'What we witnessed constituted a breach of basic human rights which can never be condoned'
The Chief Executive of HIQA has decribed as "extremely distressing" the findings of the recent RTÉ Investigates programme and the care and treatment of residents in two of the care homes and is undertaking a review of all nursing homes operated by Emeis including one in County Meath.
In her Opening Statement to the Oireachtas Joint Committee on Health, today (18th June 2025) Angela Fitzgerald of the Health Information and Quality Authority said the issues aired on the recent RTÉ Investigates programme and the behaviours witnessed "were wholly unacceptable" in any circumstance.
"I understand that the decision to place a loved one in long-term care is an incredibly difficult and emotional one. A nursing home is a place entrusted by families and the wider public to take care of our older citizens who have made their contribution to society and who have a right to be taken care of with dignity and respect. The programme raised a number of deeply concerning issues which we will address today. Fundamentally, what we witnessed constituted a breach of basic human rights which can never be condoned."
Ms Fitzgerald said HIQA was addressing these fundamental issues directly with the nursing homes and its parent company, Emeis Ireland, and is engaging in additional escalatory actions. These include conducting a number of unannounced inspections in both Firstcare Beneavin Manor and The Residence Portlaoise over the past two weeks, including during the early hours of the morning, late at night and during the day.
"The Chief Inspector required an immediate meeting with senior officials from Emeis Ireland. The providers of the two nursing homes were issued with an official warning of cancellation of registration should they fail to implement significant improvements in the centres.
"Emeis Ireland told us what immediate action they have taken, including restricting admissions in Beneavin Manor pending their assurance and ours that the services in these nursing homes are safe, disciplinary action with a number of staff and notifications to the Gardaí."
She said the Chief Inspector’s full findings and decisions will be published in our inspection reports.
"As CEO of HIQA, I met with Emeis Ireland last week with the Chief Inspector and I welcome the immediate actions that they are taking. We have sought immediate assurances on the other 23 homes that Emeis Ireland own."
Emeis Ireland owns the Residence Ashbourne which the provider descibes as "an exclusive nursing care and retirement complex in Co. Meath. It is located within 20 acres of parkland and is 3 minutes north of Ashbourne town, beside the picturesque village of Curragha."
"We offer 24-hour nursing care for long-term residential, short stay and convalescence. We provide a safe, caring, friendly environment for our residents and are committed to giving residents the right to maintain their independence, individuality and dignity at all times.
"Our 74-bed purpose built residential care facility offers an unequalled degree of privacy and comfort to residents. Each room is equipped with the very latest in nurse-call alarms and motion sensors. Residents may also carry a personal alarm system, which allows them to summon assistance irrespective of where they are in the Demesne."
Full opening statement by HIQA chief Angela Fitzgerald
The Chief Inspector will be independently assessing these nursing homes through inspections, engagement with families and residents over the coming weeks. To fully inform our work, the Chief Inspector has requested the documents and footage held by RTE.
Their Director General has confirmed that RTE will assist us in whatever way they can. We have also notified the Gardaí about our concerns on the care deficits observed in the programme.
Our priority is the residents and their families and we have reached out directly to the residents in both facilities. It is essential that their voices are heard. We always do this as part of our process of inspection, but it is particularly important at this time. We understand and fully respect that they may have questions for us about our regulatory process, as well as sharing their personal experiences and it is vital that we listen and respond.
Since this programme, our inspectors have spoken with a number of families and residents to hear about their experience. It is clear that Emeis Ireland has significant work to do.
HIQA fully accepts that we also have work to do in relation to reviewing our regulatory process. We are fully committed to examining what we can learn from recent revelations, and we have commenced work in this regard. Governance and management.
Establishing and successfully running a nursing home provides an important public good. It also places a serious burden of responsibility on the provider to keep residents safe from harm at all times. The role of nursing home providers is to ensure that they deliver safe care and support to residents. To do so, it is essential that they have effective internal systems and processes to properly assure themselves that residents receive excellent care and support every day and are safe.
The role of HIQA, as with all systems regulators, is to ensure that the systems, structures and processes that have been put in place by the provider mitigate risk, and work in promoting safe and effective care and support for residents. This is why HIQA pays particular attention to governance and management when we carry out our inspections. Good governance provides the checks that guard against unacceptable or improper behaviours. What we all recently witnessed in these particular nursing homes has amplified the critical importance of organisational culture and behaviours. Ensuring a positive culture is about top-down commitment by boards, directors and management to the highest standard of performance and, in this case, care.
HIQA’s Chief Inspector process and how it works
The Chief Inspector is legally charged with the inspection of nursing homes. As the deputies and senators will know, the Chief Inspector fulfils an independent statutory function with direct accountability to the Oireachtas. Under the law, nursing home providers are expected to be compliant with the regulations. The regulations are the minimum legal requirement for quality and safety set out by the State.
In addition, we promote ongoing quality improvement and provides resources to support providers to move beyond minimum regulatory compliance and deliver the highest standards of care.
Regulation by the Chief Inspector is comprised of a number of key activities:
registering designated centres
inspecting and reporting on the quality and safety of the services
ongoing monitoring of compliance, including receiving, analysing and riskassessing information
meeting and engaging with people who avail of the service to hear their experiences
and taking necessary enforcement actions, up to the cancellation of a nursing home’s registration.
Over the last 16 years, we have worked to improve the lived experience for nursing home residents and to ensure they are receiving high-quality and safe care and support. Through independent oversight and the publication of inspection reports, we have increased transparency for people using services, their families, advocates and policy-makers about what is happening in services. It is important to acknowledge, that we do see examples of excellent care every day. And we hear from residents about the tangible improvements they have seen in their lives as a result of regulation, including autonomy over their day and having their will and preferences listened to and respected. It is also important to acknowledge the commitment of our staff to delivering on our core objective — promoting the best outcomes for those who use health and social care services.
Most providers respond promptly and effectively to our inspection reports in terms of effecting improvements or changes. Where a provider of a nursing home fails to recognise or is challenged in addressing those issues that are impacting the care of residents, we commence a process of escalating regulatory engagement. This includes cautionary and warning meetings, imposing compliance notices and, in exceptional circumstances, the cancellation of a centre’s registration.
The Two Emeis Ireland Nursing Homes
Following routine inspections in both centres over the years, significant concerns were raised and this resulted in escalatory action being undertaken by the Chief Inspector. Specifically, there were four inspections in Firstcare Beneavin Manor and three in The Residence Portlaoise over an 18-month period.
In both cases, our inspection reports for both homes highlight:
Inadequate staffing and competence of staff
Supervision and management of staff
Governance and management issues
Recording of key information
Inadequate arrangements for meaningful activities for residents.
In both centres, we used our regulatory powers and escalatory approach to drive improvements, including carrying out additional inspections and monitoring the providers’ compliance plans. While both showed evidence of moving towards compliance, in the case of The Residence Portlaoise, we restricted admissions to the centre in April 2025.
In the RTÉ programme we saw that even within a single provider group such as Emeis Ireland where performance is poor, the underlying factors may be different.
In one centre, it was identified as immature management systems and processes which are clearly visible to us on inspection. In the other centre, it is about a poor culture that resulted in entirely unacceptable practices. It was clear that staff knew what they should do but were not doing it. These cultural factors may not be readily visible on inspection or by families. As with any centre, the solution lies with the provider who has direct accountability for effecting sustained improvements. HIQA will also review its mechanisms and processes for identifying potential poor culture.
The Regulatory Framework
Over the years, HIQA has always advocated for regulatory and policy reform.
The recent updates to our regulatory powers will bring important opportunities to strengthen our regulatory role and we want to acknowledge Government support and action in these matters. These changes, when fully implemented, will include:
Additional enforcement powers with specific reference to the introduction of acompliance notice which can only be removed in the district court
Shortening the time frame to give effect to escalatory actions
Powers to investigate specific individual complaints in residential settings
Power to seek ongoing monitoring information from providers to support and enhance surveillance and ongoing monitoring between inspections.
The RTÉ programme amplified two key concerns; namely inadequate staffing and safeguarding concerns. The planned introduction of the Adult Safeguarding Policy by the Department of Health is much welcomed. On the staffing issue, we welcome the important work being led by the Chief Nursing Officer to extend the safe nursing staffing framework to all nursing homes. This is a critical development as it will provide an objective and consistent staffing framework for all nursing homes. It will also strengthen our role in evaluating the adequacy of staffing in centres such as those run by Emeis Ireland.
Key considerations for HIQA in terms of strengthening its regulatory role
The primary responsibility for safeguarding residents in the two nursing homes rests with Emeis Ireland. As a learning organisation, we too must also look at how we can strengthen our regulatory role to ensure that residents are safe, well cared for and enjoy fulfilled lives in residential centres.
Key priorities for us in this regard include:
Driving the requirement for nursing homes to develop clinical leadership models and capabilities.
The use of the safe staffing framework for nursing homes.
Working with the Department of Health, using the recent legislative changes,
to gather key information from nursing homes on an ongoing basis to support
our ongoing oversight of safety, quality and culture.
The development of a Clinical Advisory Panel in HIQA.
Further strengthening our approach to governance, leadership and management in centres, with a focus on a person-centred culture.
The RTÉ Investigates Findings
The recent RTÉ Investigates, was incredibly distressing and I want to apologise to anyone who feels let down by HIQA as the regulator. What we witnessed in the programme should never have happened, and I hope that this can be a catalyst forchange at a number of levels. I want to assure you that we have taken a number of steps to ensure the safety of residents and will continue to do so.
In addition, HIQA is undertaking a review of all nursing homes operated by Emeis, and we have provided an interim report to the Minister of State with responsibilityfor Older People.
HIQA is also reviewing how we inspect and regulate nursing homes and use the learning to strengthen our regulatory processes.