Sage Advocacy calls for

• Implementation of Law Reform Commission framework on Adult Safeguarding
• Clinical Governance and supports for private nursing homes
• Greater State involvement in housing and care of older people

Responding to the RTE Investigates broadcast last night on unacceptable care in private nursing homes (4.6.25), Sage Advocacy has called for urgent progress on implementation of the Framework for Adult Safeguarding, as published by the Law Reform Commission (LRC) in April 2024.

Sage Advocacy is the national advocacy service for older people and CEO Bibiana Savin said both the recent Grace Report and RTE Investigates highlight that Government must take urgent action to address ongoing shortcomings in adult safeguarding.

A comprehensive cross sectoral structure to address gaps in adult safeguarding, including detailed draft adult safeguarding legislation, was published by the Law Reform Commission in April 2024 – and she said this must be progressed and implemented with urgency. (Report on a Regulatory Framework for Adult Safeguarding)

She also said that in parallel an Independent National Safeguarding Authority must be established with powers – underpinned by legislation – to coordinate safeguarding responses across all relevant sectors which protect against harm, abuse, neglect and exploitation.

“Some extremely grim individual abuses and multiple other deeply disturbing systemic failures were evident in the RTÉ broadcast. Clinical governance and the necessary supports and oversight are not always available in private nursing homes. We need greater HSE involvement in clinical governance, staff supports and monitoring of existing private facilities, including an expanded and reconsidered investigative and disciplinary role for HIQA.

“The programme also highlighted the critical need to develop a Framework for Safe Staffing and Skill mix to be applied in all nursing homes public and private. This is currently being worked on by the Department of Health and should be finalised and implemented in all care settings.

“While the horrible incidents we saw on our screens in no way reflect practice across the board, the issues raised are not unfamiliar to Sage advocates and the risks highlighted are inherent in a system that seeks to get greatest return on investment rather than placing the greatest emphasis on the right of older people to age well.”

Sage Advocacy Chairperson Mark Mellett said: “Sage Advocacy has long argued that the State must play a much greater role in the provision of person-centred care and housing for our older citizens  – reflecting the fact that, in a Red C poll conducted by the organisation, four in five people said that both home care and nursing home care are overly concentrated in the hands of private providers.

“The State needs to become central in responding to the housing and care needs of older people, as an alternative to the ongoing growth in large urban private nursing homes. 80% of nursing home care is now provided by the private sector, as the number of large commercial private nursing homes with over 100 beds has doubled in recent years. 

“Government should invest in and support community based social enterprises to go beyond sheltered housing and expand into providing a broad continuum of housing and care within localities. 

“There is already a very successful model of this approach at St Brendan’s village in Mulranny Co. Mayo, led by Dr Jerry Cowley. There is no reason why we cannot apply policy, incentive and investment to develop similar facilities right across the country. We know that this is the approach which our older people want.” 

He concluded that there is also a need for ongoing investment in independent advocacy, as the charity has forecast a more than doubling of demand for its services over the coming three years.

“Our Information Service grew from helping 5,928 people in 2023 to 9,062 in 2024, a 53% increase on top of almost 30% in 2022. Individual advocacy cases grew by 56%, with the number of people seeking advocacy services rising from 1,975 in 2023 to 3,086 in 2024.”

Sage Advocacy can be contacted at 01 536 7330, or email info@sageadvocacy.ie. The motto of Sage Advocacy is ‘Nothing about you / without you’.

Further information

Ronan Cavanagh, Cavanagh Communications: 086 317 9731

ronan@cavanaghcommunications.ie

Sage Advocacy is the National Advocacy Service for Older People. It works to ensure that people have easy access to information, support, independent advocacy and safeguarding services in all settings: homes, day centres, respite facilities, congregated care settings / nursing homes, hospitals, hostels, hospices and in the process of transition between them.

It also provides supports to vulnerable adults and healthcare patients in situations where no other service is available to them. Since late 2023 it has expanded its services with the support of the Dept of Education to meet the support and advocacy needs of survivors of institutional abuse.

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