Frank O'Rourke (Kildare North, Fianna Fail) | Oireachtas source

I welcome the opportunity to discuss home care packages, home help hours and dementia care at home with the Minister. The purpose of these supports is to maintain someone in the surroundings they are most comfortable in at a particular age in life when they might be suffering from a particular illness or sickness. It exists in order that such people can be comfortable, happy and content in the surroundings they are most familiar with. When home care packages work well and the scheme is in place, we can see the positives and the advantages they bring, but there are problems. We need to identify those problems and we need to deal with them comprehensively. Otherwise the home care packages will not meet the necessary requirements of the end user. Ultimately that can have a detrimental effect on everyone involved.

There is a problem with the application and assessment process at the moment and I am going to highlight certain examples. When the assessment is being carried out by the home care package team, my understanding is that the level of dialogue with all the stakeholders is not taking place to the extent that it should. One of my constituents is holding up a bed in a hospital because different experts and medical professionals have recommended that that person needs 21 hours of home care support to help support the family and friends in the home. Currently, only 13 hours are allocated. There is a lack of connection and dialogue between the relevant stakeholders to put the appropriate home care package in place for that person. That is not a recommendation from me or from the family. The people who are qualified to do this should be engaging with each other in order that the best package available is put in place to help that person in their home environment. That person is in hospital holding up a hospital bed which others cannot access, and in the meantime the person cannot be at home in the environment in which they are most comfortable. That is a problem, a disconnect, and something that needs to be addressed and dealt with during the application and assessment process. This is causing a problem.

There is another problem with the delivery of service by service providers, where some are to provide the service to provide to the end user but it is not being provided. I met the HSE recently about another case. Seven showers per week were allocated to a particular person. Everyone thought it was happening. Three months later the family contacted me to ask why it was not happening, and it was during that meeting I found out that while the showers had been allocated, the family did not know it had been put in place and the end user was not getting the service. That is another issue of communication and disconnect and a lack of follow through. The real loser here is the end user. There is no follow-up with the service provider to see if it is carrying out the work. There should be follow-up with the HSE when the service is allocated to check in with the end user and make sure that the service is in place, if the person is happy with it and if the service provider is carrying out the service to the highest standards.

In another case involving a change in service provider, a lady who is severely disabled has not had a shower in eight weeks. She has had a bed bath, but has not had a shower in eight weeks. One service provider reckoned the environment was okay to carry out the work and another service provider said that it was not okay. The user is caught in the middle. There is a serious problem of disconnect, and a lack of engagement and consultation. The problem is that the end user is suffering, and that is the issue that needs to be addressed and discussed in this debate.

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