstelectedtoDáilEireannin1994.Shewassubsequentlyelected againin2002andhasretainedherseatsince.MinisterLynchwasamemberoftheJointOireachtas CommitteeonHealth,2007,JointCommitteeonJustice,Equality,DefenceandWomen'sRights20022007andmemberofJointCommitteeonEnterpriseandSmallBusiness,2002-May2006.

Derry Gray DerryGraybecameManagingPartnerofBDOinJune2011,havingpreviouslybeenPartnerandHeadof BDO’sManagementConsultingDepartmentforthepast10years.SincejoiningBDOin1995,Derryhas ledteamsinprojectsrangingfrom:theMasterplanforthedevelopmentoftheDocklandsinDublin:to projectspecificplanninganddevelopmentprojectswithanumberofcountycouncilsandpublic/state bodiestoleadbusinessconsultantforthenewlyplannedNationalPaediatricHospital.Derryhas undertakenmanyNursingHomedevelopmentandfinancialfeasibilityprojectsandwasamemberof theexpertgroupappointedbytheMinisterforHealth,MaryHarney,toexamineandrecommendon resourceallocationintheHealthServices.TheReportoftheExpertGrouponResourceAllocationand FinancingintheHealthSectorwaspublishedbytheDepartmentofHealthinJuly2010.NursingHomes IrelandhasengagedBDOtoconductindependentresearchtoshapeandinformpublicpolicyinthe provisionandfundingoflongtermresidentialcareinIreland.

Dr. Sarah H. Kagan Dr.SarahH.KaganholdsaprimaryacademicappointmentasProfessor-ClinicianEducatorandisthe LucyWalkerHonoraryTermProfessorofGerontologicalNursing.HerclinicalappointmentisasClinical NurseSpecialistintheAbramsonCancerCenterattheUniversityofPennsylvania,wheresheoffers advancednursingconsultationtopatients,theirfamilies,nurses,andphysiciansonmattersofsymptom management,psychosocialoncology,geriatriconcology,andinterdisciplinaryteamwork.Dr.Kagan's secondaryfacultyappointmentisintheDivisionofHematology:Oncology,whereherparticular consultativefocusisonclinicalresearchandcareofpatientswhohaveheadandneckaswellasother cancersandaresufferingcomplex,cancer-relatedwoundsandotherchallengingsymptoms.Dr. Kagan'sprogrammeofclinicalresearchiscenteredonhumanexperienceandillness,withafocuson symptomexperienceforolderadults,particularlythosewhohavecancer.Dr.Kagancommonly examinestheexperienceofcancerforolderadultsthroughnaturalistic,interactionistinquiryusing headandneckcancerasamodeltounderstandcancerexperienceinolderadults.

Marie Kehoe O’Sulivan MarieKehoeO’SullivanjoinedHIQAinJuly2012.Marieandherteamhavebeenresponsiblefor activelysupportingandenablingacultureofpatientsafetyandqualityimprovementacrossandwithin thehealthandsocialcaresystembyhelpingtobuildcapabilityandcapacityinthepeopleproviding services.Thisisdonethroughthedevelopmentofnationalstandardsandguidanceinconsultationwith keystakeholdersandtheprovisionoftraininginqualityimprovementmethodologiesandtoolsin collaborationwiththeInstituteforHealthcareImprovement.Theseinitiativeshelpthesystemtobuilda cultureofcontinuousqualityimprovementandpatientsafety.ThisDirectoratealsooperatesother schemesaimedatensuringsafetyandqualityintheprovisionofservices.Mariehasworkedinthearea ofHealthcareQualityImprovementformanyyearsintheUSAandIreland.BeforejoiningtheHealth InformationandQualityAuthority,shewasasRegionalGeneralManagerforQualityandPatientSafety intheHSEwheresheledonanumberofnationalprojects.

Senator Feargal Quinn SenatorFeargalQuinnisfounderofSuperquinn.HehasmademanycontributionstoIrishlife,most prominently,aschairmanofAnPostfor10years.Hechairedthesteeringcommitteethatintroducedthe LeavingCertAppliedandwasChairmanofIreland’sNationalSt.Patrick’sFestival.Since1993hehasbeen anindependentmemberoftheSeanadandisAdjunctProfessorattheNationalUniversityofIreland, Galway.Feargalistheauthorof“CrowningtheCustomer”andof“MindYourOwnBusiness”.Hedid threeseriesof“FeargalQuinn’sRetailTherapy”onRTE1whichreachedtopratingsaswellasthe‘Local Heroes-aTownFightsBack’seriesontransformingDrogheda.Ontheinternationalscene,Feargalhas servedontheboardoftheAmerican-basedFoodMarketingInstituteandofCIES,theParis-based organisationrepresentingretail,andservedasPresidentofEuroCommerce,theBrussels-based retailorganisation.


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Caring for the Resident Diagnosed with Cancer Sarah H. Kagan, Professor of Gerontological Nursing at University of Pennsylvania, Philadelphia, will travel to the NHI Annual Conference 2013 to deliver a presentation entitled Caring for Care Home Residents with Cancer – an American Perspective. Ahead of her presentation, she informs as to her experience of disconnect between cancer and aging in American long-term care and endavors to advance quality care.


ne of the things I enjoy most about traveling professionally is learning from colleagues in elder care in different systems and different societies around the world. For 27 years, I've been a nurse dedicated to care of older people, particularly those who have cancer. My combined focus of geriatric oncology is still a bit unusual in American elder care. Geriatric medicine and nursing - especially in long term care - still disconnects aging and cancer. American geriatric nurses and other members of the care team are more comfortable addressing the concerns that come with the experience of conditions like dementia and arthritis. That's despite the fact that advancing age increases risk of being diagnosed with cancer. Current estimates are that almost 3 out of 4 Americans diagnosed with cancer today are aged 65+. Likewise, the majority of cancer survivors are older too. Yet, care for older people living with cancer is still viewed as a sub-specialty, despite the high prevalence of this chronic non-communicable disease. The disconnection between cancer and aging is most obvious in American long-term care. However, debate over what evidence exists and marked variation in practice occurs across the cancer trajectory and across settings of care. This includes questions about screening and detection - to screen at all and when to evaluate symptoms, how to manage the decisions and the logistics of active cancer treatment through often stereotyped ideas about goals of care and needs for end of life care. Cancer generally perplexes and puzzles.

Importantly, those elders residing in American nursing homes who have a history of cancer may not receive appropriate survivorship care to optimise their wellbeing and limit late complications. The idea of survivorship care is only now reaching community-based primary care. I often hear from colleagues that the divide between geriatric care and cancer care in the nursing home setting is too large to close. However, in our ageing society, I believe that enduring the status quo puts older Americans at a distinct disadvantage. Consequently, I often begin my efforts to sway colleagues and reveal opportunities to advance quality care with discussion about appropriate assessment of resident status and needs. If we know better what we are seeking, we are likely to do better when we find it. A national report from our Institute of Medicine published several years ago - Retooling for an Aging America - explores specific needs for workforce development across settings of care and conditions. I rely on resources such as this and other evidence, coupled with my clinical experience in care of older people, when educating colleagues. My major interest in working with colleagues who care for older people in nursing homes is to provide them with knowledge to advance their own assessment skills. I find in my own practice that strong assessment skills enables better clinical judgment and decisions with and for those residents who are living with or have survived cancer. This November, I look forward to learning from you - colleagues who work in nursing homes across Ireland - and sharing ideas and plans for better futures in both our ageing societies.

SarahH.KaganistheLucyWalkerHonoraryTermProfessorofGerontologicalNursingatPennandisa consultantinthePennCenterforHumanAppearance.SheiscurrentlyAdjunctProfessorattheAmerican UniversityofArmenia,VisitingProfessorattheOxfordBrookesUniversityFacultyofHealthandLifeSciences, andHonoraryProfessorintheDepartmentofCommunityMedicine,UniversityofHongKong. Dr.Kagan’seducationandtrainingincludesabachelorofartsinbehavioralsciencefromtheUniversityof Chicago,abachelorofscienceinnursingfromRushUniversity,amaster’sdegreeingerontologicalnursingand aPhDfromtheUniversityofCalifornia,SanFrancisco. SincearrivingattheUniversityofPennsylvaniain1994,Dr.Kaganhasdevelopedaneducationalfocusin undergraduatenursingeducation.ShecurrentlydirectstheUniversityofPennsylvaniaUndergraduateNursing HonorsProgramandtwoclinically-basedundergraduateinternationalexchangeprogramsinnursing–onein theUnitedKingdomandoneinAustralia.Inaddition,Dr.Kaganteachesshorttermstudyabroadforthe UniversityofPennsylvaniainpartnershipwiththeUniversityofHongKongSchoolofPublicHealth.Shealso maintainsanactiveprogramofclinicalscholarshipandpracticeingeriatriconcology,whichservesasawellspringforherundergraduate pedagogyandanchorsherunderstandingofthenurse-patientrelationshipandnursingcare. Dr.Kagan’sworkisacknowledgednationallyandinternationallyasinnovative,sophisticatedandclinicallyrelevant.Sheisafellowof theGerontologicalSocietyofAmericaandtheAmericanAcademyofNursing.Dr.Kaganhasheldnumerousvisitingprofessorshipsatmany notableinstitutionsnationallyandinternationally.Amongtheawardsshehasreceivedforherpractice,research,andteachingaretheSigma ThetaTauInternationalFoundersAwardforExcellenceinNursingPracticeandtheJohnD.andCatherineT.MacArthurFellowship.Dr.Kagan receivedanHonoraryDoctorateofSciencefromOxfordBrookesUniversityinJune2013


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Nursing Homes Ireland Care Awards 2013 Thursday 7th November 2013 | Citywest Hotel, Co Dublin

Congratulations to the NHI Care Awards 2013 Finalists NURSING HOME DIRECTOR OF NURSING/PERSON IN CHARGE AWARD



Sinead Beirne Annabeg Nursing Home Meadowcourt, Ballybrack, Co. Dublin

Siby Joseph Ashford House Nursing Home 6 Tivoli Terrace East, Dun Laoghaire, Co. Dublin

Chrissy Barron Moorehall Lodge Ardee Hale Street, Ardee, Co. Louth

Sheilah Climaco

Mairead McGuinness

Ashborough Lodge Lyre Road, Milltown, Co. Kerry

St. Peters Nursing Home (Trinity Care) Sea Road, Castlebellingham, Co. Louth

Valerie Joy Lisheen Nursing Home Stoney Lane, Rathcoole, Dublin 24

Kiri Mulqueen Beechlodge Care Facility Bruree, Co. Limerick

Hannah Mullen TLC Maynooth TLC Centre, Straffan Road, Maynooth, Co. Kildare




Ingrid Bula Innis Ree Lodge Nursing Home Ballyleague, Lanesboro, Co. Roscommon

Jozefa Dulanska Bishopscourt Residential Care Ltd. Liskillea, Waterfall, Co. Cork

Kevin Cahill Glenaulin Nursing Home Lucan Road, Chapelizod, Dublin 20

Antoinette Kane Suncroft Lodge Nursing Home (Trinity Care) Suncroft, The Curragh, Co. Kildare

Karen Brett Glenaulin Nursing Home Lucan Road, Chapelizod, Dublin 20 Sandra Crowe Rockshire Care Centre Rockshire Road, Ferrybank, Waterford

Agnese Leipina Orwell House Nursing Home 112 Orwell Road, Rathgar, Dublin 6

Gerard Ryan Sacred Heart Nursing Home Crosspatrick, Johnstown, Kilkenny

Karen Lordan Haven Bay Care Centre Ballinacubby, Kinsale, Co. Cork




Aurelija Kupryte (Activities Team) TLC Cara Care Centre Northwood Park, Santry, Dublin 9

Natasha Bloore Moorehall Lodge Ardee Hale Street, Ardee, Co. Louth

Thomas Mulvaney Millbury Nursing Home Commons Road, Navan, Co. Meath

Kate Mrowinska & Paul Kelly Beneavin House Beneavin Road, Glasnevin, Dublin 9

Liam Deeney Brentwood Manor Letterkenny Road, Convoy, Co. Donegal

Deirdre Mullins Haven Bay Care Centre Ballinacubby, Kinsale, Co. Cork

Clare Healy Kiltipper Woods Care Centre Kiltipper Road, Dublin 24

Marie McGahey Powdermill Nursing Home & Care Centre Gunpowdermills, Ballincollig, Cork

nHi care awards In association with Homecare Medical Supplies

A prestigious celebration of Excellence in Care! To book your tickets

Contact Olivia at (01) 4292570 19 — NHI NEWS


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‘Growing and expanding my knowledge and skills’ Michelle Curtin is a Registered General Nurse at Oaklodge Nursing Home, Co Cork. Michelle achieved a general BSC nursing degree at University College Cork before moving to employment at the Midleton-based Nursing Home. She speaks to Michael McGlynn, NHI Communications & Research Officer, about the speciality that is gerontological nursing and the responsibilities placed upon her. She informs of the challenges and the enjoyment she takes from building lasting relationships with residents and their families.

Did your studies focus upon the speciality of gerontological nursing? Did you feel your course promoted the importance of the profession and the speciality of gerontological nursing?

Yes in the genal nsing program the is a great emphasis on ce of the eldly toughout a numb of diffent modules. These e completed ov a s month piod of intense lening, discussion and written aminations. I feel the was enough emphasis on educating in this field, as o lectes took a holistic approach to ense all nsing aspects we coved and a psoncened approach was the ultimate aim. The cose embedded in us a real belief that a physical physcocial, cultal approach enhancing successful ageing is the way of the fute. My study focused heavily on promoting gontology nsing. Not only was the a lge emphasis on the theetical education, the was plentiful placement opptunities to gain practical hands-on pience. Tough my fo ye degree I had the opptunity to take up fo placements, of which two we ce of the eldly placements. I also undtook a community ce and a palliative ce placement which I pticully enjoyed as many of these patients we eldly. What was your view of gerontological nursing prior to you taking up the position within Oaklodge Nursing Home?

Pri to taking up the pition, my view of gontology nsing was based on my clinical placement, which was challenging yet rewding. Wking with the eldly involves keeping them stimulated while in a safe and conolled envonment. This is a difficult task as one has to take into account each pson’s competency and abilities when ptaking in any reeational activity. At fst I was apprehensive with the thought of being responsible f the planning and implementation of such activities but now this is something I really look fwd to and enjoy ptaking in each day. What do you see as the view of trainee/graduate nurses of gerontological nursing and employment within the nursing home sector?

The is a genal consensus among many graduate nses that wking in a nsing home diminishes yo nsing skills and is physically and mentally hausting. How did you come about your role in Oaklodge? Were you interested in securing employment within the nursing home sector prior to you fulfilling the role or did your uptake of employment come about more by chance?

The Managing Dect of Oaklodge gave a presentation to my ye on o final day of college. It was ding this presentation that my intest in Oaklodge was spked. The Dect placed huge imptance on Oaklodge’s commitment to fth education and psonal development. What was your perception of gerontological nursing/work within a nursing home prior to your fulfilment of employment within Oaklodge?

Pri to my employment, I believed that gontological nsing was going to be rewding wk. Howev I feed that I would le some imptant skills which I had recently masted while wking in an acute hpital. F me being able to keep up to date and panding my clinical knowledge whilst out of an acute sect was a real concn. 21 — NHI NEWS

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“I can honestly say that I have experienced many situations that I would not have experienced in an acute setting, and I feel my skills are developing each day.”

How has perception & reality differed?

Since fulfilling employment in the nsing home sect the realty has been in stk conast to my preconceived pception in a numb of diffent eas. I have been granted numous opptunities to grow and pand my knowledge and clinical skills. I have attended many cose days and hope to continue doing so in the ne fute. Oaklodge places a lge emphasis on continuing development and education. From the vy beginning I can honestly say that I have pienced many situations that I would not have pienced in an acute setting, and I feel my skills e developing each day. While I was concned that I was going to suff om ling skills pri to taking up employment within the sect, nothing could be fth om realty as I am constantly acquing new skills and competencies. What are you tasked with within the role? What are your responsibilities? Is there a typical day? What does it involve?

Ftunately the is no typical day when wking with the eldly, howev the is a sucted approach to the day. My responsibilities include communication to oth staff via handov, ug adminisation, attending to psonal hygiene needs, wound ce, and liaising with multi-discipliny team membs such as GP’s, public health nses and home ce teams. Also dealing with families and adhing to nsing documentation policies e pticully imptant responsibilities.

mental status; improve the living envonments and quality of life. I am happy to be pt of a team that all wk in unison to achieve a common goal that is pt of the Oaklodge mission statement – “adding life to yes and yes to life’’. What are the difficulties associated with the role? What would be the negatives?

Being the only nse of a lge group of residents can be difficult as it reques me to confine my duties to immediate priities such as dispensing medication. Documentation has become a huge priity in the nsing field which can also be viewed as a negative as it takes om basic nsing ce. Do you speak to fellow graduates about your role?

In the cent economic envonment with employment embgoes on almt all public hpitals, many of my fellow classmates have pused ces in nsing home facilities, and e pleasantly sprised as to how rewding the role can be. What advice would you provide to any trainee/graduate nurses in respect of employment within the nursing home sector?

With the inease of dementia and oth age related illnesses, my best advice to asping nses and graduates is not to not be awn into negative preconceptions and steotypes and keep an open mind.

Have you enhanced responsibility that you would not have within an acute hospital setting?

Yes definitely. I have a much lg patient load and while on duty I am solely responsible f all aspects of ce f the residents. Within the nsing home envonment you do not have the same in house suppt of a medical team, as such I must utile my decision making skills on a daily basis What are the positives associated with your role? What do you enjoy about your job?

At present I wk in a dementia specific unit and no day is the same due to the challenging behavio of the wk envonment. I enjoy building lasting relationships with residents and the families to ense the highest quality of ce is given. I take pride in the fact that I improve people’s functional and

My Nursing Home Life affords persons working within a nursing home setting the opportunity to discuss their role and advise the wider public of what it entails and employment within such a setting.


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Celebrations across Ireland for inaugural

Nursing Homes Week 2013

NHI members across Ireland celebrated nursing home life during the inaugural Nursing Homes Week 2013, which took place Monday 26th August – Sunday 1st September. A wide range of activities and events organised by members brought staff, residents, families, visitors and the wider community together for the national celebration. Activities that took place included family gatherings, music, barbeques, talks, drama, performance, outings, fitness activities, pampering, and arts and crafts. Tadhg Daly, NHI CEO commented: “The inaugural Nursing Homes Week highlighted the positivity that is at the core of nursing home life and the high quality care that is intrinsic to improving the health and wellbeing of persons in NHI Member homes. We look forward to building upon the success of this year’s week and celebrating and promoting the nursing home sector during Nursing Homes Week 2014.” Just some of the activity that took place around the country is now detailed.

COUNTY CORK Tea party celebration at Darraglynn

hter) enjoy the Molly Cronin (mother) and Tina Clehane (daug aline Road, Cork. Carrig Old , Home ng Nursi glynn Darra celebration at

Pictured on a visit to Mount Mellary Abbey, Waterford, are back row, Amelia Clifford and Karen, both staff, Mary Meade, resident, Marie McGahey, activities coordinator. Pictured front are residents Rita Murphy, Mary Murray (RIP), Margot Staunton, Mary Crowley.

At Darraglynn Nursing Home they hosted an afternoon tea party celebration and family and friends joined staff and residents for the celebration. It was a very successful event and everybody enjoyed themselves.

Activities at Powdermill

Music, shopping, baking, sewing, cards, bingo and therapeutic activities all took place in Powdermill Nursing Home.

Resident Anne O'Callaghan is pictured with Aileen McCarthy and Liz Dunne

Resident Michael O'Callaghan is pictured with his sister Joan and cousins

Afternoon tea unites all at Ardsley Nursing Home Residents of Powdermill Nursing Home, Co Cork, participating in the Sonas programme during Nursing Homes Week with the help of Marie McGahey, activities coordinator.


Staff, residents and their families enjoyed an afternoon tea-party at Ardsley Nursing Home

Resident, Kitty O'Connor is pictured with her daughter Deirdre

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COUNTY DUBLIN Song, poetry & videoke at Holy Family Residence

Lily Hynes takes to the microphone at the summer sign-along

Fun and enjoyment at the summer sing-along

Nursing Homes Week provided an opportunity for family and friends to pay a visit to Holy Family Residence, Clonskeagh. In celebrating Nursing Homes Week 2013, the home’s activity coordinators, together with staff, encouraged residents to attend daily activities for the day. These included quiz, arts and craft, light exercises, music sessions, hand massage and daily Mass. Decoration of the hall was incorporated into the activity schedule wherein the residents in the art class were involved in the planning of the hall. The Home celebrated the feast of St Jean Jugan, the mother of Little Sisters of the Poor, on Friday 30th August and the Roebuck summer sing along. Staff, the Sisters, residents, their families and friends and members of the Holy Family Residence day centre participated. Some recited their own composition of poems, some sang their favourite Irish folk songs and all enjoyed videoke. The event also featured a raffle with exiting prizes. There was excellent feedback from the residents and their families and also from the members of the day centre.

Summer celebration at Harvey

Harvey Healthcare Glenageary celebrated Nursing Homes Week with a summer party that brought residents, staff, relatives and visitors together at the home.

Pictured dancing are Brigit Reilly and Ray McDonnell, lead singer of live music band Raytone

X-Factor at Marymount

On Saturday August 31st the final of Marymount's Got the X-Factor took place.

Pictured are participants of the competition at the Marymount Care Centre, Westmanstown, Co Dublin. Featured are Thomas Gilsenan, Mary Gallagher and Betty Casey - winner with her cup - Julia Quarney, and Mary Columby. Also featured are two members of the activity team, Elaine Kinsella and Christopher Bolger. A great afternoon was enjoyed by residents and visitors alike.

Sisters Betty Wall and Mary Phyllis Devlin enjoying the summer party

Tara Winthrop

Tara Winthrop Private Clinic in Swords celebrated Nursing Homes Week 2013 with 400 people. On Saturday August 31st the nursing home celebrated with a Barbeque and entertainment from the Dublin Concert Band. Around 400 people turned out for the day of celebration. Also during the week the home ran many interesting functions that were brought together by its activities department.


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COUNTY LIMERICK Snakes & Dragon Lizards celebrate with Beech Lodge

A snake, bearded dragon lizard and a rabbit were among the ‘special guests’ at a Bruree nursing home to mark Nursing Homes Week 2013.The exotic creatures made an appearance at Beech Lodge Care Facility’s Family Fun Day, the highlight of the week. Resident Stephen Bray, from Bruree, befriended a beaded dragon, who are known as the domestic dog of the lizard world. “He was a lovely fella and got very comfortable on my shoulder,” Stephen said with a smile. “He stayed there for a few minutes and he didn’t seem to want to leave at all. I was glad of one thing though – he didn’t move too much!” The animals were provided by Cork-based company The Animal Roadshow and the lizard and rabbit proved to be the most popular attractions on the day, with few volunteering to hold the snake! Residents were also treated to live music from activities co-ordinator Jessie Griffin, who was joined in song by some of the residents’ relatives including Ide Hogan and John O’Riordan. Further activities at Beech Lodge held during the week included an outing to the hydrotherapy pool, a visit from the children of Cute n Clever crèche, an outing to the Foynes Flying Boat Museum, a men’s trip to the local pub, ladies’ afternoon tea, live music, flower arranging and internet classes. “Our residents really enjoyed Nursing Homes Week, and the families did too. It was a wonderful way to highlight the social aspect of life in a nursing home. We are looking forward to Nursing Homes Week 2014 already,” said Director of Care Anne Maria Moore.

Resident Essie Callinan enjoying the sunshine during flower arranging class

Resident Brigid O’Flanagan pictured with volunteer Erica Caufield and her dog Vodka, who is a regular visitor to Beech Lodge Care Facility

Resident Stephen Bray gets up close and personal with a bearded dragon at Beech Lodge’s

Staff member Sinead O’Sullivan meets a slippery customer at Beech Lodge Care Facility’s family fun day.

COUNTY TIPPERARY GAA stars celebrate nursing homes week with Tipperary home residents

Deerpark Nursing Home had a wonderful week of celebration that culminated in a party on Friday 30th August. The celebration featured a bouncing castle, face painting for the kids, a barbeque, musical entertainment from family members, an animal section that featured lots of the staff's pets. Limerick and Tipperary hurlers also arrived to support the event and chat with the GAA fans and enjoy the dancing and great craic. Local radio also visited and interviewed residents and staff. Residents, family and staff were all delighted with the celebration. Staff we so energised by it and they, along with residents, can't wait for next years Nursing Homes Week.


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COUNTY WATERFORD Wide ranging activities celebrate Nursing Homes Week in Cappoquin

At Padre Pio Rest Home, Cappoquin, activities to coincide with Nursing Homes Week included a traditional music and dancing evening with a local band in which young and old were involved. This was held outside as the weather was lovely on the day and the residents enjoyed being out. They enjoyed drinks and treats afterwards. Resident Margaret O' Keeffe and her A local Beekeeper gave an entertaining and grandchildren who entertained with their educational talk on beekeeping. He has been motivated fantastic traditional music to keep bees for the reward of honey, which he informed was the primary sweetener before shop-bought sugar. He brought an enclosed glass-hive so all could see the bees at work and how they go about their job. He explained the job of each bee and the vital part one plays in order to keep the process going. It was very interesting and even relaxing watching the bees in action! Residents and family really enjoyed the night. Residents and their families then joined in the home’s The O' Keeffe Brothers, Margaret O' Keeffe's grandchildren, entertaining for Trad night garden party, with music from the local gospel choir, traditional music and a local singer/songwriter. A 'Reminiscence Evening' was held with Residents where they went through local books At School by the River Bend, Them Golden Fields and The Secrets of Ireland and discussed their stories and memories of school and growing up and their knowledge of the areas involved in those books. Padre Pio also kicked off The Big Knit during Nursing Homes Week. They started knitting hats for the Innocent Juice bottles and are looking forward to hopefully Julie Margaret Keane during 'The Big Knit' in seeing some of our hats in the shops and contributing full swing to Age Action. During the week the home also held its weekly Sonas sessions, Siel Bleu sessions, bingo, parish notes and local newspapers morning round-up, Mass, and some Residents took part in art and crafts 'doodle-design' and Nora Lonergan during our 'Reminiscience Evening' ball games. Families and friends of the Residents and members of the community are invited and welcome to all activities in Padre Pio. “We have a 'door is always open and the kettle is always hot' approach in Padre Pio Rest Home,” Mary Flynn, Person in Charge states.

COUNTY WESTMEATH Activities at Sonas Care Centre, Athlone

Puzzling: Bridget Costello, Mary Fitzgibbons and Edyta Starwaska (HealthCare Assistant)

Interaction: Interaction with Chantelle Mullally (young girl) are Sr Albius Quinn and Mrs.Francis Gallagher.

Mary Fitzgibbons avails of the reflexology services of Veronica Dunne


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COUNTY WICKLOW A visit to Glenroe

Glenroe Farm was graced with a visit by the residents of Tara Care Centre, Bray, during Nursing Homes Week 2013. Pictured during the visit are Breda Mooney, left, and Joe Curran, right.

COUNTY MAYO Music, radio, dancing and crafts bring celebrations together

A host of exciting activities that included a coast excursion and traditional heritage afternoon took place at St Attracta’s Nursing Home, Co Mayo, to coincide with the inaugural Nursing Homes Week 2013. Ann Lenehan pictured with Josie Walsh, Resident The highlight of the week was the traditional heritage afternoon on Saturday, 31st August which was attended in great numbers by residents, their families and friends, many special guests and the local community. Entertainment was provided by Moffatt School of Dancing and traditional Irish music with Joe O’ Grady and Therese M. Cully. Entertainment included set dancing, Sean-nós dancing and even a few songs from the talented nursing home residents. A feast of traditional refreshments was prepared by the catering team who were assisted by Maureen Munnelly in traditional boxty making. A display of spinning, weaving and knitting was provided by Patricia Kirwan Doyle and Patricia Dancers from the Moffatt School of Dancing O’Flaherty treated everyone to a display of basket weaving. John Gannon displayed an impressive array of bog oak and Regina Stacey, Fairy Hill Crafts, brought along a fantastic embroidery display. There were also many vintage items on display - from farm equipment to household items and these added to the unique atmosphere as all present enjoyed a trip down memory lane. Alison Moore, Director of Nursing said: “It was an amazing day. Not only were we celebrating and promoting the fantastic work and important role of nursing homes in our society but also the quality of care, staff passion and commitment demonstrated in nursing homes throughout Ireland. It was also a chance for us to celebrate our Mary Lafferty, resident, with Alison Moore, Director residents and the valuable contribution they make to our of Nursing and Margaret Timon, Resident lives.” A raffle was held with the proceeds going to a local cause, Bushfield Church. There were fantastic prizes donated by local businesses with the top prize being a Mayo football jersey signed by the Mayo senior football team which was won by local man Brendan Doherty. Staff at the nursing home got into the spirit of the day by dressing up in traditional attire that added to the overall success of the day. Midwest Radio broadcast from the home and were inundated with requests from all parts of the world for the residents and staff of the nursing home. All in all a wonderful afternoon was had and sincere thanks to all those who played their part in making the event such a success. We look forward to the surprises ahead for Tommy Horan with Gerry Murray and John O’Mahony, TD Nursing Home Week 2014!


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COUNTY TIPPERARY Music fiesta & drama at St. Martha’s

It was a fun-filled seven days at St Marthas Nursing, Cahir. “We had a very busy week during which residents played Boules on Monday, Marbels on Tuesday,Bingo on Wednesday Bingo, Skittles on Thursday and an Arch Ball game on Friday,” Joanne O’Connell, Director of Nursing explains. “We had a league system and on Friday all the scores were calculated and all the residents received a certificate of participation and first, second and third places were presented with trophies on Sunday at our open day by the ‘Pride Of Tipperary’ Donna Breen. On Saturday The Butterfly Company performed a drama and musical Through The Years which was thoroughly enjoyed by all the residents. On Sunday we had our open day which was a music fiesta with a variety of local artists.” The weeks activities attracted a large attendance including families, friends and the local community. Kids enjoyed a bouncy castle and facepainting. “It was wonderful to see all the different generations having such a wonderful time in the beautiful sunshine,” Joanne said. On Tuesday 3rd September Joanne and resident Mairead Hyland spoke on Tipperary Mid West Radio to recall the week and speak of how the nursing home is enabling residents live happy and fulfilling lives in a homely, friendly environment.


Mairead Hyland is pictured with, Pride of Tipperary, Donna Breen, left

Josie Ryan, left, and Leena Bergin enjoy Nursing Homes Week

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20 year celebrations for Silver Stream Silver Stream Healthcare Group is proudly celebrating its 20th Anniversary this year, writes Kevina Daly, Development Manager. Founded in 1993 by Joe Kenny, Silver Stream Healthcare Group has successfully developed and grown over two decades and now operates six nursing homes and provides care for almost three hundred residents.


s we have reflected on our success at reaching this milestone anniversary, it is evident that the tremendous support we have received, both past and present, has greatly contributed to making Silver Stream Healthcare Group, one of Ireland’s leading residential care providers. To mark our 20th Anniversary, and to thank our loyal community of residents, family and friends, staff and volunteers, healthcare professionals and the wider community of each of our nursing homes for their support, we hosted a huge 20th Anniversary Garden Party in the gardens and grounds of our largest nursing home, Ratoath Manor in Ratoath, Co. Meath. We brought all of our nursing homes together, and what a day it turned out to be! The sun shone gloriously as crowds of people arrived by bus from each of our nursing homes. We began with a celebratory mass for residents in our private chapel. Joe Kenny, Founder and CEO, then opened the event with a ribbon cutting ceremony and unveiled a commemorative seating area, created specifically to mark the occasion.


As the music and entertainment began there was soon a fun and lively atmosphere, and the grounds began to fill with the sound of chatter and laughter. We had an eclectic mix of entertainment both indoor and outdoor, with live bands, musicians, dancers, and local children’s groups performing throughout the day. Generations of families came together and there was something for everyone to enjoy. Some browsed the market stalls and viewed the resident’s art exhibition, while others relaxed on the lawns and enjoyed the food and drinks. The children had lots of entertainment, including face painting, magic shows and a petting farm, and especially enjoyed the kid’s disco. There was plenty of dancing and singing and everyone joined in the fun. Silver Stream’s 20th Anniversary Garden Party was a fantastic way to commemorate our 20th birthday and we would like to thank everyone for their continued support. With a strong legacy Silver Stream Healthcare Group will strive to continue our success for many years to come. To learn more about Silver Stream Healthcare Group, or to see more on our 20th Anniversary Garden Party please visit

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Oral Health & HIQA inspection perceptions focus of NHI Member studies The Nursing Homes Ireland bursary offers members an opportunity to highlight and publicise research and practice development initiatives which have taken place in member nursing homes. Two staff nurses who recently completed their MSc Nursing (Rehab of the Older Person) recently conducted two pieces of research that focussed upon nurses and healthcare assistants perceptions of participating in a HIQA inspection and activities and attitudes towards oral hygiene care for the older persons with disabilities. They showcased their work at the All Ireland Gerontological Nurses Association (AIGNA) Annual Conference May 30th in the Crowne Plaza Hotel. Hannah Carry and Emma Fitzgibbon, the nurses behind the research, write further. Registered Nurse s and Health Care Assistants Perceptions of participating in a HIQA inspection The rationale for this study was to explore what facilitators of HIQA inspections thought of the process and the effect of such inspections, writes Emma Fitzgibbon. This study was undertaken in a private nursing home supporting 27 residents of high/ low dependency in the South West, with nine staff interviewed. A purposive sample of Registered Nurses (5) and Health Care Assistants (4) participated in the study, with age profile being 26-61 years of age. Individual audio-taped semistructured interviews were conducted and data analysis was guided by Braun and Clarke’s (2006) thematic framework. Older people are major users of health and social care services and this will continue due to the progressive increase in the older population and the high level of care required to meet their complex needs (Garavan et al. 2001). Increasing numbers of people are moving into residential care settings as they age. In all, 11% of Ireland’s population are aged 65 years or over and it is anticipated by 2031, the population will increase by 18%, the biggest increase will be among those who are aged 80 years and over (Skelton and Todd, 2004). It is evident that there are increasing numbers of adults residing in residential care with growing concerns for safety. In response to this the National Quality Standards for Residential Care Settings for Older People (2009) have been developed by HIQA. Aim of the research Three main themes arose from the data: P ‘Mixture of Emotions’ P ‘Opening Communications’ P ‘Caring Mechanisms’ ‘Mixture of Emotions’ Participants reported a mixture of emotions related to ‘pre peri and post’ inspection. Emotions varied from satisfaction at improvements arising from the inspection process to fear, anxiety and stress. These emotions are reflected in the following quotes, “I think things have improved dramatically with the HIQA inspections” (Participant 1) “There is improved dignity and privacy and patients have more choices and that’s just brilliant” (P8). “Very tense people get stressed and don’t want to be here on a day HIQA are here because they are afraid they will be asked a question” (P5). “It’s good if you are registered by HIQA; you know you are providing the best care possible and you are recognised for doing it” (P2). “Peoples heart rates were higher…we had an incident during follow up inspection last week where an hour after the inspectors had left we had 2 staff members fighting in the office in tears and after the first 2 day inspection we had a staff member in tears, so it is absolutely…a very stressful time” (P4). ‘Opening of Communications’ Participants were open to engaging more with inspectors and highlighted communication as an important theme again in a ‘pre peri and post’ fashion and these are reflected in the following quotes 1.“I think if they forwarded a list prior to the inspections regardless of whether they are announced or unannounced it gives you an idea of the levels of paperwork they are going to be looking at” (P9).


2.“I think when inspectors come if they met all the staff working on that day, nurses, carers, the cleaners, everybody, just even for five minutes to introduce themselves” (P8) 3.“If HIQA came a couple of hours before the inspection and got to know the staff and explained what the inspection was going to be about then everyone would just have time to relax” (P3) ‘Caring Mechanisms’ Continuing Professional Development (CPD) had arisen directly as a result of the HIQA inspection process and this influenced and changed practices with “more educational sessions on infection control, restraint, abuse of the elderly and others” being cited by one participant (P2). “Fire training, infection control, mobility, privacy and dignity the list is endless really” (P6), another stated. “It has changed the way we look at it [care provision]. Before was a military operation: get people up, washed, dressed, very routinized and I do think the person-centred [care] is fantastic” (P1). “Residents have choices now due to the fact that you have your residents committee they have more a part to play in it so that they are making choices in their home” (P2) “In general care has improved for the older patient in particular that dining experience and the privacy and dignity has improved. It has improved the quality of care” (P7). These CPD and inspection reviews were seen as positive yet challenging to care enhancement. Conclusion & recommendations The inspections were welcome because of the perceived benefits however individual fears, anxieties and challenges with the process and implementation of the inspection were described. This study found that participants’ perceptions were that care practices changed from mechanical and routine to a more holistic and person-centred approach, with increased involvement from residents as a result of the HIQA inspections. Participants were open to engaging with HIQA and identified recommendations for all stages of the inspection, namely pre peri and post. Recommendations arising from the study include: Education and training into the audit and inspection process to enhance the development and implementation of standards. P Greater cognisance of communication and awareness of individual communication strategies before interviewing residents. P

References Braun,V.andClarke,V.(2006)‘UsingthematicanalysisinPsychology’, Qualitative Research in Psychology, 3 (2),77-101. Garavan,R.,Winder,R.andMcGee,H.(2001)HealthandSocialServices forOlderPeople,Dublin:NationalCouncilonAgeingandOlderPeople. HealthInformationandQualityAuthority(2009)National Quality Standards for Residential Care Settings for Older People in Ireland,Dublin:HIQA. Skelton,D.andTodd,C.(2004)‘What are the main risk factors for falls among older people and what are the most effective interventions to prevent these falls?’,Copenhagen:WHORegionalOfficeforEurope.

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Nurses & Healthcare Assistants Attitides & Activities re Oral Hygiene Care for the Older Person with Intellectual Disabilities Oral care is essential for quality of life and in particular activities such as eating, speaking, communication and personal relationships, writes Hannah Carry. I conducted a survey and examined the types of oral health care (OHC) provided by registered nurses and healthcare assistants and the difficulties experienced while performing oral health care were surveyed. Many people in Ireland with intellectual disabilities (ID) living into old age (Kelly et al 2010, McCarron et al 2011, Jenkins 2012) have difficulty maintaining oral health due to related physical, sensory limitations and cognitive decline. NIDD (2012), predict an increase of this population over the coming years. The importance of oral health and its impact on overall health and wellbeing is nationally and internationally recognised (Crowley et al 2003, Peterson and Kwan 2004, Petersen and Yamamoto 2005, Haveman 2010, Heath et al. 2011) Findings In all, 161 questionnaires were distributed and 87 were returned. Two residential sites participated in the study. Respondents recognised the importance of oral health care and positively engaged in the practice. They were asked to answer yes or no in respect of the following difficulties they can encounter in administering oral hygiene care. Those answering in the positive were as follows 74.4% - resident not opening their mouth 68.6% - difficulty with resident biting toothbrush 22.1% - resident biting staff 33.7% - resident kick or biting 74.4% - resident refusing oral care 33.7% - resident spitting 76.7% - resident not rinsing 37% - other difficulties The further difficulties reported included not liking wearing dentures, shouting, attempting to pinch or scratch, swallowing toothpaste, breath freshness, partial cleaning due to poor co-operation, pain association. This study met its aim by evaluating RNs and HCAs ‘attitudes and activities’ of OHC for the older person with ID. Many authors had alluded to the fact that OHC was not given high priority within ID services (Crowley et al. 2003, Doyle and Dalton 2008), this study is of a different view in that:

NHI Bursary The purpose of the NHI bursary is to highlight and publicise research and practice development initiatives which have taken place in member nursing homes to assist NHI in profiling the expertise/activities of nursing and care staff working in the private and voluntary sector. The criteria, role of the applicant in respect of the bursary and the role of NHI is defined in the members section of the NHI website in the nursing section under Bursaries 2013. Bursary requests can be submitted to Please be advised the research has been brought together by parties independent of NHI and the views & opinions expressed are not necessarily those of NHI.

1. A positive approach to OHC by the respondents was found 2. 79% recognised the importance of OHC 3. 82% positively engaged in the practice of OHC In addition: 1. Environmental factors, time and adequate equipment supported the implementation and successful approach to assisting with OHC 2. 92% of the older person with an ID required some level of support 3. The wearing of gloves was practised by 75% of respondents Maintenance of infection control and standard precautions is an essential component of nursing and health care practice and in that light, 100% compliance with the wearing of gloves would be recommended. Although this study was undertaken in intellectual disability services, it has implications for practice in many healthcare settings such as nursing homes. The wearing of gloves was practised by 75% of respondents. This study cannot be generalised to all residential care settings because two sites were used within one organisation, but it provides preliminary information for future research There was no question on the questionnaire recording the level of ID and types of disabilities experienced by the older person with an ID, which could have been compared and contrasted with the level of difficulties encountered in providing OHC


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Mater Adult Hospital: ward furniture supplied to over 200 rooms in 2012






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w Date


Refer 2011,

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The Minimum Effective Dose of Oral Nutritional Supplements = 400kcals per day 1

t ONS should supply an additional

food intake of at least 400kcal/day1

t 400kcals/day results in improvements in patients ‘total energy intake’ and is linked with clinical benefits2

t 1 x Fresubin 2kcal Drink provides 400kcals & 20g Protein

t 1 Patient, 1 Bottle, 1 Day t GMS Approved Date Dat eo off Preparation: Preparation: Feb Feb 2013. 2013. EN/2kcal/002.13 EN/ 2kcal/002.13 References: 1. Raynaud-Simon References: Raynaud-Simon A: Clinic Clinical al pr practice actice guideline guideliness fr from om the F French rench He Health alth High A Authority: uthority: nutritional suppor supportt strategy strategy in pr protein-energy otein-energy malnutrition in the elderly. elderly. Clin Nutr 2011, 2 011, 3 30:321-319. 0:321-319. 2. Hubb Hubbard ard GP. GP. A ssystematic ystematic rreview eview o off c compliance ompliance tto o or oral al nutritional supplemen supplements. ts. Clin Nutr 2 2012,31:293-312. 012,31:293-312.

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NHI News Autumn 2013  
NHI News Autumn 2013  

This edition commemorates the inaugural Nursing Homes Week 2013 and previews the NHI Annual Conference. A new feature in the newsletter, My...