New standards for nursing homes to take effect next year

SINGAPORE — Nursing homes in Singapore will now have to be more mindful of the use of restraints on residents, ensure a safe physical environment to minimise fall risks and put in place a process for gathering feedback from residents and their families.

These were among the Enhanced Nursing Home Standards unveiled by the Ministry of Health (MOH) yesterday, which will take effect next year. The 66 nursing homes here will be given a one-year grace period before the standards are enforced in 2016.

Developed by the Nursing Home Standards Workgroup, the new standards were refined after a series of public consultation sessions last year to be more “outcome-based”, specifying what is expected of nursing homes in three areas: Clinical care, social well-being and organisational management.

However, homes will have the flexibility to decide how to achieve the requirements, said Senior Minister of State (Health and Manpower) Amy Khor on the sidelines of a visit to St Theresa’s Home.

For example, while they must provide care that addresses the social needs of residents, the MOH will not mandate that each home must have an in-house social worker.

“It could be the sharing of services, aggregating of demand ... (Homes) can actually draw on the services of a pool of social workers, either from their affiliates, VWOs (voluntary welfare organisations) or from the MSF (Ministry of Social and Family Development) and so on,” said Dr Khor.

The new standards emphasise psychosocial care, requiring homes to provide care that preserves the dignity of residents and addresses their psychosocial well-being. For example, restraints should only be used as a last resort when other less restrictive strategies have been unsuccessful.

Requirements on safe clinical care are also more clearly spelt out. For instance, homes must identify which patients require pain management and have a plan in place to be followed by care staff when needed.

The enhanced standards will be part of the regulatory framework under the Private Hospital and Medical Clinics Act. An enforcement team from the MOH will make periodic checks on nursing homes to ensure standards are adhered to.

Dr Khor said that if there are severe breaches, the ministry would look at suspending the admission of patients as well as the suspension or revoking of nursing home licences.

To help nursing homes achieve these new standards, the MOH will work with the Agency for Integrated Care (AIC) on support programmes.

For instance, homes can participate in voluntary baseline assessments to be conducted by the AIC this year. Based on the results, the agency will then develop programmes for them to make improvements. So far, 23 nursing homes have signed up and the AIC plans to complete their assessments within the next three months.

The AIC has also developed new courses in areas specified by the enhanced standards — such as pain management — for nursing home staff. A guide will be launched in the second quarter of the year with examples of activities and processes homes can adopt to meet the standards.

Mr Thomas Tan, Chairman of Catholic Welfare Services, which runs St Theresa’s Home, said one challenge in meeting the new standards is training manpower. The home would be keen on the new AIC training courses and hopes to see more of them, he said.