Worrying Drop In Number Of Nursing Homes Could Jeopardise Care For Older People, Report Finds

42% of existing providers want to develop additional bed numbers to meet care needs of ageing population

The number of private and voluntary nursing homes in Ireland has decreased by nearly 4% over the last five years, despite the increasing demand for nursing home care to support the needs of Ireland’s ageing population, a new survey on the sector has found.

The survey, commissioned by NHI, was undertaken by BDO in early 2015 when a detailed questionnaire was sent to every registered private and voluntary nursing home in the country.

The survey also found that while the total number of nursing homes in operation had reduced, the number of beds in the private and voluntary sector in 2014 had increased by 1,752 beds. This represents a significant slowdown in additional bed numbers when compared with the years prior to 2010.

Minister of State at the Department of Health with special responsibility for Primary Care, Social Care (Disabilities & Older People) and Mental Health, Kathleen Lynch TD, launching the report, said: “I welcome publication of the NHI Annual Nursing Home Survey 2014/2015. The data contained in this report illustrates the very important role the private and voluntary nursing home sector fulfils in meeting the health and social care requirements of our ageing population. As illustrated by the survey, the sector is a significant employer within the health sector and in both urban and rural communities. This sector is vital within the continuum of care available for our older population and of key importance to healthcare delivery in Ireland.”

Tadhg Daly, Nursing Homes Ireland (NHI) CEO, stated however that the lack of a clear and cohesive national long-term care strategy posed a huge challenge to the sustainability of the nursing home sector. “2014 was another challenging year for the private and voluntary nursing home sector in Ireland with costs continuing to increase, in particular labour costs. The increase in operating costs and increased dependency levels of residents together with the failure of the NTPF as monopoly purchaser to provide a Fair Deal rate appropriate to the cost base threatens the sustainability of current provision.”

“The worrying drop in the number of homes since 2010 risks becoming a trend unless the State does more to underpin the sector’s future viability. While this survey gives a clear indication of the desire on the part of private and voluntary homes to expand their services to meet the care requirements of our ageing population, ongoing uncertainty around the financing of long-term care under the Fair Deal scheme and serious issues surrounding the recruitment of nurses threaten the sustainability of current provision. We need to better develop a range of policies and services to address the challenges all this presents. NHI reiterates its long-standing call for the Department of Health to take the lead in bringing stakeholders around the table through a Forum that would advise Government regarding appropriate planning and policy to meet the growing demand for nursing home care.”

The survey found that there are presently 437 private and voluntary homes providing a total of 22,342 beds in Ireland. Nationally there is now one private nursing home bed for every 20.23 persons aged 65 and over in the Republic of Ireland, according to the survey.

National average occupancy amongst survey respondents was found to be 90.58% in 2014. This represented an increase of 4.18% since 2009. The average weekly rate nationally prevailing under the Nursing Home Support Scheme (“the Fair Deal”) for accommodation in private and voluntary nursing homes was €896. This compared to an average weekly rate under the Fair Deal for accommodation in public nursing homes of €1,245 in 2011, the last time this information was published for public homes.

Brian McEnery, Partner & Head of Healthcare, BDO, and author of the report, said: “BDO is delighted to undertake what we view as an important piece of research in the nursing home industry. We believe it is vitally important that operators in the industry can make strategic decisions based on informed data. We hope that this survey will give operators the knowledge they require to make these decisions. It’s clear from the results of the survey that many nursing homes are operating in an environment in which their cost base is increasing while at the same time they are struggling to achieve an appropriate remuneration rate to fund these costs. This is a trend that appears likely to continue at least into the near term, however, it is essential that this is addressed as without adequate funding the industry will not be capable of attracting the necessary investment to provide the new bed capacity required to accommodate the increasing older person population in Ireland.”
Commenting on the report, Michael Lauhoff, Head of Growth at Bank of Ireland Business Banking, said: “We have had a dedicated healthcare team for many years who have a depth of understanding of the financial requirements and challenges of this critical sector. The team was further strengthened by the appointment of Hilary Coates late last year, who has extensive experience in the health sector, having joined the team from HIQA. Our commitment to support the future investment requirements of the sector is underpinned by our lending approvals in excess of €135 million over the last 18 months and our allocation of a further €100 million to support the continued development and expansion of the nursing home sector throughout the country.”

Peter McGuinness, Director, Homecare Medical Supplies, also a co-sponsor, said: “Homecare Medical Supplies are delighted to be supporting the launch of the NHI Annual Survey Report 2014 & 2015. This survey further informs and allows the Healthcare Sector to better manage the delivery of high quality care, enhancing quality of life and better health outcomes. Homecare Medical Supplies will continue to partner with NHI, its members and the Healthcare Sector towards continuously improving the care we offer to our community.”

The survey also found that staff costs accounted for 61% of turnover in respondents homes. The national average staff cost per registered bed was found to be €27,130, an 18% increase since 2009. Average annual food cost per resident in 2014 was €2,487, an increase of 13.4% since 2009. The survey also found that over 65% of residents cared for in respondents’ homes were in the high or max dependency categories, compared to 54% in 2009. Approximately 45% of residents were reported to have been clinically diagnosed with dementia.

Contact Ken Kilmartin, Healthcare Partner BDO on 061 414455 or email kkilmartin@bdo.ie if you have any queries on the above.

The 2015 NHI Report may be purchased from the NHI, contact Michael McGlynn, NHI Communications & Research Officer on (01) 4292570

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BDO is a firm of registered auditors and is registered to carry on audit work in Ireland and the UK by the Institute of Chartered Accountants in Ireland. Details about our audit registration can be viewed at www.auditregister.org.uk under reference number 223876. BDO is also authorised to carry on investment business in the Republic of Ireland by the Institute of Chartered Accountants in Ireland.