S.I. No. 317/1985:

HOMES FOR INCAPACITATED PERSONS REGULATIONS, 1985.

HOMES FOR INCAPACITATED PERSONS REGULATIONS, 1985.

The Minister for Health, in exercise of the powers conferred on him by section 2 of the Health (Homes for Incapacitated Persons) Act, 1964 (No. 8 of 1964) hereby makes the following Regulations:--

1. These Regulations may be cited as the Homes for Incapacitated Persons Regulations, 1985.

2. These Regulations shall come into force on the 1st day of October, 1985.

3. The Homes for Incapacitated Persons Regulations, 1966 ( S.I. No. 44 of 1966 ) are hereby revoked.

4. In these Regulations--

"the Act" means the Health (Homes for Incapacitated Persons) Act, 1964 (No. 8 of 1964);

"home" has the meaning given to it in subsection (1) of section1 of the Act;

"the Minister" means the Minister for Health;

"health board" in relation to a home, means a health board within the meaning of the Health Act, 1970 (No. 1 of 1970) in whose functional area the home is situated;

"medical practitioner" means a person registered in the register established under the Medical Practitioners Acts, 1927 to 1961 or the Medical Practitioners Act, 1978 ;

"nurse" means a person registered in the general division of the register of nurses established under the Nurses Act, 1950 (No. 27 of 1950);

"patient" means a person who is incapacitated within the meaning of section (1) of the Act;

"record" means any record kept or retained in pursuance of article 5 of these Regulations including any book, card, form, tape, computerised record, film or notes.

5. (1) In every home there shall be kept a register of all patients, which shall include the following particulars in respect of each patient--

( a ) the name, address, date of birth, marital status and religious denomination of the patient;

( b ) the name, address and telephone number, if any, of the patient's relative, or other person nominated to act on the patient's behalf as a person to be notified in the event of a change in the patient's health or circumstances;

( c ) the name, address and telephone number of the patient's medical practitioner;

( d ) the latest date on which the patient was admitted to the home;

( e ) where the patient has left the home, the date on which he left it;

( f ) where the patient is admitted to hospital, the date of and reasons for the admission and the name of the hospital;

( g ) where the patient dies in the home, the date, time and the certified cause of death.

(2) Each part of a register kept under sub-article (1) shall be retained for a period of not less than two years beginning with the date on which the last entry was made in that part.

(3) In every home there shall be kept in a safe place a case record in respect of each patient which shall include the following particulars--

( a ) a medical report on the patient at time of admission;

( b ) an adequate daily statement of the patient's health and condition;

( c ) details of any medical investigations made and treatment given including drugs and medicines prescribed and administered;

( d ) details of nursing observations and treatment given.

(4) Case records kept under sub-article (3) shall be retained for a period of not less than two years after the patient to whom they relate ceases to be a patient in the home.

(5) In every home there shall be kept a record of--

( a ) the name, date of birth and details of position and dates of employment at the home of each member of the nursing and ancillary staff;

( b ) details of the qualifications and registration numbers of each member of the nursing staff employed;

( c ) appropriate duty rosters.

(6) In every home there shall be kept a record of--

( a ) the procedure to be followed in the event of fire;

( b ) all fire practices which take place at the home;

( c ) all fire alarm tests carried out at the home together with the result of any such test and the action taken to remedy defects;

( d ) the number, type and maintenance of firefighting equipment.

(7) In every home there shall be kept a record of all medical, nursing and ancillary equipment in the home together with a record of all maintenance carried out on such equipment.

6. (1) In every home adequate arrangements shall be made for the care of the dying and also for mortuary arrangements.

(2) If a patient dies in a home, the person carrying on the home or any person concerned in the management thereof shall send a notice in writing of the death to the health board not later than seven days after it occurs.

7. (1) The person carrying on a home and any person concerned in the management thereof shall--

( a ) permit designated officers of the Minister or the health board who are authorised in that behalf by the Minister or the health board, to enter and inspect the home and shall afford the said officers such facilities and information as they require for that purpose;

( b ) subject to sub-article (2), permit designated officers of the Minister or the health board who are authorised in that behalf by the Minister or the health board to inspect records kept by the home;

( c ) provide facilities for designated officers of the Minister or the health board who are authorised in that behalf by the Minister or the health board to conduct interviews (including interviews in private) with persons (including staff) in the home where the Minister or the health board has reasonable cause to believe that a patient in the home is not or has not been receiving proper care and attention.

(2) Nothing in this article authorises any person other than a medical practitioner in the service of the Minister or a health board, or the patient's general practitioner, to inspect any clinical record relating to a patient in a home.

8. Inspection of a home pursuant to article 7 shall be made by designated officers of the health board not less than once in every period of six months.

9. In every home there shall be provided for patients maintained in the home--

( a ) suitable and sufficient care having regard to the nature and extent of the incapacity of the patients;

( b ) facilities for the occupation and recreation of patients;

( c ) suitable and sufficient accommodation which shall meet the minimum standards provided for in article 10 of these Regulations;

( d ) suitable, sufficient and nutritious food, properly prepared, cooked and served.

10. (1) In every home there shall be provided--

( a ) suitable and sufficient equipment and facilities having regard to the nature and extent of the incapacity of the patients maintained in the home;

( b ) suitable and sufficient lighting, heating and ventilation, with natural lighting and ventilation in rooms which are permanently occupied;

( c ) over-bed lamps at each bed and permanent night lighting with dimming facilities;

( d ) minimum heating of 65 degrees F (18 degrees C) in bedroom areas and 70 degrees F (21 degrees C) in day areas;

( e ) bed and bedding appropriate to the incapacity of each patient and suitable and sufficient furniture and other necessary fittings and equipment;

( f ) a separate kitchen with suitable and sufficient cooking facilities, kitchen equipment and tableware.

(2) In every home there shall be provided--

( a ) adequate accommodation and space in single and shared sleeping areas and portable screens or screening curtains to ensure privacy for individual patients;

( b ) adequate day space for each patient in an area separate from the circulation and sleeping area and adequate dining and sitting space for mobile patients;

( c ) doorways and corridors which allow for easy use of wheelchairs and walking aids and access ramps where appropriate;

( d ) a visitors reception area and adequate facilities for patients to receive visitors in private;

( e ) an office for staff and general use.

(3) The person carrying on a home and any person concerned in the management thereof shall ensure that the maximum number of patients to be maintained in the home and the maximum number of patients to be accommodated in shared rooms in the home shall not exceed a number approved of by the health board in respect of that home.

(4) The person carrying on a home and any person concerned in the management thereof shall ensure that--

( a ) there is a sufficient supply of piped hot and cold water and that wash hand basins are provided in each room;

( b ) there is a sufficient number of w.c.s having regard to the number of patients in the home and that a sufficient number of w.c.s are designed to provide access for patients in wheelchairs having regard to the number of wheelchair patients in the home;

( c ) a sufficient number of commodes is provided;

( d ) there is a sufficient number of baths and showers having regard to the number of patients in the home and that a sufficient number of assisted baths are provided having regard to the type of patients in the home;

( e ) there are adequate arrangements for the laundering at regular intervals, and as occasion may require, of linen, clothing and other articles belonging to or used by patients maintained in the home;

( f ) a well ventilated room is provided for sluicing, for the provision of laundry facilities and for the storage of dirty linen;

( g ) where items such as disposable sheets and incontinence pads are necessary, they are supplied in sufficient quantity by the person carrying on the home;

( h ) bed linen, disposable sheets and incontinence pads are changed as frequently as may be required for the comfort and well-being of the patient.

11. (1) The person carying on a home and any person concerned in the management thereof shall--

( a ) ensure that the home is maintained in a proper state of repair and in a clean and hygienic condition;

( b ) take adequate precautions against the risk of fire, including the provision of adequate means of escape in the event of fire and make adequate arrangements for detecting, containing and extinguishing fires, for the giving of warnings and for the evacuation of all persons in the home in the event of fire and for the maintenance of fire fighting equipment;

( c ) make adequate arrangements to secure by means of fire drills and practices that the staff, and so far as is practicable the patients, in the home, know the proceudre to be followed in the case of fire;

( d ) ensure that materials contained in bedding and the internal furnishings of the home have adequate fire retardency properties and where possible have low levels of toxicity when on fire;

( e ) supply on demand to a designated officer of the health board, written confirmation that all the requirements of the Statutory Fire Authority have been complied with;

( f ) ensure that emergency lighting is provided in the home and that emergency call facilities are provided at each bed;

( g ) ensure that handrails are provided in circulation areas and that grab-rails are provided in bath and shower areas and in w.c.s;

( h ) ensure that adequate and safe floor covering is provided;

(i) ensure that provision is made for the storage of food in hygienic conditions and that a high standard of hygiene is maintained in relation to the storage and preparation of food and to the disposal of kitchen refuse;

( j ) make adequate arrangements for the disposal of swabs, soiled dressings, instruments and disposable sheets, incontinence pads and other similar substances and materials;

( k ) make adequate arrangements for the recording, safekeeping, administering and disposal of drugs;

( l) make adequate arrangements for the prevention of infection, infestation, toxic conditions, or spread of infection and infestation at the home;

( m ) take precautions against the risk of accidents to any patient in the home;

( n ) ensure that provision is made for the safekeeping of personal belongings which a patient has with him in the home.

12. (1) In every home the person carrying on the home and any person concerned in the management thereof shall ensure that--

( a ) a medical practitioner is available to attend patients maintained in the home and for a medical practitioner to be on-call for emergencies;

( b ) the person in charge in a home at any given time is a nurse;

( c ) a sufficient number of competent staff, including nursing staff, are on duty at all times having regard to the number of patients maintained therein and the nature and extent of their incapacity.

13. The person carrying on a home and any person concerned in the management thereof shall--

( a ) allow adequate and reasonable times during which patients maintained in the home may be visited;

( b ) indicate in all written communications the name and address of the home, and the name of the person in charge of the home;

( c ) cause to be displayed at all times in a conspicuous place in the home a notice stating--

(i) the number of ambulant and of non-ambulant patients for whom accommodation is provided;

(ii) the number of single rooms, of shared rooms and the maximum number of patients to be accommodated in shared rooms;

(iii) the hours during which visiting is permitted;

(iv) the name of the person carrying on the home;

(v) the date on which the health board has been notified of the home in pursuance of section 3 of the Act.

14. A health board shall on demand supply to any person the name and address of each home notified to it under section 3 of the Act and the name of the person in charge thereof.

15. These regulations shall be enforced and executed in the functional area of each health board by that health board.

GIVEN under the Official Seal of the Minister for Health this 24th day

of September, 1985.

BARRY DESMOND,

Minister for Health.

EXPLANATORY NOTE.

These Regulations contain provisions for the purposes of ensuring that adequate and suitable accommodation, food and care are provided for incapacitated persons while they are being maintained in certain homes conducted for private profit. The Regulations also contain requirements in relation to facilities for patients, safety, staffing levels and record keeping and also provide for the regular inspection of private nursing homes by health boards.