Dr. Kathleen MacLellan:

I thank the Deputy. The HSE is looking at a reform framework for long-term residential care, including opportunities for increasing direct public provision in relation to long-term residential care which will decrease some reliance on the private sector, but also looking at the types of long-term residential care that are being provided. One of the big learnings we would all take on board is that if we can reduce the number of congregated settings for people to live in that would be helpful in terms of protecting them around infection prevention and control. The HSE is looking at ideas such as support villages, own-door services and different types of configurations of long-term residential care. It has committed to that and there has been significant funding put in place to look at new types of intermediate care, rehabilitation beds within the community and expanding home care as well.

Part of the planning around the statutory home care scheme requires that we would look at care of the older person as a new model such that there will be a continuum of care and it is not the case that automatically the decision is made that a person would go to long-term care or receive home care. As described by Ms O'Neill, the decision-making will start with the standard assessment tool, which will look at the needs of older people and, in deciding those needs, look to what supports can be provided within the community, moving towards long-term residential care, as needed. The new home first model is already being tested by the HSE. The goal will be to reduce the number of people within long-term residential care and the length of time that they would spend there such that the admissions would be appropriate and then to look to the broader provision of both by the HSE in terms of publicly provided long-term care.