INDUSTRIAL RELATIONS ACTS, 1946 TO 2004
SECTION 26(1), INDUSTRIAL RELATIONS ACT, 1990
SISTERS OF CHARITY OF JESUS AND MARY, MOORE ABBEY
(REPRESENTED BY IRISH BUSINESS AND EMPLOYERS' CONFEDERATION)
- AND -
IRISH NURSES ORGANISATION
Chairman: Mr McGee
Employer Member: Mr Doherty
Worker Member: Mr Nash
1. Dispute concerning staffing levels and skills mix issues.
2. Moore Abbey centre provides residential care for adults with an intellectual disability. The Union's claim on behalf of nurses employed as Registered Nurses Mental Handicap (RNMH) is detailed as follows:
" (i)An independent and agreed review of staffing levels and skill mix, inclusive of agreed terms of reference.
(ii) Agreement that Management will proactively seek nurses of whatever grade, speciality or nationality as will apply, and/or agency nurses in the interim to fill current vacant nursing posts as soon as possible.
(iii) Examination of the reduction of services in the interim to ensure safety for workers and clients.
(iv) Clear written guidelines regarding professional protocols and standards of care during this staffing crisis period, to be agreed between Management and Union as a matter of urgency. "
With regard to the independent review the Employer referred to the 1999 Harmon report on the staffing in Moore Abbey which recommended the appointment of 53 additional nurses. The Employer maintains that sanction has been received from the Eastern Regional Health Authority (ERHA) for a number of additional posts and Management continues to use the recommendations of the report in their negotiations with the ERHA. Management further referred to a report on service delivery and staffing levels in two of the six units in Moore Abbey which was commissioned in April 2004 from Joe Wolfe and Associates. Management requested the Union to work with it to secure full implementation of the two reports. The Union maintains that both reports were conducted without Union consultation. In relation to the funding needed to employ the Harmon recommendations the Union stated it would have to accept the vacancy and skills mix as proposed by Management. Currently this is not agreed as the Union believes the vacancy rate to be greater than outlined by Management and does not believe that the current skill mix in any way reflects client need. The Wolfe report is unacceptable to the Union. The Union was not aware of its terms of reference, the Union understands it was not entirely a staffing review and it was carried out only in two units. The Union seeks a new jointly agreed independent review of staffing levels and skill mix in Moore Abbey. The Union claims that the employment of agency nurses would alleviate the difficulties associated with staffing levels. It seeks the reduction of services in the interim for the periods required to improve staffing levels. The Union also claims that despite seeking clear direction from Management on a number of situations arising from the low staffing levels its questions remain unanswered. Management rejected the claims. The dispute was referred to the Labour Relations Commission. A conciliation conference was held but agreement was not reached. The dispute was referred to the Labour Court on the 7th September, 2004 in accordance with Section 26(1) of the Industrial Relations Act, 1990. A Court hearing was held on the 3rd December, 2004.
3. 1. The facility is currently understaffed to a point where an appropriate level of service cannot be provided to clients. The Harmon report (while not an agreed one) indicated that the centre was understaffed by 53 posts. Twenty three of these posts remain unfilled and the dependency levels of the clients have significantly increased. Management has refused to recruit from the wider field of nursing and has also failed to employ a large number of their own qualifying students. However, other health employers have successfully recruited in non - EU locations to address this problem.
2. The Union requests the Court to recommend that the immediate vacancy level be addressed. Agreed expert opinion must be procured to establish the real staffing requirements and skill mix which is essential to provide basic dignity and quality of life to clients at the centre. In the interim the Union is seeking that significant numbers of agency nurses be recruited to cover the vacancies and reduce the service, if unable to do so. The Union also requests an immediate meeting with Management to agree written practice guidelines to protect the integrity and professional practice of the individual nurse.
4. 1. The Employer has made every effort to resolve these staffing issues. It has appointed seven student nurses, who are now registered with An Bord Altranais, an eight is pending. Arising from the Wolfe report staffing recommendations have been communicated to the Nurse Managers of the two units involved in the review.The Employer attended a recruitment fair for nurses, held in the U.K. in September, 2004. It has continued to advertise for staff nurse positions in national and local papers. It has held discussions with the ERHA to discuss the funding of the outstanding Harmon posts. The Employer is awaiting feedback from the ERHA.
2. Management has requested to work in partnership with the Union in relation to funding nursing vacancies, including a request that both parties meet with the ERHA together to seek funding for the extra posts which the Harmon review suggested.
3. The Wolfe review has been completed and the staffing levels communicated. This report may be used to seek funding and ceiling for the recommended posts.
4. The Employer has had two reviews completed and does not believe that there is merit in a third review of the same issues.
The Court is concerned at the admission of both parties that there may be inadequacies in the care standards at Moore Abbey.
In the circumstances outlined, the Court feels that every effort should be made to fill both the vacancies currently outstanding and those still outstanding from the Harmon Report (a total of 14 staff nurses at this time).
This should be done by means of
a) Intensive recruitment. While the Court understands the Management position on the primacy of the RMHN qualifications, it feels that strong consideration should be given to the recruitment, if necessary, of a number of adequately qualified RGN's, especially while awaiting any training output of RMHN's. The experience of similar organisations may prove useful here.
b) Use, where necessary, of agency nurses, particularly in relation to cover for holidays, sick leave, maternity leave etc.
When the staffing situation improves, the management and the INO should engage and have inclusive negotiations, on a partnership basis, regarding the nursing structure going forward. Any future staffing reviews should be conducted as set out by the Court in its clarification to LCR 17698.
The Court believes that the above steps represent the best way forward and recommends accordingly.
Signed on behalf of the Labour Court
13th December, 2004______________________
Enquiries concerning this Recommendation should be addressed to Tom O'Dea, Court Secretary.