Enhanced Nursing Home Standards to Provide Better Care for Seniors

1. As part of MOH’s on-going efforts to ensure that our seniors receive consistent and better quality of care, MOH has finalised a set of Enhanced Nursing Home Standards (ENHS) which will take effect in 2015. A one-year grace period will be given to providers before enforcement of the standards commences in 2016.

2. The ENHS was developed by the Nursing Home Standards Workgroup that was appointed by Minister for Health in 2012. The Workgroup comprised nursing home providers, healthcare professionals and policy experts. It reviewed existing standards and studied best practices in the process of developing the new set of standards for nursing homes.

3. Enhancements to the nursing home standards have been made in a few areas:

a.    The new standards articulate more clearly clinical areas relating to safe and good care in nursing homes. These include continence management, falls prevention and mobility, skin care and pressure ulcers, pain management, oral hygiene and advance care planning;

b.    The new standards articulate requirements to ensure that nursing homes provide care that preserves the dignity of residents and addresses their psychosocial well-being; and

c.    The new standards include requirements in governance and organisational excellence in the operations of nursing homes, such as financial management, staff organisation and management, staff competence, training and supervision, customer relations, and continuous improvement.

4. From April to August 2013, MOH ran a series of consultation sessions with nursing home providers, members of the public and caregivers of seniors to seek comments on the proposed ENHS.

5. The industry and public welcomed the enhanced standards and acknowledged the importance of raising the quality of nursing home care across the sector. There were suggestions for some of the standards to be refined to be more outcome based, as well as to strengthen standards for areas such as psychosocial care. The standards were refined accordingly.

6. MOH has also received feedback from the nursing home providers that the government should consider providing greater assistance to help the sector attain the new standards. MOH is working closely with the Agency for Integrated Care (AIC) to support nursing homes in achieving the enhanced standards. In the lead-up to 2015, AIC will introduce a suite of programmes to prepare nursing homes for the introduction of the enhanced standards:

a.    Voluntary baseline assessments – Nursing homes which would like to identify areas for improvement and develop customised improvement strategies to meet the ENHS, can participate in voluntary baseline assessments that AIC will be conducting in 2014. Based on the results of these assessments, AIC will develop targeted programmes to help nursing homes close the gaps in the areas where the sector is weaker in. Twenty-three nursing homes have already signed up for the voluntary baseline assessments.

b.    Training and development – AIC has also developed new courses for nursing care staff and supervisors in the newly-articulated areas of advance care planning, fall prevention, mental health, psychosocial support and end-of-life care. These new courses are in addition to the existing suite of more than 100 training programmes offered by AIC.  Participants in these courses may receive up to 80% subsidy on their course fees.

c.    Guide to Enhanced Nursing Home Standards – AIC will be launching a Guide in the second quarter of 2014 to help nursing home providers better understand how the enhanced standards can be implemented. The Guide will include examples of activities/processes that nursing homes can take to achieve the outcomes specified in the enhanced standards, good practices within the sector and samples of useful tools for monitoring residents’ holistic well-being.

7. “This set of enhanced nursing home standards represents the common aspiration of caregivers, nursing home providers and the government, to provide our seniors with high quality and dignified nursing home care which they deserve.  This is the beginning of a quality journey and MOH is committed to walk this journey with nursing home providers, by providing a suite of initiatives and resources to help providers attain these standards,” said Senior Minister of State for Health and Manpower, Dr Amy Khor.

Read the Enhanced Nursing Home Standards Guidelines here.

MINISTRY OF HEALTH

9 JANUARY 2014