David Stanton (Cork East, Fine Gael)
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I thank the Minister of State for being here to discuss this important issue. I also acknowledge her personal interest and involvement in this issue since it arose last summer. Last June, the announcement was made that the Owenacurra Centre would close on 31 October and that in the interim all residents, and their families where appropriate, would be consulted. It was also promised that the will and preference of the residents would be paramount when suggestions were made on possible new placements for residents, of which there were 19, although I understand there are 15 now. The reason given for the closure at the time was the building was no longer fit for purpose in that it did not allow for the needs of a modern residential and day service and it had been criticised by the regulator. There were also questions about safety.

One of the families asked me earlier to ask the Minister of State a question. We understand that some works have been carried out at the centre recently. Is she satisfied that these works will enable the residents to stay there safely for the time being and are there plans to carry out other interim works in respect of safety? That is an issue that families and residents are concerned about. I hope she can tell me this evening that she is satisfied that it is safe. We know it is not fit for purpose for reasons of size, scale, design and so forth but can the Minister of State tell me this evening that nobody will be evicted from the centre against his or her will? That would mean that people could relax, engage and wait until a proper placement was proposed to them. It would be helpful for her to tell us that.

I refer to the broader policy on 24-hour staffed residential services. We have been informed that there is an extensive community-based service operating across the local area, including a home-based treatment team in multiple specialist services, which is good. I applaud that because we want to keep people in their homes and communities as far and as long as possible. I understand that a residential type setting is being sought to provide "a supported mode of living locally" and that the site will be used for future mental health services. What is meant by “a supported mode of living locally”? Supported living means people can live but it is not the same as 24-hour staffing. The question arises: what is the future of 24-hour staffed residential services such as those provided by the Owenacurra Centre? These have been described to me as being a type of step-down facility. We know that the kind of supports and services that have been provided there have been exemplary and that people have benefited from them. Could the Minister of State outline Government policy on 24-hour staffed residential services? Recently she told me: "There are no issues with community residences for mental health.” Does that include the type of service provided in the Owenacurra Centre? If this centre closes, will east Cork be the only region in the county of Cork without such a service? Will east Cork have 24-hour residential services into the future?

What are the long-term plans for the site? The HSE stated it is engaging with the local authority about long-term plans to use it for mental health services and so on. The local people value the 24-hour staffed service for a certain number of people who benefit from that. We know that there are other people who would benefit from supported living, that more people would benefit from being at home and that more people want to live in congregated settings and need that kind of support. The Owenacurra Centre is not a congregated setting; it is one of the steps on the way to recovery. Some people have been living there all their lives. These people know the area and they can go in and out of the shops, down the street and so forth and it is their home.

Can the Minister of State confirm that the place is safe and that people can relax as they will not be moved from the centre against their will? What is the policy on 24-hour staffed residential services nationally and in east Cork?

Mary Butler (Waterford, Fianna Fail)
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I thank the Deputy for his question and for the constructive way he has phrased it. As he and I are aware, there are 19 residents living in the Owenacurra Centre and it is their home. I will not go over the history of it but in June 2021, the HSE notified the Department of its decision to close the Owenacurra Centre. The current building is not fit for purpose and cannot be brought to the standard required. The works being undertaken in the facility currently are to ensure that it is safe for the residents who live there. The Deputy will be aware, for example, that the kitchen was removed because it was a fire hazard and that food was being brought in from another facility.

The HSE's focus is on the impact of this closure on residents and their families in order that the will and preference of each individual will be heard like the Deputy said. Since the HSE informed staff and residents of this decision in June, it has been consulting with them on an ongoing basis and this consultation is continuing. The multidisciplinary team has met with all of the residents and their families where the person wishes to have family members involved, which is not always the case, and where the family members wish to attend meetings, which also is not always the case, to discuss their options. Unfortunately, I have to point that out. The will and preference of each resident is core to this process. I spoke to the area lead for mental health, Mr. Kevin Morrison, today and the relocation process is progressing. As of today, all the residents have had their needs assessed so that they can be appropriately placed in accordance with their assessed needs. The latest position is that of the 19 residents in Owenacurra, four have already transferred.

Two people have moved to nursing homes, one person has transitioned to a high support hostel, and another individual required admission to acute care but has a place secured with St. Catherine's continuing care centre. It is planned that a further two people will be moved to alternative placements this week, one to a nursing home and another to St. Stephen's hospital. These residents are being moved to a nursing home because their physical health challenges now outweigh their mental health challenges.

Residents will not be moved until appropriate placements have been found for each person based on their individual assessed needs, will and preference. I can give Deputy Stanton a guarantee on that. The Mental Health Commission is being informed of every single one of these moves and has asked to be kept apprised of what is happening. The priority of the Government and the HSE is the welfare of the remaining residents in the centre and that was always my concern too. While some people may require ongoing continuing care, others will be facilitated to live in lower support settings, based on their assessed needs. A residential-type setting for a number of residents is being sought to provide a supported mode of living locally. By this, I mean the community houses I spoke about last week. There are approximately 1,200 community houses throughout the country which provide ongoing, continuing care. Typically four or five people would live in these homes and they would be supported within the community. A possible location has also been identified to restore the day service in the town and negotiations are under way on its use. Deputy Stanton will appreciate that this is commercially sensitive but HSE Estates is involved and progress is being made. It is very important that the day care centre opens up as soon as possible.

Importantly, the Owenacurra site will be used in the future to build supported living accommodation for mental health service users and discussions have commenced with the local authority to explore options. These discussions are at an early stage and the HSE will proceed with developing proposals to this end over the coming months.

David Stanton (Cork East, Fine Gael)
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I thank the Minister of State for her very positive response, particularly her assurance that residents will not be moved "until appropriate placements have been found for each person based on their individual assessed needs, will and preference." That means that no pressure will be put on people and they will have to agree before they move to location X, Y or Z. That is hugely important and will be of great relief to the residents and their families.

I ask the Minister of State to explain what she means by building "supported living accommodation for mental health service users". I want to go back to the second part of my question this evening which is in respect of a 24-hour staffed service. I envisage a stepped service involving places like St. Stephen's, from which people can move down to somewhere like Midleton where there is a 24-hour staffed service, then there is the supported living which may not be a 24-hour staffed service and finally, care in the community and at home. They are all important but I would like the Minister of State to elaborate on the 24-hour staffed service. There is only one such service in east Cork which serves Youghal, Midleton, Cobh and right up to Glenville. It is a huge area. There are four such services in north Cork and there are others in west Cork and across the country. These services are 24-hour staffed, with people living in their homes but if they need support any time of the day or night, it is there for them. The policy, which is the Minister of State's responsibility, is what I want to tease out this evening. What is Government policy around this? Is it the intention of the HSE that such a service will be provided in east Cork? I would like to see a small centre in Youghal, another in Midleton and one in Cobh but there must be at least one such service in east Cork. This comes back to the question as to whether this service is required. Is a 24-hour staffed service part of the overall plan? It could be described as supported living but a bit more intensive than what the Minister of State described in her earlier response.

Mary Butler (Waterford, Fianna Fail)
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Improving all aspects of mental health service delivery is a priority for me and that is what I try to do when I secure as much funding as possible, particularly for the recruitment and retention of staff. As we all know, the delivery of mental health services depends on the staff we have. Deputy Stanton referred to the fact that east Cork will be left without a facility like Owenacurra. The national implementation and monitoring committee is currently undertaking a bed capacity review for mental health beds across the whole country. It is looking at acute and community services, including the community houses to which I referred, to determine how we are fixed in that regard. It is also looking at forensic mental health services in the context of our prisons and the facility at Portrane.

A commitment has been given by the HSE that mental health support services will always be provided on the Owenacurra site, which is massive. We know that the building is not fit for purpose and that the residents have to leave. As Minister of State with responsibility for mental health and older people, what I do not want is that the only possibility for people is ending up in a long-term residential care facility. That is what I do not want. I want people to have the supports they need. There will be a range of people who want to live in supported housing with the correct wraparound supports. That does not mean that they will have somebody 24-7 but that they will have the correct wraparound supports, as determined by the individual. There are people living like that within the community.

Deputy Stanton asked about a 24-hour staffed service which is only available in Cork and Dublin through mental health crisis resolution teams. There are only two such teams in the whole country. I can only assume that is what Deputy Stanton is referring to, but I will check that out and revert back to the Deputy.

I want to make sure that the residents of Owenacurra have the best possible outcome.