Ciara Conway (Waterford, Labour)
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I know that this is an issue of which the Minister is acutely aware and that over the summer she took the time to visit the facility in Waterford about which I speak. The matter I raise is the need for supportive care homes to be held by HIQA to separate standards from those for a nursing home. Those working in supportive care homes welcome the intervention of HIQA and the opportunity to work alongside that organisation. However, it must be recognised that the model of care is different from that available to people in nursing homes. I have been working on this matter with my colleague the Minister of State, Deputy Ann Phelan, particularly with reference to the HoIy Ghost supportive care home in Waterford city. It seems there are more of this type of care facility in the south east than elsewhere in the country. The Holy Ghost supportive care home is an interesting facility. It was established under a royal charter granted by King Henry VIII in 1545 to care for the elderly of Waterford. The buildings are a little younger, but the proud tradition of looking after our older people dates back to those days.

The Holy Ghost supportive care home depends on the HSE for a small amount of section 39 funding and is also supported through fundraising by the people of Waterford city. Any increase in funding would be very welcome, but the main issue is the model of supportive care homes which is very different from that for a nursing home. The aim of the care provided is to reflect a philosophy which encourages independence in a home-like setting. The staff work to meet the individual needs and preferences of the residents and the facility provides the residents with care assistants, as opposed to nurses, and a range of recreational care services in a homely, yet professional manner, with a plethora of activities, from art to bingo to knitting and crafts, yoga, singalongs, music and supervised trips. The level of independence of a resident in a supportive care home is very different from that of someone in a continuum of care who may need to progress to a nursing home.

These facilities are being held up by HIQA to the same, otherwise very welcome and necessary, standards as in a nursing home, but the group is keen to stress that the services it provides are very different. The supportive care home facility encourages independence in persons who are not ready to move into a nursing home. These great facilities have the capacity to decrease costs to the health sector owing to the fact that there is no need for nursing staff to be available, relying as they do on care assistants and a skills mix to look after the people who reside in them.

As I know the Minister of State is acutely aware, many people enter a nursing home too early, at a stage when they could be at home or in a facility such as the Holy Ghost residential home. The supportive care home model is considerably less expensive and more suited to those who need some help but do not need the intensive care provided in a nursing home.

I ask the Minister of State to look at the supportive care homes and address the issues raised, if she can. Let us have them assessed using the correct criteria, standardising the model of care. While this issue may be specific to the south east, the rest of the country may be able to benefit.

Kathleen Lynch (Cork North Central, Labour)
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At the Deputy's request, I visited the facility she mentioned. It is probably a model we should consider for use in the rest of the country as it provides an intermediate piece. We will need to see how these homes fit into the standards we have set for HIQA.

I thank the Deputy for raising this issue. All long-term residential services for older people must meet the national quality standards for residential care for older people in Ireland. The Health Information and Quality Authority, HIQA, is the independent authority established under the Health Act 2007 to drive continual improvement and monitor safety and quality in Ireland's health and personal social care services.

In the context of supportive homes, HIQA recognises the necessity for proportionality in how it applies regulatory provisions. The authority has emphasised that all decisions on compliance in the areas of clinical governance, policy development and skill mix are considered with regard to reasonableness, proportionality, fairness and in the context of the service provided.

While the Deputy is referring specifically to supportive homes, I am aware that at a wider level there are concerns about the implications of national standards for residential facilities generally. The Government is committed to ensuring long-term residential services for older people meet the 2009 national quality standards for residential care for older people in Ireland. The standards and the associated national regulations that underpin them encompass issues relevant to the privacy, dignity and respect of residents and seek to support the provision of a physical environment that meets modern day standards and the needs of vulnerable people living in designated services.

The Government's recently published capital plan, Building on Recovery: Infrastructure and Capital Investment 2016-2021, commits to a major multiannual programme of capital investment in public and voluntary provided social care facilities. A total of €300 million in Exchequer funding has been made available, together with further potential to develop projects through public private partnerships. The shortage of public capital funds in recent years due to the economic crisis has meant a number of publicly provided or voluntary services have not met standard 25 of the national quality standards for residential care for older people in Ireland within the previously stated timeframe of 1 July 2015. As a result of the capital plan, it is now possible to set a revised policy and outline a revised timeframe for ensuring all public and voluntary services which are currently non-compliant with standard 25 demonstrate compliance to HIQA.

The revised policy will ensure all services will fully achieve the national standard by the end of the capital plan period in 2021. In the coming weeks the HSE will submit to HIQA its plans, focused at individual service level, to meet the requirements of standard 25. The individual plans will be in line with the revised policy timeframe. They will also detail proposed capital expenditure at each individual centre level. The HSE will also support relevant voluntary providers with which it has service level agreements in submitting individual plans. In addressing this issue of non-compliance by some public services, the Minister and I acknowledge the investment and achievements of the independent sectors in recent years in meeting environmental and other standards. I hope any similar plan for services in the independent sectors will be given consideration by HIQA.

Ciara Conway (Waterford, Labour)
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This is very welcome news. In speaking about supportive care homes the Minister of State used the word "proportionality". That is exactly what they are looking for. They want to work in partnership with HIQA and the HSE to ensure this. It is really significant and will be of huge comfort to many older people in public nursing homes and their families. There was a cloud hanging over them in not being compliant with HIQA requirements. It is welcome that the Minister of State has stated €300 million will be made available to ensure all public nursing homes will be compliant. There has been an ongoing campaign by many people in Waterford to ensure St. Patrick's Hospital will continue to look after older people who need that level of care. It will be quality compliant, which is what older citizens deserve. To hear that money is being made available lifts a huge burden from the residents in these public nursing homes and their families. I eagerly await publication of the HSE's plans as to how it will use the €300 million that has been made available.

Kathleen Lynch (Cork North Central, Labour)
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As the Deputy rightly points out, we need to look at the type of regulation we have asked HIQA to implement. It is Government policy and HIQA does it very well. It is usually the last line of defence in looking after very vulnerable people. We need to look at the different types of care available. The care homes in the Deputy's area are delivering a different type of care that is not overly medicated and does not have a medical model attached to it; it is more of a social model. We are going to have to look at how we tweak these things. We have to ensure people are safe and that the service they receive is of a particular standard. Nevertheless, they are different from long-stay nursing homes.

The reason the €300 million for public nursing homes has been mentioned today is that we are close to concluding our talks. There is more to be done in terms of how we are going to manage it in the timeframe of the capital programme. The Deputy has mentioned public nursing homes that are very worried that they are not going to meet registration qualification requirements and, therefore, could be put on notice that they would have to close beds or would not be able to admit more residents. It is very good news for them that we will now have a plan to ensure they will all meet the criteria in order to be registered by HIQA in the timeframe up to 2021. That is genuinely very good news for them. It has taken a lot of work, in which many people have been involved. I am glad that it is bearing fruit and that the plan will be published very shortly.