HIQA limited power over extras charged at private Laois nursing home

Following the revelation of the multiple extra fees charged to families at the Residence Portlaoise nursing home, HIQA has clarified the limited range of powers it has over such charges.

The Leinster Express / Laois Live recently reported the extra charges on top of the €1,200 monthly rent, revealed by Cllr Caroline Dwane Stanley.

The fees are for essential health and wellbeing items, charged to residents of the private nursing home owned by Emeis that featured in a RTÉ Investigates special following repeated failures in HIQA inspections.

Among a long list of "additional services" in the contracts of The Residence Portlaoise are monthly bills for medication and dressings, chiropody €35, physiotherapy €60, and incontinence wear for people without a medical card up to €90. Wheelchair repair is €95 plus parts. Families are charged €15 a week to rent a sensor that sounds an alarm if their loved one falls out of bed. If residents go to a hospital, they must pay for the taxi or ambulance and up to €45 per hour for a staff member to go with them.

Portlaoise Municipal District Cllr Dwane Stanley had said she had "no confidence" left for HIQA who inspect nursing homes, saying one family was hit with a €140 bill for a taxi to Tullamore hospital. She had tabled a motion in mid June calling on the Health Information and Quality Authority (HIQA) and the HSE to meet Laois councillors immediately to address the "huge concerns around the appalling treatment of residents in the nursing homes in Portlaoise."

The Leinster Express / Laois Live asked HIQA what authority it has to examine such costs, and can any action be taken.

They gave the following response.

"HIQA inspectors examine additional costs that residents of nursing homes are charged from the perspective of residents’ rights and contracts of care, but cannot make a regulatory judgment as to the amount of the charges. (E.g. this is reviewed under the regulation for residents’ rights and regulation for contracts of care. There are no specific regulations on additional costs or charges.)

"From the perspective of residents’ rights, inspectors examine whether residents are being charged for services that they are entitled to receive free of charge such as physiotherapy, occupational therapy or other healthcare services or services that they are unable to avail of.

"From the perspective of contracts of care, inspectors examine whether the registered provider has complied with the regulatory requirements to have a contract of care and whether additional charges are clear from that contract and if residents were notified as required with regard to any increases in these charges.   

"In 2019, following engagement with HIQA’s Chief Inspector of Social Services, the Competition and Consumer Protection Commission (CCPC) published guidelines for contracts of care in nursing homes. These guidelines were updated by the CCPC in 2023," HIQA said.

Cllr Dwane Stanley is still waiting for that meeting to happen she said.

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"I was hoping to pursue it when they have the meeting with the elected members.  So far no date has been set. The family in question that gave that (contract showing fees) to me have been paying for the last year, also many other families are just paying and saying nothing. So hopefully when the meeting takes place I will be putting this to them," she said.

The most recent inspection by HIQA of The Residence Portlaoise in February failed it on 10 of 12 regulations. However HIQA only stopped admissions to it at the end of April.