The Nursing Home Support Scheme (NHSS), commonly referred to as 'Fair Deal', is a system of financial support for people who require long-term residential care. The primary legislation underpinning the NHSS is the Nursing Homes Support Scheme Act 2009. Participants in the NHSS contribute to the cost of their care according to their means while the State pays the balance of the cost. The Scheme aims to ensure that long-term nursing home care is accessible and affordable for everyone, and that people are cared for in the most appropriate settings.
The Nursing Homes Support Scheme Act 2009, the legislation which underpins the scheme, outlines in Part 2, Section 7 (6) the criteria which comprises the care needs assessment under the Act. Those seeking to apply for the NHSS scheme must complete a care needs assessment. The care needs assessment is used to identify the individual requirements and care needs of the applicant and includes evaluation of the applicant’s capacity to perform activities of daily living, their cognitive ability, the family and community support that is available as well as the applicant’s access to medical, health and personal social services being provided to or available both at the time of the carrying out of the assessment and generally. The Act also includes provision for any other matter that affects a person’s ability to care for himself or herself, and consideration of the likelihood of a material alteration in the person’s circumstances during their lifetime that could potentially inhibit their ability to care for themselves.
There are currently no plans to revise the Nursing Homes Support Scheme care needs assessment criteria. I have not expressed, nor do I have, any particular concerns regarding the adequacy of the care needs assessment procedures under the Nursing Homes Support Scheme. My recent public comments have expressed ongoing legitimate concerns in relation to safeguarding older adults which materialise whenever further changes to the NHSS are suggested.
It is therefore important that any proposed changes to the scheme are equitable, evidence-based and also provide appropriate safeguards for vulnerable older people. As the NHSS is governed by primary legislation any proposed future changes cannot be completed without due diligence, gathering and analysing all available evidence, and giving due consideration to the implications and consequences of those proposed changes.
