Seniors advocates are calling on the Bermuda Government to enforce tighter standards at care homes amid concerns some are unwilling to come on board of their own accord.

Claudette Fleming, the executive director of Age Concern, questioned whether the Government has the will to enforce measures ensuring management, ethics, risk prevention, client rights and financial viability are up to scratch.

Under a pilot programme, Age Concern, in tandem with related organisations and the Bermuda National Standards Committee, has assembled a working group aimed at inducing facilities to sign up for certification followed by accreditation by 2018. Five facilities have begun the process, with another two signing on in recent weeks.

But Jeff Bormaster, the liaison officer with the United States Council on Accreditation, said authorities are “still struggling to get all the agencies to come on board”.

“Being licensed by the Government means you have met minimal standards. What you see in the news from time to time as a horror story says that being licensed is not enough. The idea of accreditation is to say that you need to meet accepted standards of practice,” Mr Bormaster said.

“Organisations that have been providing services for human beings historically had to be only registered or licensed. There were no standards.

“This is a voluntary process, as it’s always been. Government cannot set standards of excellence, but it can require entities to meet them.”

Asked if funding was an issue in tightening the monitoring and enforcement of residential care home standards, he said: “It’s not money, it’s political will.” Dr Fleming added that the programme had “proved that Bermuda has the expertise” but said: “It’s not for lack of knowledge. It’s a matter of having the will to do it.”

As of April, the island had 22 homes on the Government’s registry, 17 of which were registered. A further five were listed as conditional, meaning they were “required to meet specified regulations within a defined time period”. The list included the Summerhaven home for the physically challenged.

Ageing and Disability Services pledged in September 2015 to get tougher on facilities that fail to deliver adequate care. However, saying that ADS still “don’t have any power”, Dr Fleming added: “The ball is in the court of the Government of Bermuda.”

Dr Fleming called it unrealistic to have ADS creating and enforcing legislative standards, noting: “You really can’t have the same office doing both of these things.”

ADS has reported that Bermuda’s facilities for its ever-rising senior population are at capacity, with a particular dearth of resources for dementia patients.

Although dementia is not a mental illness, a report last month from the Bermuda Hospitals Board noted that staff at the Mid-Atlantic Wellness Institute were under increasing pressure, with elderly patients showing dementia-related disorders being brought to the facility.

The Bermuda National Standards Committee was established in 2004, aimed at covering local charities.

“We’ve been doing this for 12 years, working with organisations that deal with children and families,” Mr Bormaster said. “Claudette proposed bringing it for senior services.

“It’s a two-step process. You get certified, which means that you are using best practices to operate.

“Then, two years later, you become accredited, which means you operate your services according to recognised international practices.”

Dr Fleming said one difficulty had been “balancing care versus the business side of it”.

“That’s been a big challenge for the working committee, which includes the Bermuda Health Council, Ageing and Disability Services, the Bermuda Small Business Development Corporation and the Bermuda Hospitals Board.

“We all bring our various strengths and have different ways of looking at the practice environment. What we find is there are times when the business side and the nursing side conflict. Those two areas are constantly competing. A happy medium has to be struck, that does not compromise quality care.”

According to a spokeswoman, the Ministry of Health and Seniors is taking part in the initiative, and “the relevant legislation is being updated to enhance the regulatory requirements and enforcement mechanisms”.

“This work is in development at present and consultation with stakeholders is currently under way. Improvements to date have included standardisation of the registration process, publishing the register of residential and nursing care homes, and working collaboratively with administrators to improve capacity and compliance.”