Government policy in relation to older people is to support people to live in dignity and independence in their own homes and communities for as long as possible and, where this is not feasible, to support access to quality, long-term affordable residential care.
The Home Care Package (HCP) Initiative was introduced in 2006. This year, the Government has made available a total of €130m to allow the HSE provide packages to some 9,000 people at any one time or around 12,500 people during the course of the year. This includes an additional €10m provided in the recent Budget. Such packages provide supports over and above existing mainstream community services to help maintain older people at home and in their communities. They are targeted particularly at older people at risk of inappropriate admission to acute hospital or long-term residential care, or those requiring discharge home from acute hospital. They were designed to be as flexible as possible to best meet the needs of each individual. These criteria were indicated to the HSE when packages were introduced, and have been the basis for administering the programme since.
The capacity of the HSE to provide approved levels of Home Care Package services continues to be reviewed in the context of overall resources available to the Executive. It is incumbent on each Local Health Manager to ensure that HCPs are delivered within allocated budgets. This requires a stringent on-going review of the application of resources.
Levels of services provided under the HCP Initiative are reviewed regularly by the HSE. As a result, the service in individual cases may increase, decrease or may remain the same, based on the assessed need of the individual. Professional staff on the front line, who are aware of local circumstances, undertake individual client assessments and services are targeted at clients with a high level of dependency and in accordance with their assessed need.
An independent Evaluation of Home Care Packages was commissioned by the Department and undertaken by PA Consulting in 2009, and was published on 3 December last. The recommendations of this report, including a more standardised approach to means assessment, will help inform future policy and direction for this service. Following the findings of this report, the Department is satisfied that the funding for HCPs, which is a limited resource, has been used as intended by the HSE. It accepts the recommendations on the need for a more standardised approach to various aspects of the programme. These would include Governance, Operational Delivery, Performance Management, and Funding.
The Department, and the HSE, are at present progressing the implementation of the recommendations of the PA report on Home Care Packages in 2010 including:
agreeing national standardised access and operational guidelines for delivery of Home Care Packages,
the adoption and dissemination by the HSE of a voluntary code of Quality Guidelines for Home Care Support Services for Older People, which will apply to public and private providers, and
a more standardised approach to Procurement of HCPs nationally.
I have referred the Deputy's question to the HSE for direct reply, in relation to the detailed operational information sought.