NHI News Autumn 2016

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NHI News published by: Nursing Homes Ireland, 2051 Castle Drive, Citywest, Dublin 24, D24 K299 Tel: 01 4699800 | Fax: 01 4796477 | E-mail: info@nhi.ie Visit us online: www.nhi.ie


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State abuse of dominance within nursing home sector laid bare

Tadhg Daly, Chief Executive Officer, Nursing Homes Ireland

‘Gulf in nursing home costs put HSE on the spot’ the headline in the Irish Times read. After five years of concerted pressure and defences for failure to disclose, on 5th October the HSE finally published the costs of care in its own operated nursing homes. The published costs lay bear the true costs of nursing home care and the glaring inequality and discrimination within Ireland’s nursing home sector. An analysis of the fees payable across the country reveals huge chasms that are unjustifiable. Within County Laois, the average cost of a week’s care in the three HSE operated nursing homes is €2,720, as opposed to €910 in four private and voluntary nursing homes – a 199% cost differential. Within neighbouring Westmeath the differential is 135% - with two HSE operated nursing homes averaging €1,899 per week as opposed to average €808 for the 12 private and voluntary providers. The difference in Longford is 108%, in Offaly 107%, in Limerick 83%. The national average cost differential is a staggering 53% between HSE and private and voluntary nursing homes. There is no requirement for the HSE to negotiate payments for each of its nursing homes. Their costs do not encompass capital costs, rates and other State charges, resulting in them not reflecting the full costs being incurred by the taxpayer for care provision in HSE nursing homes. Independent research and analysis of nursing home care has outlined private providers are leading in providing dementia care and the present funding model is simply unsustainable. Yet private and voluntary nursing homes are being coerced into accepting fees that do not reflect the true costs of providing nursing home care. It is a scandal that HSE nursing homes have increased the fees payable to themselves by 13% over the five year period yet private and voluntary nursing home fees have failed to realise CPI increases. “The increase in prices negotiated (1.71%) has been lower than the 01 — NHI NEWS

increase in the CPI over the same period (3.79%),” Deloitte’s Review of the Pricing Process informed in respect of the setting of fees for private and voluntary nursing homes for the period 2010 – 2013. NHI has written to and called upon both the Public Accounts Committee and the Office of the Comptroller and Auditor General to query State spending with regard to HSE nursing homes. It is the view of NHI that that issue of public nursing home costs provide a prime example of accountability being absent and nonaccountability being applied in respect of State spending. The €4,000,000 to be paid by the Department of Health to 4,000 nurses who graduated 2011 - 2015 in backdated payments (€1,000 per nurse) is further evidence of the State abusing its dominant position within the health sector. It followed the announcement within the Budget that an additional 1,000 nurses would be recruited through “the highest health budget ever,” according to Minister Harris. Our Department of Health preaches regarding the necessity to focus on enabling healthcare be delivered within the community and removed from acute hospital settings, yet key healthcare providers in this regard – private and voluntary nursing homes – are denied the resourcing required to support them in meeting the care and staffing requirements of persons requiring nursing home care. The measures announced in respect of nursing seek to provide the State with a monopoly on the hiring of nursing graduates, contradicting its purported ideology of focussing on ensuring healthcare needs can be met in the community. Who will meet our older persons complex care needs in the community? Without the State addressing the severe inequities within our nursing home sector, nursing homes will not be enabled to ensure the required levels of clinical care are available to meet requirement.

CONTENTS READ ALL ABOUT US Irish and Australian residents, previous strangers, have become pen-pals. Louth residents enjoy their holidays in The Garden County and a 76-year old travels from Australia to celebrate her 103-year-old mothers birthday. Residents in Co Clare celebrate art success and a Co Wexford resident writes of the positivity of nursing home care.

NHI UPDATES In conjunction with the HSE, NHI launches the Train the Trainer initiative. NHI representatives meet with PAC Chair Seán Fleming and read of our submission to the Oireachtas Committee on Future Healthcare. The impact of increase in wages in nursing home sector are laid bare and NHI calls for reform of the law in relation to the NTPF. Read of what was within our 2017 Budget submission.

NURSE RECRUITMENT Employment opportunities in NHI Member nursing homes are promoted to 14,000 nurses classified by the NMBI as ‘inactive’ through an initiative with the nursing board.

FAIR DEAL PRICING NHI’s representations to the review of the Fair Deal pricing mechanism advance funding structure to recognise high dependency care needs.

NHI ANNUAL CONFERENCE 2016 Minister for Health Simon Harris TD will deliver the opening address at A Fair Deal for All, NHI’s Annual Conference 2016, with presentations focussing upon staffing, HIQA monitoring, decision making for people lacking capacity, vetting and the financing of care.

CARERS Read of measures advanced by NHI to the Expert Group on Future Skills Needs to combat carer and nursing shortages. The Group advises the Irish Government on current and future skills needs of the economy.

VIEWPOINT Dr Brian Beach, a speaker at the NHI Annual Conference 2016, writes the adult social care sector needs to innovate to survive and examines the emerging role of an enhanced care worker.

NHI CARE AWARDS 2016 Read a full listing of our NHI Care Awards finalists 2016. The celebration of excellence in care will take place Wednesday 16th November at Citywest Hotel.

NURSING HOMES WEEK 2016 This year’s Nursing Homes Week celebrations took on a green theme, coinciding with Ireland’s participation in the European Soccer Championships. View our extensive gallery of pictures featuring celebrations from across the country.

CARE FOR CARERS Promoting self-care and resilience in house is being increasingly recognised by HR as an important part of the value proposition to attract and retain staff in nursing homes.

1916 COMMEMORATIONS Residents, staff and visitors to nursing homes have been participating in 1916 commemorations

1916 CENTENARIANS Over 40 centenarians living in NHI Member homes were honoured to mark this special commemorative year.

STIMULATING ENGAGAEMENT A pioneering resource aimed at triggering happy memories using nostalgic recipes and tailored activities has been launched..

While it consistently refuses to recognise the true costs being incurred by private and voluntary nursing homes because of its low-balling of nursing home fees through the actions of the NTPF, the State can find resourcing to benefit its own purposes. There is an urgent requirement for our Department of Health to work with all stakeholders to develop a workforce plan for the entire health service, and ensure planning and resourcing is not confined to the public system. Clinical care requirements are growing across all nursing disciplines. The published costs of care in its nursing homes add further impetus for the true costs being incurred by private and voluntary nursing homes to be legitimately recognised. At the time of writing, the costs have just been published. NHI has contacted the offices of Ministers Harris and McEntee in the Department of Health seeking an urgent meeting. The stark inequality presented with the publication of the costs is not tolerable. The huge differences in the fees that are payable to HSE nursing homes as opposed to private and voluntary must hasten the review of the Fair Deal pricing mechanism. This must bring into effect a fair pricing model that provides fees to private and voluntary providers that are reflective of the true costs of providing the high dependency care that nursing homes are delivering in our communities. Similarly, representations will be brought before TDs and Senators. The extent of differences in fees payable across the country will be brought to their attention. Equality in fees payable must become an immediate priority. Over a number of years, the buck has been passed in this regard by successive Ministers. The disclosure by the HSE of its costs must propel this issue of inequality and discriminatory practice to be addressed with haste by the State.


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.


READ ALL ABOUT US! What activities are taking place in your home? How are residents fulfilling 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 michael@nhi.ie.

Pen friend links formed between Termonfeckin and Adelaide, South Australia 10,000 miles of distance between them has not stopped two nursing home residents who have never previously met or held any connection from striking up a friendship. Resident Mae Sherlock of Sunhill Nursing Home, Termonfeckin in Co. Louth, has become pen friends with a 92-year-old resident in a nursing home called Burunga Village in Australia. Burunga Village is located in Port Broughton, South Australia. The friendship was initiated when Darren Robinson, an activity coordinator in the Australian nursing home, emailed Elaine Moloney, Director of Nursing at the Co Louth Nursing Home. Darren simply came across Sunhill through Google and asked would any of the residents be interested in becoming a pen friend to Joan Gill. Geraldine Murray, activity coordinator at Sunhill, then approached the residents about the exciting initiative and Mae, who takes great enjoyment from writing, was agreeable to becoming a pen friend to her Australian counterpart. “Mae was absolutely thrilled to receive her first letter and was so proud showing everyone what she had got,” Elaine explains.

The concept of a pen friend was not one she had come across before and she has now embraced the initiative. The friendship is blossoming.“They have arranged to share a skype call so they can see each other over the next few weeks,” Elaine explains. “This is a very exciting moment for all the staff and Mae’s Family.” P

The Garden County welcomes Sunhill Mae’s fellow residents travelled to Glendalough, Co Wicklow, for a four day holiday. They stayed in a large dormer bungalow in Trooperstown and they packed a lot in in their four days, including visits to Bray, the beautiful town of Avoca, Wicklow Gaol, Powerscourt House and Powerscourt gardens and waterfall, the Sally Gap and Bridgewater Shopping Centre. They also enjoyed a bowling tournament in Wicklow town in a trip that was peppered with singsongs, games and story-telling P


10k jump to Daughters trip support Alzheimer from Oz for 103 Society of Ireland year old birthday Try jumping out of a plane from 10,000 feet! That is what staff of Parke House Nursing Home in Co Kildare did to raise valuable funds for the Alzheimer Society of Ireland. The story begins September 2015 with the opening of a specialist dementia care unit in the Boycetown-based nursing home. Emer Donnelly, spa supervisor at the nursing home, explains: “The staff of Parke House are extremely passionate about what we do and after a bit of deliberation we agreed on a sponsored sky dive in aid of the Alzheimer Society of Ireland. Five brave souls stepped up to put their bodies on the line - Witold Jacob, Taylor Little, Barbara Buckley, Monika Gladysz and myself. We agreed to take on the jump from 10,000 feet.” Sponsorship was collected from families, friends, fellow colleagues and local businesses. Saturday 18th July was D-Day. The jump was to take place from Clonbullogue Airfield in Co. Offaly. Due to heavy cloud, the jump for the morning was postponed to the afternoon. Eventually it prevailed and all jumped successfully. An excellent €1,500 was raised from the jump and presented to the Alzheimer Society of Ireland. The funds will help with the running of a helpline and for home help services P

A 76-year-old travelled from the land of Oz to Hillview Nursing Home to mark her mother’s 103rd birthday. May Morris celebrated her birthday with fellow residents and staff at the Co Carlow nursing home and her daughter Rose flew from Australia for the celebrations. May was three years old and living on the family farm in Castledermot when the Rising broke out. She can recall her parents talking of the poverty in inner city Dublin during this historic period and the sense of tension and revolution. Councillor Fintan Phelan, the chair of Carlow County Council’s 1916 committee, presented May with a commemorative 1916 medal. May is a great, great, great grandmother and is one of six people in the county to be presented with the medal P

St Gobnait’s Alzheimers Tea Party



Glenaulin pilgrimage to Knock

Art celebrations for Millbrae residents

On 4th July 14 residents of Glenaulin Nursing Home, Chapelizod, Dublin, travelled to Knock, where they celebrated Mass at Knock Basilica P

First and second prize were claimed by residents of Millbrae Lodge Nursing Home in an art competition in Co Clare that was open to day care centres. Charles Ginnane was the winner of 1st prize and Bridget Quigley won 2nd prize P

Larchfield Gardening

Clarenbridge honoured

Residents of Larchfield Park Nursing Home in Co Kildare Participated in a Nutricia Gardening competition and were the successful winners! Residents created an excellent floral display as their entry. Congratulations to all! P

Clarenbridge Nursing Home was named Nursing Home of the Year at the Irish Healthcare Awards. Pictured for the presentation of the Award are, from left, Mr. Denis Mc Elliggott (Proprietor), Mr. Pat Kennedy (Proprietor), Dr. Jack Nagle (Judge/C.E.O Alpha Healthcare), Ms. Frances Neilan (Director), Mr. Marty Whelan (M.C) P

Teresa’s 100 year celebration Teresa Murphy enjoyed a very special 100th birthday celebration in Dealgan House Nursing Home in Dundalk. Mass was celebrated in her honour and an evening of celebration, with musical artists and poetry selected by Tereasa, was staged in the nursing home. Teresa is a former teacher and past pupils and former teaching colleagues joined in the celebrations along with fellow residents. Providers Nora Byrne and Fintan Farrelly presented Teresa with a special certificate and cheque to mark her outstanding achievement P


How could I not like where I live? During Nursing Homes Week 2016, one resident of a County Wexford nursing home penned an piece regarding the positive life she is living. This article has been written by May Moran Doyle, a resident of Valentia Nursing Home in Enniscorthy. As a four score and almost three years widow living now in Valentia House Nursing Home, I find it very easy to like where I live. During my life I have changed residences on many occasions and was content in each. Even though I know this is the “departure lounge” for the realms above, I feel very content and why not? Having had a stroke out of the blue and as we thought on the way out, after much professional and successful help in the physiotherapy department of St. John’s I came to live here. Why do I like this place? Well to my mind one couldn’t but be contented here. There are so many assets and so many pluses. The atmosphere is friendly, caring and homely. I feel safe and secure, unlike when I lived on my own in the country. In spite of censor lights, the tall light from the neighbours’ house and alarm systems, one is never at ease living on your own, especially at night. Doors are locked all day. Here one has no responsibilities. Others are there to care, comfort and advise if necessary. From my bedroom window scenic views flash before me. I watch the little birds which I feed, as well as the hedgehogs and squirrels. I await the trees to come into leaf. I am so fortunate in having a ramp outside my exit door so that with the aid of my walker I may go out to the lawn. In the summer the trees offer shade on the warmest days. I am an avid reader and again I am fortunate in that my sight so far is good and with “Hidden Hearing” I hear the doves and all the other little birds chirping and calling. Yes I am in love with “Valentia”. It is wonderful to be in contact with so many great people, both residents and staff. Care and kindness are at a premium. I don’t think I have ever experienced such gentle patience. Naturally I am very slow but never have I heard those two words “Hurry Up”. The food is always palatable and varied and served with a smile. Some are fed in their rooms but I am able to come to the dining room so that we can converse at meals. Little things mean so much when one reaches the eighty mark. The day I was able to dry my toes I felt I had really accomplished something great.

My religion means everything to me so it is such an honour to be able to prepare the altar in the oratory for Mass or Service. Staff members help me in washing linen and looking after the flowers – in fact doing certain things I am unable to do without hurting my back. Christmas is a wonderful time here. Last year, the Mothers Union came in to sing carols for us. We all joined in, in spite of croaky, out of tune voices. There was a party the week before Christmas and many relations and friends came to wish everyone the blessings of the season. Christmas Day was special, always is, and we had music and dancing. The staff were brilliant and entertained us. There were sweets and drinks and as the evening drew to a close there were sandwiches and cakes to round up the day. I went to bed and to a very comfortable pillow happy as a child after her birthday party. A nurse came saying “good night and god bless” which she says every night. After six years here for me there is very little change in the caring and kindness. Of course, staff have come and gone over the years and naturally I’m not as active as I was six years ago but the atmosphere has not changed. Care and kindness are the norm. I rarely think of the bungalow of which I have many happy memories Thank God. Many have gone to glory since my first days and I know I’ll soon be on my mysterious journey. When? I still read and look at my favourite TV programmes and talk to my friends. So I still like where I live. We have added other projects within the last few weeks. Jackie is one of our tremendous staff and is most creative, helping many to get a thrill in arts and crafts. She also helps in having an Ecumenical Prayer group which is enjoyed by ever denomination. A colourful garden has almost arisen overnight. The furniture and surroundings have been painted in various bright shades. This causes great delight to some residents suffering from dementia. How could I but like where I live? P

Curragh Lawn Alzheimers Tea Party Alzheimer’s Tea Day 2016 was celebrated in nursing homes across the country, with tasty treats lined up for staff, residents and visitors. Curragh Lawn Nursing Home, Co Kildare, was one such home to celebrate and raise valuable funds for the Alzheimer Society of Ireland. Val Ryan, Provider of Care said:

“The residents really enjoyed the activity on the day and it was all for such a worthy cause.” Tea Day is a national day of celebration and fundraising that honours people affected by Alzheimer's and Dementia.


HIQA National Standards 2016 Significantly raising the benchmark of care At first sight of the new National Standards for Residential Care Settings for Older People you may be forgiven for believing that little has changed from its 2009 predecessor. However, this would be a very incorrect assumption. Reflective of international best practice in regulation, the new standards focus has moved from predominantly structure and process requirements, to demonstrable evidence of successful outcomes, in both care and management. This is a significant challenge for the aged care sector. Overall the benchmark of care required has been raised from $#"!# now requiring services to provide an , where services must "Improve the health and wellbeing", not just This can also be seen in with regards to:

! - " $# # " # #" # " #"he document (up from 9 in the previous version); " $# # " # #" # # ! # " ! " ! #! # " $# # indness$# # # ! " ! #" ! ! " Requires more personal accountability throughout

Specific points of notes which will challenge the sector in demonstrating compliance include:

Implementation of Advance Care Planning Address Diversity and Equality Ensure the needs and preferences of those with cognitive impairment are understood Care plan must name those responsible with agreed timescales Psychological needs to be considered in every care plan Physical and psychological wellbeing for the cognitively impaired are addressed Individual risk management plans required " # " ! # # ! #"!# -based practice A structured quality improvement programme is required Addition of Change Management requirements Regular systems audits Skills and competencies of each staff member are reviewed

For further information, contact Health Care Informed (HCI) on 01 629 2559 / 093 36126 or email info@healthcareinformed.com

NHI UPDATES Committed to excellence in care www.nhi.ie


Train the Trainer initiative launched at national education day Minister of State with Responsibility for Older Persons Helen McEntee TD has launched the HSE / NHI Train the Trainer Initiative. Minister McEntee launched it at an education day titled Principles of Safeguarding Older People in our Residential Services that was hosted 21st September. At the event Bridget Mc Daid from the HSE National Safeguarding Office outlined the process and criteria required for nursing home staff to apply to become Facilitators in Safeguarding Training and to be listed on the National Safeguarding Office database of approved Safeguarding facilitators Minister McEntee commented: “We all have a role to play in safeguarding, both as individuals and collectively. We must always seek to uphold the rights of vulnerable

persons to live full and meaningful lives in safe and supportive environments. This is an important development in ensuring that a consistent safeguarding message is delivered and will provide a foundation for the future delivery of safeguarding training to staff. This approach ensures that the messages being delivered to HSE nursing home staff and private nursing home staff are the same – what we are saying here today is that there should be no ambiguity. It also helps to ensure that the knowledge conveyed through the training is the same, regardless of the setting – whether it be residential care, community care, day care, in disability services or in services for older people.” At the education day Bridget Mc Daid, HSE National Safeguarding Office, outlined

the process and criteria required for nursing home staff to apply to become Facilitators in Safeguarding Training. Presentations at the education day included: P The safeguarding of vulnerable persons P Implementing a nurse prescriber to educate staff and promote safeguarding awareness P Safeguarding human rights in residential care P Perspectives on safeguarding in residential care They are available do download from the Education folder on the Members section of the NHI website – www.nhi.ie

Pictured at the launch of the Train the Trainer Programme are, from left, Paschal Moynihan and Michael Fitzgerald, HSE Older Person Services, Helen McEntee TD, Minister for Mental Health & Older People Bridget McDaid, HSE National Safeguarding Office, Tadhg Daly, NHI

Consultation with Department of Health & Minister McEntee On 8th September NHI attended a Department of Health hosted consultation that was convened with older person stakeholders to discuss how older person services can be improved. At the consultation Minister with Responsibility for Older Persons Helen McEntee said it is not the policy or the intention of the Department of Health to extend Fair Deal to homecare. Prior to the consultation, Minister McEntee was provided an extensive briefing by NHI to inform re nursing home care, the significant threats to the sustainability of nursing home care, and measures required to place nursing home providers on a sustainable footing.


Meeting with PAC Chair Seán Fleming NHI representatives met with Oireachtas Public Accounts Committee Chair Seán Fleming to outline the considerable discrepancy in fees payable for nursing home care between public and private / voluntary nursing homes. Tadhg Daly, NHI CEO, and Gearóid Brennan, NHI Commercial & Financial Affairs Subcommittee, met with Deputy Fleming 26th July. They informed of Fair Deal review stating 58% average fee differential, non-transparency being applied in respect of HSE nursing home costs, and the DKM analysis on behalf of the Department of Health that stated the present funding framework for nursing home care is unsustainable. NHI had written to Deputy Fleming in his role as PAC Chair on 18th July stating “a complete lack of accountability and transparency” is applied with regard to cost of care in HSE nursing homes.

Community Submission to Oireachtas Committee on Future of Healthcare Bed Bureau The Oireachtas Committee on the Future of Healthcare has been established to “achieve crossparty consensus on a single long-term vision for health care and the direction of health policy in Ireland, and to make recommendations to the Dáil in that regard”. The Committee sought submissions from representative organisations to inform a ten year strategy for health care and health policy in Ireland, and to make recommendations on a changed model of health care. NHI’s submission is available to view via the publications section of the NHI website under the NHI submissions heading. Key recommendations within it include: P Requirement for introduction of an evidence-based funding model for Fair Deal that recognises the assessed care needs of persons requiring nursing home care and their associated costs.

P Utilisation of the expertise, purpose built facilities, specialist equipment and staff within nursing homes to extend provision of care services such as Day Care, Independent and Supported living etc.

The HSE Community Bed Bureau is live since 5th October within the following Community Healthcare Organisations: P

CHO 6 - Wicklow, Dun Laoghaire, Dublin South East

P Development and resourcing of a continuum of care that ensures our older population can avail of the specialist care they require at each stage, with ‘ring-fenced’ budgets.


CHO 7 - Kildare/West Wicklow, Dublin West, Dublin South City, Dublin South West


CHO 8 - Laois/Offaly, Longford/Westmeath, Louth/Meath


CHO 9 - Dublin North, Dublin North Central, Dublin North West

P Workforce planning to provide the appropriately skilled staffing complement that will be required to meet our population’s healthcare needs. P A clear and cohesive policy and national strategy for the long-term care of our older population, with certainty, transparency and equality of funding arrangements.

Impact of increases in wages on nursing home sector The knock on effect of an increase in the minimum wage is likely to result in additional costs of circa €34k to €79k annually for nursing homes and would require an increase in the Fair Deal rate of 2.2% just to absorb this increase in payroll costs, a report by BDO states. Examination of the Financial Impact on the Nursing Home Sector of Changes to the National Minimum Wage has been undertaken by BDO on behalf of NHI. The Chartered Accountants have estimated the overall cost to the sector would be in the region of €21.8m per annum. “Further increases in the minimum wage to €10.50, as proposed under the life of this government, will result in an additional annual cost to the sector of €53.8m,” it further states. “An increase in the FDR [Fair Deal Rate] of 5.5%

would be required to absorb this increase in payroll costs. The cost to individual nursing home operators will range from €83k to €196k per annum.” The report states in a competitive labour market any efforts or attempts by the private and voluntary nursing home sector to offer a living wage as a means of attracting and retaining staff represent the greatest financial challenge to the sector. “Such measures will result in additional payroll costs of €146k to €343k per annum for individual nursing home operators,” it outlines. “It would require an increase in the FDR [Fair Deal Rate] of 2.2% just to absorb this increase in payroll costs. The cost to the sector as a whole could be up to €94.5m per annum.”

Budget 2017 The Fair Deal budget allocation for 2017 will remain same as allocation for 2016 - €940m The HSE has revised downwards the numbers it is anticipating the scheme to support by year end 2016, while maintaining waiting period at four weeks. In its service plan for 2016 the Executive originally projected the scheme to support 23,450 persons year-end. This has been revised to 22,989 persons year-end. It is indicative of the slowdown in numbers supported by the scheme. The HSE has previously stated the numbers leaving the scheme are higher than projected, reflecting the older profile of persons in nursing home care. Overall, the numbers supported by Fair Deal decreased by 128 persons since the beginning of the year. More people continue to be supported by private nursing homes, with net 97 more persons supported by the scheme over the first seven months of the year. Over the corresponding period HSE nursing homes have seen a net decrease of 101 persons.

Emergency Department overcrowding The HSE is to make direct contact with NHI regarding appropriate engagement as part of its overall response to ED overcrowding. Minister for Health Simon Harris Private Secretary David O’Connor wrote to NHI on behalf of the Minister in letter dated 14th July. He stated: “Having consulted with the HSE, it is the Department’s view that there is a requirement to engage with Nursing Homes Ireland on specific issues [surrounding A & E overcrowding] and I am advised that the HSE is planning to make direct contact with you to seek appropriate engagement with Nursing Homes Ireland as part of the overall response to addressing ED overcrowding.”

The Bureau enables nursing homes to input to the HSE on an ongoing basis bed availability within their nursing homes and provide profile regarding bed availability. Following evaluation of the process in CHO 6,7,8 and 9 at the end of November 2016, a decision will be made on the process and requirements to commence roll out of the system to the remainder of the country in early 2017.

NHI advances work for overseas candidates during registration process An NHI submission to the Department of Jobs, Enterprise and Innovation has advanced overseas candidates interested in getting registered as a nurse in Ireland should, once suitably vetted, be given permission to work as a pre-reg nurse / care assistant until their registration is processed. The case is advanced within our second submission to the Department’s Expert Group on Future Skills Need. The registration process can take a year or longer to complete. The submission further recommends suitably qualified health care professionals from Non-EU countries could get a work permit and permission to stay in Ireland based on the ongoing crisis in recruitment and retention of nurses and care assistants. The submission advances permitting overseas candidates to work as pre-reg nurses or care assistants during the registration process would assist in combatting carer and nursing shortages. It would also mean staff would be fully trained and orientated when NMBI registration came through and their English would improve. The measures is further advanced withain the submission that is featured on the publications section of the NHI website.



Flaw in law leaves NTPF outside regulation warns NHI Nursing Homes Ireland has called for reform of the law relating to the National Treatment Purchase Fund, stating it currently falls outside the law for regulatory purposes. NHI contends the fund is not subject to independent oversight. Tadhg Daly, CEO of NHI, said it was a weakness in the law that allowed NTPF to be outside the oversight of an independent body. “NTPF is the funder and commissioner of many healthcare services including nursing home care,” he said. “Our sector has long had concerns with the NTPF and the level of non-accountability that is applied to a public body that is responsible for the commissioning of over a billion euro of health spend per annum. It is incredulous that its legislation provides no recourse for independent appeals. It is striking that the NTPF is an independent corporate body and is not part of the Health Service Executive as defined in the Health Act of 2007. Through this loophole, it evades independent oversight and is not subject to HIQA, Ombudsman or even Department of Health oversight.” “As an agency that procures services on the State's behalf, it should be answerable. For years, our

sector has had issues with the manner in which the NTPF 'negotiates' with nursing home owners and the variance between the low price it pays for private care, while public care is at up to three times the cost. The absence of a proper control mechanism such as regulation leads to poor oversight of service performance in any funder of health care. It is of huge significance that outgoing Minister at the Department of Health Kathleen Lynch and independent analyses have highlighted substantial discrepancies with how fees are derived for provision of nursing home care. The NTPF should be required to produce robust evidence on the decisions it takes on the delivery of healthcare. Yet this transparency is completely absent from the procurement process.” During Summer, HIQA CEO Phelim Quinn said accountability must lie not only with the entity providing the service but also with that which procures the service. Mr Daly added: “Independent analysis has informed the complete disconnect between HIQA’s regulatory requirements and what the NTPF pays for fees for nursing home care is “untenable”. Since introduction of national regulations and standards in 2009, NHI has

consistently highlighted this considerable anomaly within our health services. Yet HIQA, in its role as regulator, and the NTPF, in its role as commissioner, have both turned a blind eye towards the complete chasm and disconnect that exists between what is required of one party and the nonacknowledgement in this regard of the other.” The NTPF issued a statement in response. It stated: “The NTPF is a statutory body directly reporting and accountable to the Minister for Health through the Department of Health. Its operations are fully reviewed and audited by the Comptroller & Auditor General on an annual basis.” It further added: “The NTPF has clear, established systems and processes for agreeing prices with private nursing homes. It does not set or impose prices. It is a commercially negotiated process based on strict criteria, previous pricing, benchmark prices and cost norms. Pricing proposals from private nursing homes for long term residential care are robustly assessed and examined to ensure best value for the taxpayer, while also being fair and sustainable for the operators.” It further added a review process is available to nursing homes, stating it has been used 34 times since 2009.

NHI Budget 2017 Submission

provision resulting in increased cost to the State through public provision and additional demands on an already stretched acute hospital system.” The submission outlined requirement for:

The cost associated with provision of high-quality personcentred care must be recognised by the State, the monopoly purchaser of nursing home care, NHI’s Budget 2017 submission states. The submission also states the Fair Deal 2017 budget must be adequately resourced and increased to address the incessant and sustained cost pressures together with increases in wage inflation. “Private and voluntary nursing homes, which are largely entirely dependent upon price paid by State for provision of services, will be unable to absorb further cost increases,” the submission warns. “Failure to recognise the costs associated with provision of high quality residential care including further increases in minimum wage could threaten capacity of nursing home

P Additional funding required in 2017 Budget for the NHSS (Fair Deal) to take account of the increasing costs to providers – general business costs and payroll costs.

P The nursing home sector is highly labour intensive delivering additional payroll and help to reduce the numbers on the Live Register with the associated savings in the social welfare benefits. This clearly demonstrates that amendment of the restrictive criteria of the EIIS scheme to the nursing home sector could be self-financing and could ultimately deliver a positive return to the Exchequer. NHI recommends that the restrictive criteria introduced in 2015 Finance Act be rescinded and amended.

P Introduction of an evidence-based cost of care model that acknowledges the true cost of providing residential nursing home care. P Fair Deal should be a reasonable rate based on ROI and capex and not an arbitrary decision by NTPF. There should also be an agreed annual indexation mechanism to increase rates based on legitimate cost increases. The NTPF previously included an indexation measure so there is precedent there.

Updated HR section – www.nhi.ie The Members Section of the NHI website now features a HR section with resources to support Members in meeting and exceeding HR requirements and needs. The relevant subsections incorporate: P ISME: As a member of NHI you have free membership of the Irish Small and Medium Enterprises Association (ISME). This provides access to a wealth of information, business advice and support. The ISME subsection provides economic, commercial, employee relations and social affairs advice and assistance. P Employment Law: Access a presentation that was delivered by ISME regarding employment law at an NHI Education Day in April 2016. It informs of your requirements in this regard and policy measures that will ensure you do not end up in the Labour Court. P Paternity Leave: Paternity Leave entitles a “relevant parent” to two weeks leave to be taken within 26 weeks of the child’s birth. Provided within the Paternity subsection is an information sheet, paternity leave policy, and advice note. P Workplace Relations: A Chambers Ireland briefing informs services offered by the Workplace Relations Commission, preparing a case and how the Commission operates. It also informs of the Labour Court and the Workplace Relations Adjudication Service heard by the Court.


The submission was submitted to Minister for Finance Michael Noonan, Minister for Public Expenditure Paschal Donohoe, Minister for Health Simon Harris, amongst others. It is available to read in full via the NHI submissions section of the NHI website.

Recently hosted NHI Webinars now online – support your staff in improving care practice A number of recently hosted NHI webinars are available to view online. On Wednesday 19th October, in conjunction with Fresenius Kabi, we hosted Nutrition and Hydration in the Care Home Setting. The aims and objectives of the webinar included: P To provide communication in relation to the nutritional management of individuals in the care home setting; P To provide information on best practice in meeting nutrition and hydration requirements of this population group; P To examine the current challenges/ barriers facing nursing homes in the provision of high standard of nutrition care. The Culture and Restraint webinar that was delivered by Lynne Phair, Independent Nurse Consultant and Expert Witness, Care of the Older Person, UK, at our national education day on restraint 9th September is also available. It explored the concept of compassion in care and how this relates to behaviour management, before focusing on restraint reduction strategies. PEG feeds, safe and evidence-based practice-including HIQA guidance on safety was hosted in June. It was delivered by Helga Gerlitz, Senior Community Dietician, HSE.


Nearly 14,000 nurses encouraged to return to nursing practice by NMBI in association with Nursing Homes Ireland Experience of ‘inactive’ nurses can bring enormous benefits to nursing home sector Nearly 14,000 nurses classified as ‘inactive’ are being encouraged to return to the workforce to provide nursing care to the elderly. The Nursing and Midwifery Board of Ireland (NMBI), in conjunction with Nursing Homes Ireland, is writing to 13,774 nurses who are categorised as ‘inactive’ on the NMBI’s register. “The quality of patient care across our health system is hugely dependent on an adequate workforce of nurses,” Mary Griffin, NMBI CEO said. “The aim of this initiative is to encourage some of the many thousands of nurses whose names are on the inactive file of the register to consider reactivating their registration and returning to practice in Ireland. Currently there are significant employment opportunities throughout the country, both on a full-time and part-time basis, that offer nursing staff the prospect of advancing their education further and developing new skills. We are happy to partner with NHI on this initiative and to urge nurses currently out of practice to consider returning and bringing their specialist skills to bear within communities and care facilities in need of nursing care and expertise.” Tadhg Daly, NHI CEO said: “We are delighted to partner with the NMBI for this important initiative. Nursing homes in our local communities offer great opportunities for inactive nurses to return to practice by offering them fulfilling roles that bring immense satisfaction. Their background and experience can bring enormous benefits and support to the dedicated homefrom-home healthcare settings in our communities that are nursing homes. The majority of people who are dependent upon nursing home care are very old, being aged 85 years or over. With this cohort of the population projected to increase considerably by the CSO, requirement to provide specialist, gerontological care is growing significantly.” A bursary to the value of €1,500 is available to nurses wishing to complete HSE-run return to nursing practice courses. The communication issued to the 13,000+ inactive nurses informed them of the bursary available and how they can reactivate their registration. It also informed of NHI’s dedicated recruitment website, www.careersinnursinghomes.ie, and A Career in Nursing Homes, the organisation’s booklet that provides information and advice to nurses considering careers in nursing homes.

Pictured at the launch of initiative between NHI and NMBI are, from left, Essene Cassidy, President, NMBI; Enrique Vives Sanchez and Carolina Marques, Belmont House Nursing Home; and Helena Gleeson, NHI Project Officer Nurse Recruitment.

NURSES WHO RETURNED TO PRACTICE IN NURSING HOMES Marie Colgan, Bed Manager, Orwell Healthcare, Rathgar, Dublin Marie Colgan previously fulfilled role of psychiatric nurse in St Vincent’s Hospital and as a General Nurse in North Infirmary Hospital, Co Cork. Marie stopped working due to family commitments and in 2016 returned to nursing after 21 years out of the profession. She assumed the role of bed manager at Orwell Healthcare, Co Dublin. “Understandably I was apprehensive to begin with but this is slowly subsiding as I gain more experience within my new role and learn the systems within Orwell Healthcare,” Marie comments. “It brings a good feeling to be getting on top of aspects of the job and is very reassuring after being so long away from the workplace.” The mother-of-three states getting on top of the new role “bit-by-by” and “coming up to speed with advances in technology and modern practices in healthcare” have given her immense satisfaction and proven extremely rewarding and satisfying.


Marie speaks of the benefits of working in a nursing home setting as opposed to the previous hospital settings she fulfilled her nursing duties within. “It’s a smaller environment, more personal and has a nice mixture of nursing and care,” she states. “My role at present is an administration and liaison role which is a new challenge for me. The residents in nursing homes are not acutely ill in general so there is less nursing pressure in that sense.” What would she say to any ‘inactive’ nurse who is considering a return to nursing and looking at nursing home care as an option? “I would recommend it as it is a less stressful environment to re-enter nursing after being inactive due to the mix of relatively healthy residents and therefore a good place to re-familiarise with technology and nursing practices.”

NURSES WHO RETURNED TO PRACTICE IN NURSING HOMES contd. Joan Lee, Staff Nurse, Cedar House, Goatstown, Dublin Joan was inactive for 14 years before she returned to nursing practice. She had previously nursed as a diabetes specialist nurse in St Vincent’s Private Hospital. She took the career break in 2004 due to family commitments. She returned to practice to Cedar House just over a year ago, in May 2015. How did she feel about returning post a ten year break? “Excited and terriďŹ ed in equal measure,â€? she explains. “I’m absolutely delighted to have made the return to nursing practice. I ďŹ nd the job rewarding in many ways. There’s the generous support of colleagues, positive feedback that comes from patients and relatives, the job satisfaction at the end of the day.â€? She said the ďŹ nds the role she is pursuing “very rewardingâ€?. “I especially like the team role where the team works as a unit each day and night towards the care and support of all residents holistically.â€? Asked of the beneďŹ ts of working in a nursing home as opposed to a clinical setting, she states her present role provides exibility, with her working two days concurrently. “It’s not a stressful area and the home setting is natural,â€? she adds. So what would she advise inactive nurses considering returning to nursing? “I would say talk to the nurse manager in the nursing home in the locality where you live. Take a tour of the facility, see what roles are available, ask would they offer a return to practice type of upskilling, as my employer did and this helped me ease into the role. Look out for an atmosphere of support towards continued practice development.â€?

Mary Maguire, Staff Nurse, Killure Bridge Nursing Home, Waterford After a 19 year absence from nursing, Mary Maguire was understandably “nervous and lacking in conďŹ denceâ€? when she returned to nursing in 2013. Mary was previously nursing in intensive care and providing clinical care to persons with spinal injuries. She stopped pursuing her nursing career in 1995 and spent an extended period overseas. In 2013 she returned to nursing at Killure Bridge Nursing Home in Co Waterford. “I went to live in Malaysia where foreign, non-Asian nurses were unable to get registration approval,â€? she explains. “I left in 1995 and only returned to nursing at Killure Bridge in 2013. “I felt nervous and lacking in conďŹ dence upon my return but I am very happy that I made the decision to return to nursing practice. I enjoy being back in a professional environment and having something very important to contribute. A nursing home is a perfect stepping stone for nurses returning to practice to re-enter the workforce. It provides a more gentle environment and has supported and enabled me to regain my conďŹ dence and skills. I would deďŹ nitely recommend anyone considering to return to nursing and looking at nursing home care as an option to be look at it as an excellent setting in which to return. It can provide a very rewarding career with great satisfaction.â€?

Curtains Direct




Nursing homes demand funding structure to recognise high dependency care needs A survey undertaken by NHI of private and voluntary nursing homes revealed they are strongly of the view the present funding model is not enabling them support residents with high dependency care needs. The respondents also expressed a complete lack of faith in the fee negotiation review process. 96% of private and voluntary nursing homes believe the present funding structure does not enable them to adequately support residents with high dependency / complex care needs. A survey of nursing homes was undertaken by NHI regarding the pricing mechanism. It was undertaken to inform NHI’s input to Deloitte, who are undertaking in conjunction with Prospectus Management, a review on behalf of the NTPF of the Fair Deal pricing mechanism.

INDEXATION An indexation methodology has previously been introduced by the HSE to encapsulate costs payable to private and voluntary nursing homes in contract beds and also by NTPF under NHSS (Fair Deal). Staffing costs generally account for 60%+ of nursing home turnover and it was advanced an appropriate indexation methodology may reduce the need for the NTPF to renegotiate with all nursing homes at the end of the deed.

KEY FINDINGS 196 nursing homes participated in the survey. The timeframe for completion of the pricing review is scheduled to be June 1st 2017, but the Minister for Health has asked that NTPF consider whether it can be completed before then. Key findings emanating from the survey include:

APPEALS PROCESS The complete lack of confidence in the present appeals process was evident from the survey undertaken by NHI Members. 95% stated they do not have confidence in the NTPF’s process. With just 36 nursing homes engaging in the internal NTPF review process between 2009 and the end of 2014, NHI impressed upon Deloitte the lack of use by nursing homes of the current appeals process is a reflection upon there being effectively no appeals process that nursing homes can have faith in, with present mechanism being effectively set up to penalise anyone attempting to appeal. Effectively, a large amount of public expenditure is allocated in an exploitative, irrational, short-sighted manner by NTPF account managers with little or no accountability, NHI advanced. It stated for an appeals mechanism to be effective and fair, there is requirement for:


An overwhelming majority – 96% - state that the current funding structure does not enable them to adequately support residents with high dependency / complex care needs;


86% are of the view fees payable should be linked to resident dependency levels;


79% of respondents favour indexation (not CPI);


Only 5% of respondents had confidence in the current NTPF review process for appeals.

At a meeting with Deloitte and Prospectus 20th October, NHI representatives presented findings emanating from the survey to advance required change in the pricing mechanism and outline nursing homes frustration with regard to how it operates. TRANSPARENCY IN FEE SETTING The representatives advanced the criteria under which Fair Deal fees are established must be clear, logical, rational, fair and transparent. Such criteria can deliver a sustainable nursing home sector with sufficient residential capacity and ensure the care requirements of those with complex needs outside the acute hospital system are met. Independent evidence1 that informs there is no standard objective assessment basis for setting price related to efficient capital and operating costs or level of dependency of residents was presented, with the final analysis for the rate for each nursing home being derived from ad hoc negotiation. Fees must reflect increasing dependency levels and associated care, HIQA staffing and regulatory requirements, return on capital, and enable nursing homes to compete with public sector / HSE in respect of staffing, NHI advanced. RECALIBRATION OF FEES The case for once-off recalibration for nursing homes on low rates was presented, with inadequate income levels threatening the sustainability of current provision. NHI advanced immediate requirement for a onceoff recalibration for all nursing homes on current low rates that are not viable or sustainable. Fees payable to HSE nursing homes are a national average above 50% beyond those payable to private and voluntary counterparts. NTPF and HSE must recognise and reflect cost pressures experienced by the sector in fee rates, with the situation unsustainable and an increase in funding levels imperative, Deloitte were informed. Escalating cost pressures were outlined: P

Rising staffing costs;


Increased recruitment and retention costs


Increasing staffing numbers/costs to meet HIQA requirements for staff ratios and skill mix;


Increasing commercial and insurance premiums;


Changes to minimum wage and its ripple effect;


Prospective living wage requirements and further ripple effect.



A clear, transparent and fair pricing mechanism to reference. By consequence, appeals can be based upon objective and transparent criteria;


Fixed timeframes for an appeal;


Necessity for appeal outcome to be backdated;


An external appeals process to be available should the internal appeals process fail;


Necessity for appellant not to be penalised.

NHI is of the view an independent appeals process will strengthen the governance process for State spending within healthcare and adhere to principles of good administration. INDEPENDENT RESEARCH At the meeting, the representatives informed of a body of independent research undertaken which highlights the shortcomings of the pricing mechanism. DKM Economic Consultants, in a report published December 2015 titled Potential Measures to Encourage the Provision of Nursing Home and Community Nursing Unit Facilities, stated the pricing model operates in an ad hoc manner, lacks rationale, consistency and fairness, and is unsustainable. It also advanced the main barrier to investment in nursing homes is uncertainty around future income streams, inadequate income levels to enable a return on investment, and the pricing model's lack of reference to dependency levels of residents. The Dementia Services Information and Development Centre (DSIDC), in a report published January 29th titled An Irish National Survey of Dementia in Long-Term Residential Care, stated the complex and high dependency needs of persons with dementia need to be more realistically reflected in fairer resource allocation. It also advanced payments made through the NTPF need to be commensurate with level of care, staff training and skill mix and type of non-pharmacological interventions expected to be delivered. The previous Oireachtas Health Committee, in its Report on End of Life & Palliative Care in Ireland (July 2014), advanced requirement for an evidence-based cost of care funding model. 1

DKM Economic Consultants, Potential Measures to Encourage the Provision of Nursing Home and Community Nursing Unit Facilities, December 2015


Examining an Emerging Role of the ‘Enhanced Care Worker’ in the UK Social Care Sector The challenges facing the adult social care sector are well known, including chronic long-term underfunding and challenges around staff recruitment and retention. With an ageing population often with high support needs, the sector needs to innovate to survive, writes Dr Brian Beach, Research Fellow at the International Longevity Centre-UK (ILC-UK). The International Longevity Centre-UK (ILC-UK), a think–tank addressing the challenges of demographic change and population ageing, were commissioned by the Department of Health in the UK to explore an emerging role in the social care sector where a care worker is upskilled to provide enhanced clinical support to registered nurses. Our report provides the first insights into this role, which we label the enhanced care worker (ECW), highlighting the characteristics of the job, the challenges present in establishing and providing the role, and lessons learned on how to best implement it. Drawing on a series of interviews with care home managers, nurses and enhanced care workers from a range of different care homes, the research identified certain similarities that run across the various examples of the ECW role, namely: enhanced clinical support, the importance of softer skills, and qualities related to leadership and management. Alongside how the role has developed across the sector, we also identified some key themes associated with it in practice, highlighting what is working in the role, the challenges involved in its implementation, and how any barriers were addressed and overcome. Such themes included: P Training and the development of qualifications and skills that are specific to a care home setting P The importance of the relationship between the RN and the ECW P Concerns over accountability P How the ECW role makes a real and positive difference

The report also includes key lessons learned that would help providers interested in developing such a role to do so more effectively. Successful implementation would be enhanced by: P Establishing clear communication on the lines of accountability and the delegation of tasks P Involving both RNs and ECWs in regular planning meetings P Focusing on or recognising softer skills P Acknowledging that there will be growing pains The scope of the research involved did not allow for a full evaluation of the role, so it remains clear that there is still the need for further research. Still, the report provides the first insights into this emerging and innovative role in the adult social care sector and offers important clues into how other care providers might consider developing a role of their own. The report is available at http://www.ilcuk.org.uk/index.php/publications/publication_details/innovate_to_alleviate Dr Beach will speak at the NHI Annual Conference 2016 on The Role of an Enhanced Care Worker. The Conference will take place Wednesday 16th November at Citywest Hotel.


Dr Brian Beach joined the ILC-UK as a Research Fellow in June 2013. In this role, he has conducted research on a range of topics related to population ageing, such as loneliness, serious illness, and housing, with his main expertise relating to the issues around employment in later life. He has worked on this subject and the changing nature of retirement for nearly 10 years, most recently with the three reports in ILC-UK's The Missing Million series published by BITC. He is also an active member on various strategic and advisory groups with universities, the voluntary sector, and government as they examine older people and the world of work. Brian received his doctorate in 2016 from the University of Oxford, studying at the Oxford Institute of Population Ageing, where he explored how the concept of employability plays a role in the labour market behaviour of older workers, in England as well as in different European social policy contexts. Prior to this, he worked in the International Affairs office of AARP in Washington, DC, where he helped organise a number of international dialogues and conferences on issues related to population ageing. His work also included fostering AARP's on-going collaboration with the United Nations Programme on Ageing, conducting outreach among the diplomatic and research communities. Prior to his position at AARP, he completed the TransAtlantic Masters Program in Political Science through the University of North Carolina at Chapel Hill and L'Università degli Studi di Siena, Italy. Through this programme, he gained extensive knowledge on European Union institutions, the process of European integration, and European welfare states. He speaks French and Italian, with varying competence in German, Portuguese, and Spanish.

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A Fair Deal For o All


09.05 09.05 - 09.30 - 09.30 OPENING OPENINGADDRESS ADDRESS Minist SIMON SIMONHARRIS HARRIST.D., T.D.,Minist ter terfor forHealth Health

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11.30 - 12.00 Neeil Eastwood, Founder, Sticcky People 11.30 - 12.00 Ne eil Eastwood, Founder,in Stic cky PeopleHome Sector Reecruitment & retention the e Nursing Re ecruitment & retention in the e Nursing Home Sector

Sticky People Ltd and a worldwide expert and international speaker on nursing and care Neil Eastwood is the founder of S He has spent many studyingexpert the best practices of carspeaker e recruiters ound the world. worker recruitment retention. Neil Eastwood is the and founder of S Sticky People Ltd andyears a worldwide and international on ar nursing and care providerthe andbest studied at Harvar de Business School. Previously he wasand a dirretention. ector at aHe 10,000 stafff UK homecar worker recruitment has spent many years estudying practices of car recruiters around the world. Previously he was a director at a 10,000 stafff UK homecare provider and studied at Harvard Business School.

12.00 - 12.30 QU UESTIONS & ANSWERS 12.00 - 12.30 QU UESTIONS & ANSWERS Ch hairman John Bowman 19 — NHI NEWS Ch hairman John Bowman

Citywest Hotel, Saggart, Co. Dublin, Wednesday 16th November 2016 12.30 - 13.00

BREAKOUT SESSIONS 1. Representative of National Vetting Bureau Overview of e-Vetting

2. Sinead Heaney, Partner, Corporate Investment & Business Advisory, BDO Funding option for the Nursing Home Sector - An overview of the Employment & Investment Incentive Scheme (EIIS)

The National Vetting Bureau

Sinead Heaney

Since the commencement of the National Vetting Bureau (Children and Vulnerable Persons) Acts 2012 to 2016, the National Vetting Bureau is the single point of contact in An Garda Síochána to conduct Garda Vetting. Its primary objective is to provide an accurate and responsible vetting service which enhances the protection of children and vulnerable persons through enabling safer recruitment decisions.

Sinead Heaney is a Partner in the Corporate Investment & Business Advisory Department of BDO. Sinead has considerable experience in structuring BES/EII Scheme investments. She also has extensive experience working with small, medium and large privately owned businesses in both developing and achieving their strategic plans.

13.00 - 14.30

LUNCH Sponsored by - Unilever Food Solutions Opportunity to Visit Exhibitors

15.30 - 16.00

Chairman - John Bowman 16.00



14.30 - 15.30


KEYNOTE SPEAKER - Christy Kenneally Communications Training Consultant and best-selling author, poet, T.V. scriptwriter and presenter.



NHI CARE AWARDS CEREMONY www.nhicareawards.ie


Role of carers advanced with State skills group Measures have been advanced by NHI to the Expert Group on Future Skills Needs to combat carer and nursing shortages. It is a second submission brought forward by NHI to the group with regard to making suitably qualified and interested healthcare assistants available to nursing homes. Nursing homes are hugely dependent upon such professionals to run their facilities. The Expert Group on Future Skills Needs (EGFSN) advises the Irish Government on current and future skills needs of the economy. Two NHI surveys undertaken in January and September 2016, highlighted requirement for more nursing and care staff within nursing homes to support healthcare delivery, with some having, in severe cases, to close beds and suspend admissions. The submission advanced candidates who are interested in getting registered as a nurse to work in Ireland should be given permission to arrive into and work

in Ireland, once suitably vetted, as a pre-reg nurse or care assistant while their registration is being processed. The recommendation should be expediated to address the nursing crisis and the recruitment of care assistants, the proposal stated. Additionally, suitably qualified healthcare professionals from non-EU counties could get a work permit and permission to stay in Ireland based on the ongoing crisis in recruitment and retention of nurses and care assistants. As well as combatting carer and nursing shortages, NHI advanced the measure would enable staff to be fully trained and orientated when registration from the NMBI is fulfilled. It would also improve staffing levels, provide continuity of care for residents, and support the healthcare workers to settle. Read the submission in full at www.nhi.ie


NURSING HOMES IRELAND CARE AWARDS 2016 Wednesday 16th November 2016 | Citywest Hotel, Co. Dublin

Congratulations to the NHI Care Awards 2016 Finalists NURSING HOME DIRECTOR OF NURSING/PERSON IN CHARGE AWARD Caroline Day Moorehall Lodge Drogheda, Old Dublin Road, Drogheda, Co. Louth Tanya Grandon Mount Hybla Private, Farmleigh Woods, Castleknock, Dublin 15 Frances Neilan Clarenbridge Nursing Home, Ballygarriff, Craughwell, Co Galway

NURSING HOME SOCIAL & RECREATIONAL PROGRAMME AWARD Activities Co-Ordinator Team Mount Hybla Private, Farmleigh Woods, Castleknock, Dublin 15 Ferndene Creative Arts Society Ferndene Nursing Home, Deansgrange Road, Blackrock, Co Dublin



Catherine Donnelly Hamilton Park Care Facility, Balrothery, Balbriggan, Co Dublin

Philip Archbold AnovoCare Nursing Home, Stockhole Lane, Cloghran, Swords, Co Dublin

Jane Dunne Knightsbridge Nursing Home, Longwood Road, Trim, Co Meath

Lorraine McNally Parke House, Boycetown, Kilcock, Co Kildare

Binimole Santhosh Esker Lodge Nursing Home, Esker Place, Cathedral Road, Cavan

Churchill Yanez Ferndene Nursing Home, Deansgrange Road, Blackrock, Co Dublin



Catering Unit Rathkeevan Nursing Home, Cahir Road, Clonmel, Co Tipperary

Dermot Fallon Sonas Care Centre Cloverhill, Cloverhill, Co Roscommon

Andrew Dunne TLC Centre Citywest, Cooldown Commons, Fortunestown Lane, Citywest, Co Dublin

Laszio Nagy Áras Chois Fharraige, Pairc, Spiddal, Co Galway Gavin O’Neill Orwell Healthcare, 112 Orwell Road, Rathgar, Dublin 6

Niamh Kelly Altadore Nursing Home, Upper Glenageary Road, Glenageary, Co Dublin

Sarah McDonagh Clarenbridge Nursing Home, Ballygarriff, Craughwell, Co Galway



Jordanna Baker TLC Centre Maynooth, Straffan Road, Maynooth, Co Kildare

Dementia Care Education Team, Marymount Care Centre, Westmanstown, Lucan, Co Dublin

Carrigoran Health & Wellness Centre Carrigoran House, Newmarket on Fergus, Co Clare

Sarah McGrath Strathmore Lodge, Callan, Co Kilkenny

Linda Carew Millbrae Lodge Nursing Home, Newport, Co Tipperary

Des Mulligan Sonas Care Centre, Ard Na Gréine, Enniscrone, Co Sligo

Carol Carty Maynooth Lodge, Rathcoffey Road, Crinstown, Maynooth, Co Kildare

Roisin Quinn Millbrae Lodge Nursing Home, Newport, Co Tipperary

NURSING HOME END OF LIFE CARE AWARD Chrissie Barron Moorehall Lodge Ardee, Hale Street, Ardee, Co Louth

WINNER - NURSING HOME RESIDENT ACHIEVEMENT AWARD 2016 Patrick Donnelly Hamilton Park Care Facility, Balrothery, Balbriggan, Co Dublin

NHI Care Awards 20 16 MC Marty Whelan

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

Contact Olivia at (01) 4292570 | www.nhicareawards.ie NHI NEWS — 22



BOYS IN GREEN A FOCUS FOR NURSING HOMES WEEK 2016 CELEBRATIONS The fervour of Ireland’s participation in the European Soccer Championships was replicated in Nursing Homes across the country. And it coincided with the national celebration and promotion of nursing home care: Nursing Homes Week. Nursing homes across the country hosted celebrations that brought residents, their families and friends, staff and wider communities together to celebrate the positivity of nursing home care. With the encouragement of NHI, many nursing homes celebrations were hosted to coincide with the Boys in Green games. Media interviewed residents cheering on the Boys in Green, providing wider public with an insight into the wonderful characters who reside in these homes from home. A Boys in Green themed launch for the week took place at Ferndene Nursing Home in Co Dublin, with team sponsors Three Mobile providing team memorabilia for residents and staff to enjoy. RTE soccer commentator Stephen Alkin kindly attended. During the week, NHI launched an appeal for residents 100 years of age or older during this special commemorative year to be brought to our attention for receipt of a special cert. The first of the certs was presented by Minister for Older People Helen McEntee to the remarkable 106-year-old Elizabeth ‘Lizzie’ Dempsey, a resident of Ailesbury Nursing Home, Sandymount, Co Dublin. Nursing homes across the country brought residents, their family and friends, staff and wider communities together during the week to celebrate nursing home care and the wonderful staff providing it. Some of the more novel celebrations to be hosted included visits to nursing homes by the Sam Maguire cup, a wedding fair, latino day, vintage car and steam engine show, race days, threshing display, a community fun fair.



NURSING HOMES WEEK MEDIA COVERAGE Nursing Homes Week seeks to promote the positivity of nursing home care to the wider public. This year media coverage within following outlets for the outlined stories encompassed:


Irish Times, Irish Examiner, Evening Herald, Daily Star, Daily Mirror articles covered the presentation to Elizabeth Dempsey of NHI 1916 commemorative cert by Minister Helen McEntee.


The presentation received extensive coverage online, with Journal.ie receiving over 26,000 reads for an article about the presentation that was shared over 1,000 times by Facebook users. It was also featured on independent.ie.


RTE News (Six One & Nine O’Clock) the RTE website featured an interview with 95-year-old soccer supporting resident Mick O’Neill. An article and video feature with Mick was also promoted on Indepenent.ie


Newstalk & Today FM news bulletins featured an interview with 96 year old soccer supporting resident John Foley.


Newstalk Breakfast broadcast a report from Middletown House Nursing Home, Co Wexford, as residents cheered on Ireland v Sweden.


Age Action’s website featured a blog penned by residents of St Gobnait’s Nursing Home, Co Limerick, that informed of their positive experiences and outlook of nursing home living.


Irish TV broadcast a report depicting the celebrations in Castlemanor Nursing Home, Co Cavan.


NHI’s Facebook posts informing of the celebrations received 9,000+ views, being shared widely amongst nursing home audiences and the wider public.

NHI TO TAKE LEGAL ADVICE OVER PUBLIC NURSING HOMES To coincide with the focus on nursing home care, NHI criticised the anti-competitive practice within nursing home care of fees payable to public nursing homes not being disclosed to wider public. “Private and voluntary nursing homes are tasked with providing care for fees that are a national average 58% below those paid to their public counterparts,” Tadhg Daly, NHI CEO stated. “We have a situation across the country whereby the fees payable are published for private and voluntary nursing homes but not disclosed for HSE homes. It is an extremely important and pertinent question: why the failure to disclose fees payable? What are the public not being informed of? Is it because if they were published, private and voluntary homes would have a legal case about the unsustainable low level of payments by the State.” Our statement can be read in full under the news section of the NHI website. It was covered by the Irish Independent, Irish Examiner and the issue was further raised in Dáil Éireann with Minister for Older People Helen McEntee.

NHI OIREACHTAS OPEN DAY We again hosted our Oireachtas Open Day during the week, taking place Wednesday 15th June in Buswell’s Hotel. 50 TDs and Senators were provided with a briefing by Members that informed of the unsustainability of the nursing home funding model, with it not recognising reality of costs incurred to provide care; no independent recourse for providers dissatisfied with fees tabled by NTPF; requirement to implement a workforce plan to ensure we plan to care for ageing demographic’ healthcare requirements. TDs and Senators to attend included Minister Helen McEntee (Older Persons), Minister Patrick O’Donovan (Minister of State), Minister Denis Naughten, Deputy John Paul Phelan (Chair Dáil Budgetary Committee), Deputy Michael Harty (Chair Oireachtas Health Committee), Deputy Louise O’Reilly (Sinn Féin Health Spokesperson), Deputy Caoimhghín Ó’Caoláin (Sinn Féin Older Person Spokesperson), Senator Mary Butler (Fianna Fáil Older Person Spokesperson).

COUNTY CARLOW Borris Lodge Nursing Home, Borris An excellent turn-out of local people joined residents and staff for a vintage threshing display and a tractor and steam engine show. “Our hope was to create fond memories for our residents of a time and place in their past which we succeeded in doing,” Mary Behan, Activities Coordinator explains. “Most of our residents remembered having to work hard during the threshing season but they had great fun also as they were with friends and neighbours. There was lots of talk about tractors, threshing and steam engines for days after our big day. We had the best day, as the sun was shining and everything went to plan.” The week of celebration concluded with live music and dancing.

Riverdale Nursing Home, Ballow ‘The Three Amigos’: Three residents enjoying the Summer sun during the Nursing Homes Week celebrations


COUNTY SLIGO Ard na Greine, Enniscrone Back by popular demand, a Step Back in Time returned for Nursing Homes Week. This saw memorabilia from years past featured throughout the nursing homes. A high Nellie bike was just one of the many items on display. Residents loved the day.

Riverdale House Nursing Home, Ardnacrusha Wild Encounters, an animal outreach programme, visited to host a special celebration of the natural world. A visit from the Hunt Museum, with 800 years of fashion on display, was also a highlight.


Millbrae Lodge, Newport The annual Pink Ribbon Walk brought residents and staff out for a very special cause. St Martha’s, Cahir A number of celebratory events brought great enjoyment to all. Residents and staff travelled to Cork for an outing to Fota Wildlife Park, where they viewed animals and birds from continents across the world. The Hunt Museum from Co Limerick facilitated a celebration of 800 years of fashion. A dog parade, barbecue, music session, monster bingo and ball games were also hosted. Rathkeevan Nursing Home, Clonmel The residents enjoyed an amazing experience when the Wild Encounters Mobile Zoo visited, bringing wide-ranging exotic creatures that included birds, mammals, reptiles and creepy crawlies. A special tribute to Elvis Presley had toes tapping and a bake-off was also hosted.

COUNTY WEXFORD Middletown House, Gorey Newstalk were visitors to Middletown House. Reporter Kieran Cuddihy recorded a piece with residents watching Ireland’s opening European Soccer Championships game against Sweden. In the days previous, 96-year-old resident John Foley, a keen soccer fan, had featured on Newstalk and Today FM previewing Ireland’s chances. Kieran’s piece with John and fellow residents was broadcast on Newstalk Breakfast. Moyne Nursing Home, Enniscorthy Moyne Nursing Home hosted a week jam packed with lots of fun activities for residents. One particular highlight was a sports day that saw staff and residents participate over a great series of fun events. Valentia Nursing Home, Enniscorthy The inclement weather brought the garden party indoors but it did not deter the celebrations.


Garbally View Nursing Home, Ballinasloe Marie Dolphin, Activities Co Coordinator writes: “For our main

event during Nursing Homes Week our residents experienced an afternoon of Japanese culture. The evening kicked off with children from a local Karate Club treating the residents to a display of traditional martial arts followed by a demonstration of the ancient art of weaponry. The children also provided some music for everyone to relax to. By the time the show was over our residents had worked up an appetite and were ready for an eastern food tasting session. The food and drinks were served to the residents by staff wearing the traditional Japanese Kimonos. The Japanese main course followed by Mini Dorayaki Cakes. Even if it was slightly more of a challenge using chopsticks instead of knives and forks! Whilst the green tea from Japanese tea pots was sampled by all, it was decided that nothing could replace the cup of Barry`s. No Japanese cultural event could conclude without raising a glass of Sake in a toast to health and happiness to all gathered, and this we did. Kanpai (Slainte).” Rosemount Nursing Home, Gort Stories, piseogs and old cures were compiled by activities coordinator Deborah Walsh from staff and residents in anticipation of Nursing Homes Week. This led to compilation of booklet with the stories and it was published and presented to residents and visitors. Legendary storyteller and writer Eddie Lenihan came to the nursing home to entertain all with tales of fairies, woodland creatures and the infamous Biddy Early.


St Gobnaits Nursing Home, Ballyagran Traditional music provided entertainment with Irish dancers and a Seanachi also featuring. A visit to De Valera’s Cottage in Bruree was also hosted and to coincide with the focus on the birth of a nation ‘Michael Collins’, who obliged with rebel songs, and ‘Countess Markievicz’ visited.


Cúl Dídin, Tralee Pattern Mass was celebrated in the garden and it was followed by the opening of Frankies Corner, an area of natural beauty with tranquility and reflectiveness within the grounds of the nursing home – good food for the soul! This community service was also symbolized by the planting of an Oak Tree in the 1916 Memorial Garden. The Grand Oak was donated by the Tarrant family in memory of their late Mum Frankie. St Joseph’s Nursing Home, Killorglin A tea party brought the residents, their family and friends, staff and wider community together. Live music led to dancing, with the waltz, being a particular favourite.

COUNTY LOUTH Dealgan House, Dundalk Pampering, relaxation, arts and crafts celebrations featured during the celebrations. The week concluded with a garden party featuring a barbeque, live music, a magic show and face painting. A more restrained tea party celebration took place the Sunday.

COUNTY CORK Fairfield Nursing Home, Drimoleague Residents, staff and visitors enjoyed participating in a Wedding Fair hosted in the Drimoleague-based nursing home. Padre Pio Nursing Home, Rochestown Royal Ascot Padre Pio Style Day was a highlight, featuring elegant dress and tasty canapé’s The nursing home’s annual BBQ was also hosted, with music provided by a four-piece band accompanied by a ukulele group.

COUNTY ROSCOMMON Abbey Haven Care Centre & Nursing Home, Boyle A Vintage Day was the feature celebration, bringing together a display of antiques. A very impressive display of vintage cars provided residents with trips down memory lane. Music was broadcast via grammaphone, with old records spinning.

COUNTY LEITRIM Shannonlodge Nursing Home, Carrick-on-Shannon Celebrations commenced with Mass, and Blessing of St. Anthony Relics in St. Mel’s Cathedral and trip to Knock Shrine. A mobile farm visited, with items from times past on display, enabling residents reminisce of times past. Frank Feery visited to perform hits of the 50’s. A trip to Tullyboy Farm, Boyle and a picnic was enjoyed by all. The piece de resistance was a visit to the nursing home by Sam Maguire. It was a tremendous occasion to celebrate. A BBQ with live entertainment concluded a memorable week of celebration. Craddock House, Naas The local primary school visited where both senior infants and sixth class pupils performed their end of year show. Children from fifth class displayed commemorative 1916 Rising projects for residents. Wooly Ward Travelling Farm also paid a visit, where residents came up close with goslings, hedgehogs and bottle fed a lamb. Curragh Lawn, Curragh They rambled into the Wild West in Curragh Lawn. A Wild West themed Barbeque with live music and great food was organised. ‘Wanted’ signs, a saddle post, cacti, ponies and a wagon added to the Wild West atmosphere. Oghill Nursing Home, Monasterevin A cowboy themed afternoon celebrated nursing homes week, with live music and a Barbeque. Parke House Nursing Home, Kilcock Vintage cars visited the nursing home, providing residents with a very special trip down memory lane. A trip around town was hosted for residents in a vintage car. The Relic of St Therese of Lisieux visited, with residents blessed. The week’s celebrations started with a sports day. Fairground games were another celebratory activity, and residents and staff were in fine voice for the Reeling in the Years Karaoke Day.



Beechlawn Nursing Home, Drumcondra Beechlawn’s Got Talent saw songs, ballads, comedians, dancers and even balloon shapers perform. The art group had prepared a magnificent stage setting and fellow residents created performing outfits. “The variety of acts from staff, family and residents, coupled with some very witty judging, made for something that can only be described as great craic,” Linda Martin, Senior Activity Coordinator commented. Brymore House, Howth A busy programme included a culture day, random acts of kindness day, live music, games, and a charity walk to raise funds for dementia awareness. Cara Care Centre, Santry Home Run, a new activity devised by Cara Care Maintenance Manager Matthew Lacey, was launched. It is a virtual bus for residents to travel in. Matthew fixed three cameras onto Cara Care Centre’s own transport buses and drove around local areas familiar to residents, recording it all. His recordings were transferred to a custom made mock bus with three TVs to give a surround effect and a feel of travelling through the different areas. The initiative is designed to assist dementia residents with visual reminiscence of past memories. Other activities hosted during the week included a joint pottery class with TLC Santry, a fudge tasting afternoon, vegetable seed planting and live music. Foxrock Nursing Home Cairnhill Estate Street Feast brought the residents and staff of Foxrock Nursing Home together with their local neighbours. A band favourite, Down the Line, kept all dancing. To coincide with the European Soccer Championships, a soccer knock-out competition was hosted, with the Irish team sharing top spot with the Italians.

Griffeen Valley Nursing Home, Lucan The Marie Caren School of Irish Dancing visited to stage a wonderful performance of Riverdance. Hamilton Park Care Facility, Balbriggan Hamilton Park kicked off Nursing Homes Week with a social night to coincide with Ireland’s first game against Sweden in Euro 2016. Tuesday saw residents join residents of St. Joseph’s in traveling to St. Gabrielle’s in Raheny for a game of mega bingo. On Wednesday musician Billy Mc Gee entertained and the ladies enjoyed Calendar Girls during movie evening. Thursday saw residents undertake work on their Adopt a Patch that they have adopted from the local tidy towns committee. Residents have added some lovely colour to their Adopt a Patch and love the beeps and attention from the locals while they work. It is their pride and joy. On Friday local organisations and clubs were welcomed to Hamilton Park’s Nursing Homes Week celebration party. The over 65s club, Meals on Wheels and Balbriggan ICA were delighted to accept an invitation to an afternoon of music and fun. Holy Family Residence, Clonskeagh The week opened with a trip to St Enda’s Park, one of Dublin’s most charming and atmospheric parks. Residents visited the former school run by Patrick Pearse - now a museum – and its beautiful grounds. The following day the residents talents were on display for the Holy Family Residence We’ve Got Talent show. Talents of a different kind were on show the following day, Wednesday, for sports day. Thursday brought choice. ‘University Challenge of Life’ had the quiz buffs assembled. Baking and cup cake decorating was also hosted. Later that day volunteer George hosted Timeless Classics, a concert for all to enjoy. That afternoon the Davenport Family – three generations of gifted musicians, entertained with live music and song.

COUNTY DUBLIN Little Sisters of the Poor, Raheny A Strawberry & Cream afternoon featured live music and dance. Marymount Care Centre, Lucan Resident Brigid Halley, would will turn 100 in September, was visited by Quarter Master General David Morrissey and presented with a copy of the 1916 commemoration. A family quiz night was hosted and a great success. Sixth class students from Ladyswell National School in Mulhuddart joined residents and staff for an intergenerational school community quiz and music morning. Newpark Care Centre, The Ward The Great Newpark Bake-Off competition was contested between Apple Crumble & Rock Buns. A Tea Party was also hosted with Brian Mc Guire and Newpark Got Talent featured guest judge Paddy. Riverside Nursing Home, St Margaret’s Sam Maguire was a visitor. Also, a traditional Irish music concert, flower arranging session, rock ‘n’ roll bingo and a special visit by children from St Fintan’s School, Finglas, to sing to residents, were other highlights.

St Gabriel’s Nursing Home, Raheny A sweepstakes garnered additional excitement for the European Soccer Championships and a mega bingo afternoon saw residents from Hamilton Park, Balbriggan, and St Joseph’s, Raheny, join in the excitement. 16 games were played simultaneously during a Games Day, featuring chatter, laughter and fun. And to culminate the visit from Wolly Wards Farm had residents and staff ‘oohing’ and ‘aahing’ over some very cute and cuddly young animals. St John’s House, Merrion Road It was Euro themed celebrations that were hosted during Nursing Homes Week 2016 in St John’s. It kicked-off with a gathering for the Ireland v Sweden Euro Championships and it was a Euro Singalong that was hosted Tuesday. A Euro quiz took place Wednesday, and Euro Bingo, A Taste of France and the another gathering for the Ireland v Belgium match finished off the week.

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Recruitment and Retention - The Staff Wellbeing Advantage

Have you noticed lately that you can’t walk into a supermarket or convenience store without tripping over rows of protein bars, chia seeds, gogi berries and all sorts of healthy options? It seems the national pastime these days is sharing the latest in getting healthy from head to Fitbit. Workplaces are no exception. Just open your staff canteen fridge and you’ll see that open tins of trusty old Bachelors are being replaced by 5 bean quinoa salad, with more Alpro than Avonmore on the door! We know ourselves what happens when we take up a fitness practice or start to eat better - our health improves and we start to look and feel good. There is also a corresponding rise in our physical stamina, which is the core energy we need for our working life. Research tells us that lowering stress is the number one way we can improve our overall wellbeing and employers have a greater hand in this than you might think. Promoting self-care and resilience in-house is being increasingly recognised by HR as an important part of the value proposition to attract and retain staff in the healthcare sector. Employee wellbeing and resilience programmes have been shown to improve performance and reduce absenteeism, so taking good care of our teams makes sound sense. According to the Eurobarometer, exposure to stress is considered the main health and safety risk in the workplace, as indicated by 53% of those surveyed. 30% of workers reported suffering from stress, depression or anxiety that had been caused by or worsened by work in the past year. Additionally, there are stresses which are particular to health and social care environments when treating others in emotional or physical pain. Implications of stress for healthcare organisations and nursing homes include reduced work performance, staff conflicts, absenteeism, high turnover, and increased mistakes and accidents. Costs on the caregivers themselves are many and varied and can include illness, job dissatisfaction, burnout, reduced ability to care, sleep problems, addictive behaviours, to name a few. So what do nursing homes need to know about the burgeoning topic of staff wellbeing and what some simple steps to take? Self Care for Carers work across a diverse range of organisations in health and social care, so our perspective is a broad one. However, my own background includes working in elder care for many happy years. Although nursing homes may not have the same drama as say an emergency room, there is a significant emotional ‘loading’ in this area of caregiving that can present challenges for staff. Working in elder care means acknowledging that we are accompanying people towards the latter part of their lives. Because we care, relationships build up between staff and residents - and their families - over time. So it is natural then that connections are formed when we provide the level of person-centred care that is so essential.


The Cost of Caring The very act of being person-centred means that we are empathetically present, aware and focussed on the person in our care, and this can be challenging at times. In the cut and thrust of an ordinary nursing home day, it is not uncommon to feel a variety of emotions such as frustration, joy, anxiety, relief, sadness. These are part and parcel of the deal and to be expected in this sector. At times, we have a particular task or duty to be performed and the resident is having ‘none of it at all’, and this can be challenging. Other days are filled with lovely moments and lots of laughter. You take each day as it comes. One of the other aspects about being truly present is that you are right there with a resident who may be suffering, feeling very lost, in physical pain or confusion. This is commonplace particularly, in caring for residents on their dementia journey. As international author, teacher, and promoter of integrative medicine Naomi Rachel Remen states, “the expectation that we can be immersed in suffering and loss daily and not be touched by it is as realistic as expecting to be able to walk through water without getting wet”. Nurses, doctors, caregivers at various stages of their careers can suffer symptoms of compassion fatigue (CF). Also referred to as ‘the cost of caring’, CF isn’t a disorder, rather it is a set of symptoms which responds well to skill building and committed self-care. Symptoms vary from person to person but can include sleeplessness, apathy, irritability, anxiety, loss of focus, interpersonal conflicts, increase in pessimism, feeling drained and burnt out. Skills building and selfcare in this context means (a), learning how to relax and decompress from work, and (b) how to care for ourselves optimally, so we can then provide the best care to others. The emotional aspects of caregiving, the pace of work, plus competing demands on our time and attention can present challenges to anyone. According to Charles Figley, the father of compassion fatigue research, “it is the caregivers who care the most, and are very compassionate and empathetic in their work, that are at the greatest risk of compassion fatigue”. So aren’t we then speaking about one and the same people who provide truly person-centred care for residents? They are indeed the staff who require some additional care for themselves.

Karen Brennan runs Self Care for Carers, Ireland leading organisation providing healthy caregiving strategies to staff in healthcare settings. More information at www.selfcareforcarers.ie

WELLBEING PROGRAMMES Staff wellbeing programmes, which enable skill building in selfawareness and stress management, can yield immediate benefits. Here are some additional steps that employers can implement to help staff move towards wellbeing and greater self-care. 1. Self Care from Day 1: Why not include a question about self care at recruitment stage and also during induction? “So this work is very rewarding but can also be challenging at times, what do you do in your free-time to relax?” This question can tell a lot about a candidate’s level of life and level of self awareness before starting in your organisation. 2. Normalising Occupational Stress The stiff upper lip which is the default response in many workplaces often falls short when people are really struggling with fatigue. Talking openly with staff about stress-inducing situations can be very productive. This doesn’t just include carers and nurses but all departments including household, kitchen team, admin. Our workshops always start by acknowledging how widespread carers stress is in all areas of healthcare, and that we that we all feel stress at times. Such early and upfront honesty increases communication and trust amongst team members. Walls come down, it becomes safe to discuss and share with one another. This is accompanied by a sense of bonding and relief that everyone is kind of feeling of the same and finally talking about it.

3. Consideration in Rostering I did my fair share of rostering and know how tricky it can be, especially around holidays or when you’re short staffed. However, it is important that if a staff member seems to be adversely effected by an event, such as the passing of a resident, the thoughtfulness of organising their roster to allow for a little extra time off can be much appreciated. 4. Relaxation Practices Body wellness practices can really help to lower anxiety levels. Regular brief group relaxation sessions result in stronger team cohesion. Some nurses teams we work with practice Tai Chi together at handover, and it has altered the team dynamic in a really healthy way. 5. Extracurricular Events Spending time together in relaxing group situations outside of work is a wonderful way of increasing team bonding. Work nights out are common place but it’s interesting to look at what the research says about connecting with team in caregiving roles. According to Kyle Killian (2008) social support at work is the most significant factor association with Compassion Satisfaction (CS). Opportunities to engage with one other outside work also strengthen bonds. Are there some events coming up in your local area that your organisation can get involved with? Events which don’t end up in the pub can be refreshing and reinforce the message around self-care.

PROMOTING WELLBEING Get Moving Physical exercise is one of the best ways to de compress and raise our energy levels. There is someone connected with or working in every nursing home in Ireland who is into fitness. Why not engage them to help organise a staff fitness and wellness committee at work? Or ask the local weightwatchers or Slimming World leader to visit your home. Team members could work towards doing a sponsored walk or run – you don’t have to wait for Operation Transformation. Competition increases appetite! Eat to Live Healthy eating, especially for snacking, is important for busy staff on the go. Providing the occasional fruit plate or fresh juices into the staff room again sends out a healthy message. The perennial box of chocolates is always doing the rounds, but healthy slow release carb snacks keep sugar level constant for the duration of a shift. Adding healthy snacks to the vending machine also encourages healthier eating. Money, money, money Many common stresses and worries stem from our monthly incomings and outgoings. Having an expert pop in to give a talk on areas relevant to staff in financial planning, budgeting and tax could be very much appreciated.

Healing Diversity Many of our colleagues from overseas come from wonderful living traditions of healing. Indian culture is steeped in Ayurvedic therapies and medicine, which has much to teach us. Hilot techniques from the Phillipines include wonderful relaxing head and shoulder massages. Slavic cultures are expert on herb use and eating for greater health. Many staff are only waiting for the opportunity to share what they know and love from their home cultures. Encouraging the sharing of health practices from within the diversity of your team will promote understanding, team bonding and health. Why not organise a week of sharing where staff members are encouraged to share techniques and practices find healing and helpful. In the current recruitment climate, attracting and retaining the best people is more important than ever. When staff feel understood, valued and appreciated they are more likely to stay. Notwithstanding the confines of costs and remuneration, there are other creative options that that nursing homes can offer which will be attractive to staff and increase loyalty and happiness at work. Staff wellbeing programmes are here to stay because happier staff means happier residents.



Nursing homes gather as residents take centre stage for 1916 commemorations

James Connolly’s heritage is rich within the Galway village of Spiddal. The matron at Áras Chois Fharraige nursing home, Pat Folan, is great granddaughter of James Connolly. Three of Pat’s sons have children residing in Spiddal. Pat’s granddaughter Louise is great, great, great granddaughter of the proclamation signatory. And Louise’s daughter Isabella is the great, great, great, great granddaughter of the Republican leader. Pat was the guest of honor when a sculpture created by sculptor Mick Wilkins of the 1916 proclamation was unveiled within the Gaeltacht village. The local tidy towns committee led the 1916 – 2016 commemorations and commissioned the sculpture. “I think it was a lovely thing for them to do to make a garden of remembrance,” Pat commented. “It was a community project and well done to the committee who saw it through; it will forever be captured in stone.” Pat attended the official commemorations at Arbour Hill in 1966, for the 50th anniversary of the rising, with her grandmother Ina, James Connolly’s daughter. Pat says that little attention was given to James Connolly when she was in school but her grandmother frequently talked about him. “James Connolly came from a very poor background and that was his main interest really, fighting for the poor,” she says. “He was involved in the unions and was very much involved in women’s rights.” Glenaulin Nursing Home, Chapelizod in Dublin, hosted a special commemorative ceremony. A lone piper led all those present into the nursing home gardens. The tricolour was raised and Seargent Leona Walsh and Captain Niall Goff of the Defence Forces read the proclamation. Resident Jeanne Plunkett sang the national anthem and Eithne Malone recited the Pádraig Pearse poem The Mother. The event came to a close with Mary McCormack planting a heritage tree in the


gardens of the nursing home. Live ‘trad’ music provided entertainment for residents and staff for the afternoon. At Ratoath Manor in Co Meath, a 1916 commemorative plaque was unveiled by Ratoath Municipal District Chairman Councillor Nick Killian. The proclamation was read, the tricolour was raised and the national anthem was sung. A short history of the Rising was also delivered to residents, their family and friends, and staff. A booklet informing of the history of the Rising was published to coincide with the special gathering. St Mary’s Centre, Merrion Road in Dublin 4, brought a special commemorative event together. Novartis supported a community partnership day that brought St Agnes School Parents Orchestra, Crumlin, into the nursing home to perform music from 1916 for residents and staff. This was complemented by Irish dancing and a fascinating talk by historian Pat Liddy. Residents of Ashlawn Nursing Home in Co Tipperary created a 1916 commemorative poster. “A majority of residents were involved at some stage as this activity interspersed with other regular activities and it therefore took a number of days to be completed,” Patricia McKeon, activities coordinator at the nursing home stated. “Each resident came up with one thought, memory or recollection of that particular period. These were then featured on the poster.” Sample quotes included: P

“People hid in their homes in the Silvermines.”


“My Grandmother told me the Black and Tans searched local houses for valuables and guns.”


“My great grandfather was a member of the RIC.”


“Men coming to hide in my Granny’s back yard.”

Clockwise from left: Pat Folan, great granddaughter of James Connolly; pictured after unveiling 1916 commemoration sculpture in Spiddal; Glenaulin Resident Jeanne Plunkett sings the National Anthem, Staff of St Mary’s dressed in 1916 attire for the commemorations; Resident Eithne Malone reciting the Pådraig Pearse poem The Mother; Ashlawn Residents pictured with the 1916 commemorative poster that they created.

$ $ $ $ Residents of Beechwood House in Newcastle West, Co Limerick, were invited to bring together personal stories surrounding 1916 and the War of Independence. Provided are ďŹ ve such recollections. # ! $ ##

#"$ #""

I was born in 1921.My father Joe Magee was with the Old IRA. He was working in the Railway in Limerick. He was mentioned in a book in the Easter Rising. He was a Secret Active Supportive Volunteer. My Father’s job was to notify all the trains. The Old IRA were importing 20,000 ries from Germany to be used against the English. That happened off the coast of Kerry Banna Strand, but there was a English Patrol boat and they killed him; his name was Roger Casement. Roger Casement was English but he fought for Ireland. He was killed by the English; they gave him awful death. Mr.Donovan, I can’t recall his ďŹ rst name, had a hotel and bar in Limerick. The Black and Tans were pretending that they were Irish and they took him out in his back yard and shot him. The reason they shot him was that there was IRA men staying in the hotel and he wouldn’t tell them. My Father had a lovely a Green, White and Gold Irish Flag. If the English found it, my father would have been shot. That ag was hidden in my cot. It had written on it “Soldiers of Irelandâ€?. That ag is in a Museum in Limerick.

My dad would have all of us around the bed, telling us all of 1916 and the hanging of Kevin Barry. He got us to learn the Kevin Barry song. My Father’s brother was a dispatch carrier. 1922 was the Civil War. My uncle got arrested, he was taken up to the Curragh to jail. They couldn’t charge him because he was only 16 so they left him off. England wanted the whole of Ireland; that was the reason of the war. The British broke into houses, searched them and were running after people. There was a fellow shot coming off the train in Knocklong, I can’t remember his name. My Father put a Cross down by Newtownshandrum for a girl who got shot in 1922 she was only 19 years old. My Father got a medal for being in the Old IRA. He went on to Charleville to become a tailor and started up his own business in Dromcollogher Co. Limerick

!" $ "! I was born in 1931.My father fought with the British Army. He was a sailor. He was always away. My mother told me; he died in 1936. He died out sailing but he didn’t die in the war. I was the youngest in the family. There was seven of us - three boys and four girls. My sister sent money from England home to my mother to help her with the running of the house.


1916 COMMEMORATIONS #! ## $ # ! The sad memory of Molly Egan The Egan’s were a well-known family in the parish of Newtownshandrum, Co Cork. The story of Molly Egan’s fatality stretches back to 1922. She was then a servant at Dan Keane’s farmhouse. On the fatal night she was making her way home from the farm, a party of IRA men who were taking cover from the Free State Army at Mortell’s Farmhouse were making their way to the village when they were stopped by Pat White at the schoolhouse. He informed these men, Ned McCarthy, Tom Gray, Mark Strum and Hugh Ahern that the place was surrounded by military and they should not attempt to enter. They combined a short distance along the road where they met Molly Egan. They gave her a lift in the pony and cart into the village. At the patient’s gate, they were met with indiscriminate ďŹ ring. Molly Egan tried to get out but she was caught up in a hail of bullets and fell dead in Hugh Ahern’s arms. After getting no response from the life of Molly, Hugh belly-crawled along the road to Bill Drew’s house. Upon opening the door, bullets sprayed from a sub-machine gun and split the mortar in several places. The military removed Molly Egan’s body to Pat Sullivan’s house, although the ďŹ ring continued non-stop for several more hours. Molly Egan’s body was then taken to the Church and buried the following day at Ballinakill Cemetery She was 17.

#!" # $ ! $ ! " $ ! $ ! "# " ! # $ !" "! $ $" #$ " "# Eithne Flood’s story is a remarkable one. Five of her uncles were involved in arguably the most pivotal moments in Irish history: the 1916 Rising and the War of Independence. Her story entails Kevin Barry, ďŹ ghting at the Four Courts, the Black and Tans, ambush, capture, execution, prison-break and the assumption of dominion status in 1921. The resident of St Gabriel’s Nursing Home in Raheny, Dublin, brought her story to paper. My name is Eithne Flood. My father was from Dublin and was a Policeman stationed in Castlebar, where he met and married my mother. His name was Albert and he was the youngest of eight brothers. They lived in Emmet Street, Mountjoy in Dublin city and later at 30 Summerhill Parade near St. Augustine’s Church, near North William Street. The eldest in the family was a girl, Mary or 'Caussi' as she was always known. Although my grandfather had been a member of the Royal Irish Constabulary, ďŹ ve out of the eight boys in my father’s family became involved in the Irish Volunteers. Sean, the eldest brother of my father was born in 1894 to John and Sarah Flood. He fought in the area of the Four Courts and Kings Inns Quay during the 1916 Rising. Eye witness accounts state that he was among those who led the attack and that he was a “great providerâ€? during the siege, sourcing food from hotels around the building to keep the troops fed. He was 21 years old at the time. I suppose that it is no surprise that the younger brothers were also drawn into the ďŹ ght for independence. Early in 1920 my Uncle Frank and twins Peter and Edward (Eddie) joined up, though Eddie complained that he was not sent out on active service missions as Sean, who was the commander, would not allow it. I suppose as the older brother by nine years he was trying to protect them. They all eventually were on active service. My uncle Sean was a Captain in the First Battalion, C Company of the Dublin Brigade IRA and he fought all the way through until the end of the War of Independence. He was captured in Derry during a mission to break some condemned prisoners out of jail in July 1922 and was imprisoned in Peterhead in Scotland. I believe that treatment of republican prisoners was harsh there. He was released around April 1926 but his health had been broken by his years of imprisonment and on 29th November he died from the effects of illnesses and wounds inicted on him while in prison. Sean’s' younger brother, my uncle Frank, was educated at O’Connell Schools, run by the Christian Brothers. It was here he ďŹ rst met and became ďŹ rm friends with Kevin Barry. He must have been a very bright student as he won a university scholarship to study engineering in UCD in 1918, where Kevin Barry became a medical student. While at the college my Uncle Frank became active within the Literary and Historical Society and together with Kevin Barry became more involved in the struggle for independence. In September 1920 they both took part in a raid in Church Street during which three British soldiers were killed and Kevin Barry was captured. As a member of the brigades active service unit Frank was involved in several failed attempts to rescue him from jail.


In 1920 the British government had started a new armed police force to deal with all the civil unrest of the time. They were called the Black and Tans because of the colour of their uniforms. A section of the new police force was stationed in Collinstown in Dublin 6. Seven of them went to a bank in the city every Friday morning to collect their pay. It was decided to ambush them while passing Clonturk Park in Drumcondra. In a charge of ďŹ re, three of the unit were shot dead. Frank and ďŹ ve others were captured on January 21st 1921 and were sentenced to death for their role in that attack. Apparently Dublin Castle had been telephoned by someone who had seen them waiting for the truck. Frank was only nineteen years of age, but was the First Lieutenant ASU (Active Service Unit) of the Dublin Brigade. He was found with a grenade in his pocket. He was charged with High Treason, found guilty, and executed by hanging on March 14th 1921 at Mountjoy Prison. My Grandfather said that when he had visited his son on the eve of his execution he “was as light hearted as if he were going on holidayâ€? and when he was informed that plans were being made for a reprieve he asked not for a reprieve but for justice. My grandfather asked for the body of his son to be returned but received no reply. But he said that the officials at the prison were most courteous to him when he visited Frank and he was informed the condemned men had been singing “God save Irelandâ€? and other ballads. He also said that he knew that Frank had died well, and that he knew that Frank had nothing to fear in going to his death. His last words had been “Let you pray for me tomorrow morning and I shall pray for you.â€? He wrote letters from his prison cell to his mother and family assuring them that he was at peace with God and assured them that he would be praying for them in heaven. We still have the letters. Kevin Barry had been executed in 1920 and Frank requested to be buried as close as possible to his former friend and comrade. During the night somebody chalked in huge letters on the prison gate “Up the Republic, the People will win, Terrorism will not availâ€?. Huge crowds gathered outside the gates of Mountjoy with the relatives as the executions were carried out, two every hour, from six o'clock in the morning. They prayed quietly, singing hymns and saying decades of the rosary. At eight o clock the official notice was posted that announced Frank Flood had been executed. All over the city work ceased that morning, shops and business premises of every kind closed their doors until eleven o clock as a mark of respect and mourning and prayers were said at every mass in the city for the repose of the souls of the six young men. They were buried in the grounds of the Prison. Following a long campaign by the relatives his remains, along with the remains of Kevin Barry and eight others who had come to be known as The Forgotten Ten, were exhumed and given a state funeral at Glasnevin Cemetery on 14th October 2001. Another brother Thomas was arrested during the attack on the Customs House in 1921. The plan was to burn it as it was the seat of British intelligence at the time. He was arrested and charged with treason, the sentence for which was hanging. But fortunately the night before his court-martial he developed appendicitis and had to be transferred to hospital for surgery. By the time he recovered the treaty had been signed and prisoners were released so he escaped the death sentence. I am so glad for my Grandmother who must have suffered terribly during all these tragic years. I often think about what she must have gone through and my Grandfather too. Peter, one of the twins that I mentioned earlier, as Commandant Peter Flood led the national army into what is now Collins Barracks during the takeover from the British after the Treaty had been signed. He later joined the Marist order and became Brother Sean, spending his life ministering in China and later retired to Dublin. Eddie immigrated to Australia and had a family there. Though Eddie died relatively young, I remember that his family visited Ireland in the 1960s when the 50th anniversary of the rising was being celebrated. They took a house on the Howth Road for their visit. I know that I can be very proud of all of my uncles and their idealism and courage at the time of the birth of the Nation. I also feel that it must have been an incredibly difficult time for my grandparents and for the countless other families who found themselves caught up in the turbulent events of those years and indeed in the decades since on this island. Above all I feel sad for all the beautiful young lives that were lost. "Ar dheis DĂŠ go raibh siad - May they be at God's right hand"


Special honour for 2016 centenarians Over 40 centenarians living in NHI Member homes were honoured to mark this special commemorative year. Commemorative certificates were issued by NHI to Member homes with residents who were 100 years of age or older during this centenary anniversary year of the 1916 Rising.


The presented certs featured a copy of the proclamation and a commendation for reaching such a significant milestone. Within the cert was an inscribed quote from Pádraig Pearse: “There are in every generation those who make it with joy and laughter and these are the salt of the generations.” An photograph of Dublin City Centre titled ‘Straight on Left or Right to Westmorland Street’, which was taken in 1932 and featured trams, buses and pedestrians, was featured on the cert. The first presentation was made by Minister for Older People Helen McEntee to 106-year-old Elizabeth ‘Lizzie’ Dempsey, a resident of Ailesbury Nursing Home, Sandymount, Dublin. Minister McEntee commented: “It has been a real pleasure to meet Elizabeth and to present her with this special commemorative certificate that recognises the truly magnificent milestone she has reached of one hundred and six years of age. Nursing Homes Ireland is to be congratulated for this initiative, which celebrates the remarkable lives of our centenarians in nursing homes right around the country.” Tadhg Daly, NHI CEO said: “Older persons living in nursing homes should be cherished and celebrated. During our recent annual celebration of nursing home care – Nursing Homes Week – we appealed for information regarding those who are 100 years of age or older in our Member nursing homes. The special commemorative cert provided opportunity for the nursing home and the resident’s relatives and friends to enjoy celebratory recognition of these people who have lived remarkable lives.” Elizabeth professed her secret of living such a long life. “Plenty of fresh air, good food and an 11am coffee that sets me up for the day. I’ve had a very even existence and got the balance right in my life. I try not to stress and worry unduly. I worked nice and quietly in an enjoyable job and have lived a calm life.” The presentation by the 30-year-old Minister to the 106 year old received national media coverage.


Cobh Community Hospital resident Edward Dorney was presented with his NHI certificate by Deputy County Mayor, Cathal Rasmussen. Family Members and Cllr Rasmussen are pictured with Edward.

Minister McEntee greets 106year-old Elizabeth Dempsey.

Elizabeth is presented with her NHIcommemorative cert by Minister for Older People Helen McEntee.


Life Stories Activity Pack offers food for thought

Michael O'Connor, Key Account Manager for Unilever Food Solutions and Bernie Gorman, Activities Coordinator for Sancta Maria Nursing Home, Co Meath, celebrate the launch of Unilever's Life Stories activity pack with residents Betty McGlynn, Tess O'Reilly and Catherine Forde.

pioneering resource aimed at triggering happy memories using nostalgic recipes and tailored activities that stimulate resident engagement and mental stimuli has been designed by Unilever Food Solutions. The Life Stories resource is designed to promote, monitor and maintain cognitive health for nursing home residents. The activity pack works to improve the well-being of those in residential care. This is achieved by enabling residents to share their lives with others through fun and engaging activities. Jim Reeves, Customer Director of Unilever Food Solutions explains: “Freeing chefs to love what they do is the ethos of Unilever Food Solutions, so it was imperative we ignite inspiration to the nursing home chef community by providing traditional Irish recipes with a fresh twist in our Life Stories pack. “Aware of the vital role of the activity coordinators in nursing homes everyday across Ireland, we’ve worked closely with our partners to help design a resource pack that can not only help nursing home staff monitor their resident’s health, but can hopefully trigger memories that residents can share and enjoy together. “Our regional sales team has experienced a tremendous amount of positive feedback from nursing homes so far, so we are really proud of what Life Stories has achieved and hopefully over the coming months we’ll see more nursing homes coming on board.” Tadhg Daly, Chief Executive of Nursing Homes Ireland, believes that Life Stories is a positive tool that will add to the creative engagement that is daily within nursing homes. “This resource will no doubt play a role in supporting the dedicated staff in nursing homes who are enhancing the well-being of residents in their care. Creative activity and reminiscence therapy are pivotal within nursing homes to assist the physical and cognitive well-being of persons living within them. I


commend and congratulate Unilever Food Solutions for developing this resource that will complement the holistic care provided within the home from home settings that are nursing homes. Life Stories, a holistic assessment tool, can support nursing home staff in triggering and sharing memories, bringing discussion, enjoyment and supporting cognitive development.” Bernie Gorman, Activities Coordinator for Sancta Maria Nursing Home, in County Meath has introduced the Life Stories pack into her activity programme and believes it is a positive and engaging resource: “The Life Stories pack is a great addition to our activity programme,” she said. “It not only brings our residents’ enjoyment, it also helps our staff gain valuable information about the residents through informal chats – allowing us to track resident’s memories by asking questions about the sorts of brands and foods they grew up eating, helping us to not only stimulate their brains’ but also bringing everyone closer together. I recommend Life Stories as a tool for any nursing home activity programme.”

Order a Life Stories Activity Pack: More information about Life Stories is available here:

http://www.unileverfoodsolutions.ie /promotions/lifestories


BRÓD Healthcare Management & Consultancy expands to offer an INTERIM MANAGEMENT SERVICE to the Nursing Home Sector BRÓD’s market leading position has been achieved based on the strength of delivery and ongoing commitment to provide superior levels of consultancy service to the nursing home sector in Ireland. BRÓD possesses an unrivalled understanding of the strategic importance and value of contribution an experienced Interim Management Service can offer which is of paramount importance given the current scale of organisational transformation in the nursing home sector. BRÓD’s INTERIM MANAGEMENT SERVICE provides the temporary provision of management resources and skills to nursing homes. This service is seen as a short-term assignment to Registered Providers from a leading consultancy to assist a Registered Provider to manage a period of transition, crisis or change within their nursing home. Given the challenges that face Registered Providers in terms of senior management recruitment, governance, management and accountability etc. a permanent solution may be unnecessary or difficult to find on short notice. Additionally, the centre may not have the skill-sets internally which can manage a particular period of transition. There are a number of different nursing home situations that result in the need for BRÓD’s INTERIM MANAGEMENT SERVICE and these typically are situations such as:

• • • • • • • • • •


The following stages of BRÓD’s INTERIM MANAGEMENT SERVICE are typical of how BRÓD enters into an interim assignment, reaches and carries out the actual implementation, and finally exits the interim assignment: ENTRY - The Registered Provider and BRÓD explore the requirement sufficiently for the Registered Provider to be able to decide to engage BRÓD to address the situation. DIAGNOSIS - BRÓD researches the current situation in order to understand it, how it came about, what are the requirements of the varying stakeholders. PROPOSAL - BRÓD presents a more detailed proposal which acts as the interim assignment objectives and plan. IMPLEMENTATION - BRÓD takes responsibility for managing the intervention, project, or solution, tracking progress and conducting periodic feedback reviews with the Registered Provider. EXIT - BRÓD, approaching project end, ensures that objectives have been met, that the Registered Provider is satisfied. This stage may involve ‘knowledge handover and training’, determining and sourcing ‘business as usual’ successors, and ‘sharing lessons learnt’ in the process.


Business Development & Project Management I Governance Clinical Governance I Regulatory Matters I Development & Training HR & Industrial Relations Tel.: 087 9031661 / 087 9282151 | Email: info@brodhealthcare.com


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