John Paul Phelan (Carlow-Kilkenny, Fine Gael) | Oireachtas source

I thank Deputy Crowe. I am taking this Topical Issue on behalf of my colleague, Minister of State, Deputy Jim Daly. In the case outlined by the Deputy, where 21 hours of home help is required, one could not but wish to see a person of that age and who still has her faculties in her family home situation.

The Government's core stated objective is to promote care in the community so that people can continue to live with confidence, security and dignity in their own homes and communities for as long as possible. A wide range of services are provided, including home supports, day care and residential care, through direct service provision and through voluntary and private providers. Respite care is an essential component to ensuring older people with care needs in the home, including those with dementia, can be cared for in their community and close to their carers. The service offers additional assistance to families and carers, thus helping to alleviate the ongoing stress associated with providing care. Respite can often assist with avoidable acute hospital admissions. Respite is provided in several different ways and settings across the health system. It is provided through designated respite beds in public residential centres and contracted by the HSE in private nursing homes – where it is used to increase the availability of such beds to meet demand – within the resources available in the local area.

There are over 1,800 short stay beds in public long stay units. These may be used interchangeably for respite, rehabilitation, convalescence or other uses, depending on current demand in the centres. Therefore, the number of respite beds in any one month can fluctuate up and down depending on demand for that bed.

Planned respite can be provided, allowing carers to have planned breaks throughout the year. Respite may be provided as part of an enhanced home support package, where the funding can be used to procure a period of respite. Respite can also be provided on an emergency basis for unforeseen circumstances, for example, due to bereavement or illness of carers, or emergency environmental changes to the residence of the client. The provision of respite beds is part of an integrated model of care and the HSE strongly advocates and supports the system of respite care nationally. The HSE is currently considering the role of the respite services and how these can contribute to the provision of a streamlined pathway of care for older persons. Respite services are also an important part of the range of services supporting people with disabilities and their families. Short breaks can also provide an opportunity for individuals to meet and engage with other people socially. This year, the HSE will provide over 182,500 respite nights and 32,500 day respite sessions.

Home care is an increasingly important part of the supports for enabling older people to remain in their homes and communities for as long as possible and for facilitating their discharge from acute hospitals. Last year, a single funding stream for home support services brought together the funding for home help and standard home care packages which now operate as a single home support service. In excess of 53,000 people will receive more than 18 million home support hours this year. This will assist older people to live independently in their homes and enable large numbers of people to return home following acute hospital admission.

Despite this significant level of service provision, demand continues to rise and there is considerable variation in access to services in different parts of the country. While the existing home support service is delivering crucial support to many people, it needs to be improved to better meet the changing needs of our citizens. That is why we propose to establish a statutory scheme for home support services which will improve access to the service on an affordable and sustainable basis while also introducing a system of regulation that will ensure public confidence.

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