To ask the Minister of Health, Social Services and Public Safety for his assessment of the provision of nurses in statutory and private nursing and residential care homes.

Mr Hamilton

All registered residential care and nursing homes are required by legislation to employ an appropriate number of staff to enable them to meet the health and welfare needs of residents. The registered person and registered manager must ensure that enough staff of the appropriate skill level are on duty at all times to meet residents' assessed needs. The Regulation and Quality Improvement Authority (RQIA) has responsibility to regulate, register and inspect a wide range of specified services delivered by HSC bodies and by the independent sector. I recognise that there are many challenges facing nursing recruitment in the statutory and independent sectors which need to be addressed on a range of fronts. My Department is taking forward a number of measures to address those. It is developing a strategic approach to the future supply and demand of nursing in Northern Ireland that addresses the needs of the statutory and independent sectors and which will take a long-term approach to workforce planning.

We have just launched a return to practice campaign that is designed to encourage nurses in Northern Ireland who have been out of nursing practice to renew their registration and return to the profession so that they can make a valued contribution to the care of our local population. I have provided funding for an additional 100 places on that return to practice programme, which is to be delivered by Ulster University in spring 2016. That initiative will support the statutory and independent sectors. In addition, we have just launched a career pathway for nurses and midwives showcasing opportunities for development in a range of settings, including the independent sector. The career pathway has profiled the independent sector as a means of encouraging staff to apply for positions there. I am aware that the Health and Social Care Board and the Public Health Agency are continuing to work closely with independent sector providers to review the current workforce within private nursing homes. It is important to keep up to date with changes in patient complexity and to identify and develop competency levels of practice for senior care assistants and to explore the potential for maximising their role within nursing homes.

Mr Hamilton

I am well aware of the issues with the sector. I met representatives of the Independent Health and Care Providers (IHCP) a couple of weeks ago. Whilst they wanted to discuss a range of issues, as you might anticipate, that was one that they wanted to particularly talk about. I wanted to listen to them and to the concerns they had. I can quote all sorts of figures, and people can quote figures back at me, but unless you are talking to providers, as the Member has, you do not get a sense of what it means on the ground. It was a useful and interesting conversation that highlighted the fact that there is a shortage right across nursing, whether that is in the statutory sector or the independent sector, where it is particularly pronounced. That is why we are trying to work at it. We are not just trying to work to get numbers up in the statutory sector, which people might think is our priority; we realise and appreciate the importance of the independent sector and the work it is doing. We saw that, particularly with emergency departments and the pressures that we faced over the holiday period. That is why the board and the PHA are trying to work very closely with the statutory sector and the independent sector to increase the number of nurses. That is also why we have the return to practice campaign, which will hopefully bear some fruit. It is a challenge. I think we need to be realistic and to realise that we cannot wave a magic wand or click our fingers and make the change overnight. A shortage of nurses is not just a Northern Ireland, a British or a UK problem; it is a worldwide problem. We need to be strategic and long-term in our thinking, but we also need to carry forward some of those initiatives and, indeed, others that will increase the number of nurses that are coming out of our universities. I recently announced — I think it was in the Chamber just before Christmas — that I do not want to do away with the bursary, as it will allow us to encourage nurses to stay and train here. In that context, I think it is also important to look at ways of keeping our nurses, particularly our newly qualified nurses, practising in Northern Ireland, whether that is in the statutory or independent sectors.

Mrs Dobson

Minister, I met the management of Four Seasons last week, and I know the very real concerns it has with workforce recruitment. On a personal note, I am disappointed that you turned down my invitation to come to Donaghcloney Care Home to see at first hand the work that is done there. What help and reassurance can the Minister give to companies like that that wish to invest in and care for our elderly people in Northern Ireland before we see even more homes close and the pain and the worry that that will bring?

Mr Hamilton

I do not need to accept the Member's invites to know what is going on in residential care homes. I see plenty of them, so I know what is going on. I speak to people from the sector, including those from Four Seasons. I have met the chief executive of Four Seasons in a different capacity, but I am seeking to meet the company in the not too distant future. We are still very concerned about its decision to close some of its homes. Sadly, the sale of the one in Garvagh fell through, but I welcome and am thankful that three of the others are being sold. That will ensure that residents can remain in what have become their homes. I reflect on the fact that, a couple of months ago in the Chamber, people called on me to throw all sorts of money at some of those companies, knowing full well that the reason why Four Seasons in particular was closing homes was because of the very particular financial problems that it was experiencing. The fact that three of those homes are being sold to other providers shows that there is viability in them. I understand the pressures that the system is facing and the pressure that the sector is facing, and that it is a critical part of our health and social care sector. I do not think that we have always given it the attention that it deserves in the past. I think that we have always tended to focus more on primary care or on secondary care and not given social care the consideration or thought that it needs. Realising the issues that will come to the fore over the next number of years, with a growing and also ageing population, we acknowledge this as an area that we need to start giving attention to on the same scale that we have with the reconfiguration of hospital services. That can be done in a way that has been done with successive pieces of work before, including the expert panel currently looking at the issue. It is something that will cause all of us long-term problems if we do not get to grips with it, starting very soon.

Mr McCrossan

Will the Minister to outline the current position with the Greenfield residential care home in Strabane? There has been some uncertainty about it in the past, and I would like clarification on his current position.

Mr Hamilton

I welcome the Member to the House. I am sure that he has been welcomed plenty of times before, but I particularly welcome him to health questions. I am not aware of any particular issues around the said home in Strabane. Rather than guess at it, I will come back to the Member in writing. I am not aware of any particular problems.

Mr Lyttle

I ask the Minister whether he made representations to Four Seasons Health Care to request that they reconsider the closure, or timescale for closure, of residential nursing homes. How many of the residents affected by the closures are still to be relocated? I also ask for an update on his review of residential nursing care in Northern Ireland.

Mr Hamilton

There are about four questions there, certainly three anyway. As a Department, we were aware of issues with Four Seasons, not least because its financial difficulties were well publicised, certainly in the mainland press. Obviously, in addition to this, officials kept in close contact with Four Seasons about the possibility of closures. That said, we, or I, were certainly not aware of what was happening until the day that it announced the seven closures. There had been indications of potential closures, but nothing had been confirmed until the day that it was announced to the press. In respect to residents who are currently in homes, my information is that — the Member will be, I suspect, particularly interested in the two homes in his constituency that are being closed — all the residents in those homes will be successfully moved to other homes and that they have all agreed to do that. I accept that that is far from ideal. I would rather that they stayed in their current homes, but, unfortunately, that is not case because of the decision taken by Four Seasons. The board, the trust and the RQIA have worked very closely with Four Seasons to ensure that there is minimum disruption for residents, and I hope to see that continue.

Mr Allister

Two months ago, the Minister made a useful statement halting the consultation on the closure of statutory care homes. Can he indicate whether he will totally lift the cloud from over those homes by announcing that there will be no closures?

Mr Hamilton

I always worry when the Member says that I have made a "useful statement", but, on this occasion, I will agree with him that it was a good statement. To be fair, he did congratulate me on the day for making that statement. I have halted that decision and started a review, and the terms of that review have now been agreed between my Department and the board. One of the things that they will be looking at is the reopening of the homes for new admissions, and it is only right and proper in that context that that is done. However, we should bear in mind that the decision that I took was due to an uncertainty at that time around the market as a whole, and most of the residents in the Four Seasons homes were nursing care patients as opposed to residential care patients. The decision that I took was on the basis of that. However, I think that it was right that we froze the consultations at that time just in case other things happened in the market. Thankfully, nothing similar has happened up to this point, although I do have concerns, which were affirmed through my recent meeting with the independent sector. It was only right that we took the decision that we did, and included in that is a review of whether it is appropriate to reopen the homes for new admissions.

If that is what comes back from the analysis, I will certainly make sure that that happens.

Mr Principal Deputy Speaker

That ends the period for listed questions. We now move to topical questions. Topical question 1 has been withdrawn.