I propose to take Questions Nos. 34, 42 and 54 together.
Government policy is to support older people to live in dignity and independence in their own homes and communities for as long as possible. Where this is not feasible, the health service supports access to appropriate quality long-term residential care. Access to appropriate quality long-term residential care is underpinned by both the system of registration and inspection of nursing homes and the financial support available under the Nursing Homes Support Scheme.
The Department is working closely with the Health Service Executive to develop an overall plan regarding future public provision of long-stay residential care services. The plan will reflect both national and regional requirements and will have regard to the current severe financial constraints, restrictions on public sector staffing and recruitment and the on-going need to meet service and safety standards, all of which pose challenges for community nursing units across the country.
The review of the Nursing Homes Support Scheme will also influence the future direction of residential care services. This review will consider the long-term sustainability of the Scheme as well as looking at the community based services. Work on the review is on-going and it is expected that the review will be completed in late 2013 or early 2014. A longer-term plan for public residential facilities is therefore expected to be completed by approximately mid-2014 following completion of the review of the Scheme.
The Health Act 2009 (Care and Welfare of Residents in Designated Centres for Older People) Regulations 2009 provide that each nursing home must have a Statement of Purpose. The Statement of Purpose must include details of the range of needs that the designated centre is intended to meet. It would be inappropriate for the Minister for Health to require all private and voluntary nursing homes to provide a minimum number of places for higher dependency patients because the nursing homes may not be able to adequately cater for needs of the residents.
Our aim is to ensure that people are being cared for at the point of lowest complexity. People should only be entering long-term nursing home when this becomes absolutely necessary. This means that only the most dependent people should be in long-term nursing home care. One of the key priorities identified in the HSE's National Operational Plan 2013 is the progression of a single assessment tool for older people. This standardised framework will ensure that there is a robust, equitable standardised care needs assessment nationally. It will also allow resources to be targeted towards those with the greatest needs and enable supports and services to be designed in the most appropriate way possible.
