On 31 March 2025, changes to the rules governing the care of residents in designated centres for older people came into operation. The 2025 Regulations bring changes in response to recommendations made by the Covid-19 Nursing Homes Expert Panel report.

Some of the key amendments which have been introduced by the 2025 Regulations are as follows:

1. Person in Charge.

The Person in Charge (“PIC”), where they are not the registered provider, requires at least 3 years’ experience of nursing older persons within the previous 6 years. A person who is employed to be a PIC shall also have not less than 3 years’ experience in a nurse management role in the health and social care area.

If employed prior to 31 March 2028, the PIC will be required to have a post registration management qualification in health or a related field. The PIC will subsequently be required to hold either a Level 8 post‑registration management certificate or a Level 9 postgraduate nursing qualification encompassing management and/or leadership modules by no later than 31 March 2028.

For a PIC employed on or after 31 March 2028, they will be required to already hold either the level 8 or level 9 qualifications, as well as have the mandatory 3 years’ experience. A maximum of two designated centres may share a PIC if HIQA is satisfied on governance arrangements.

2. Visiting.

Designated centres must now have a written policy containing the procedures for visitor access, together with the procedures for visitor access during the outbreak of communicable diseases, epidemic or pandemic. The policy should also list the arrangements for nominated support persons, including visitation for such support persons during restrictions. Details of arrangements for visits from this policy should be provided to residents as part of the resident’s guide, and the policy itself should be made available for staff within the designated centre.

3. Governance.

There must be clear deputising arrangements for the key management roles within the designated centre, such as the PIC. There is also a requirement to ensure that an annual review of the quality and safety of care delivered to residents in the designated centre is carried out to ensure care is being provided in accordance with relevant standards, following which a quality improvement plan is to be developed and implemented to address highlighted issues from this review.

4. Risk Management.

The risk management policy of a designated centre must now include measures and actions to control infectious diseases. Further to this, a process is also required to be in place to ensure certain actions will be implemented following serious incidents or adverse events to patients.

Significance of the 2025 Regulations.

The amendments introduced by the 2025 Regulations are designed to bring about improvements in the standard of care for older people in designated centres. In particular, the 2025 Regulations aim to avoid a situation where residents are cut-off from their loved ones, such as we saw occurring during the Covid-19 pandemic, and that appropriate processes are in place from a disease prevention/control perspective in order to mitigate risk in that regard. Recent media attention on the care of the elderly should lend a sharper focus to the issues that the 2025 Regulations aim to address.