Jennifer Murnane O'Connor (Carlow-Kilkenny, Fianna Fail)
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I had a meeting recently with care home representatives in my constituency. I was joined by Deputy Funchion, who apologises for being unable to attend the debate this morning. I will outline the issues raised with us by the people to whom we spoke. Their biggest concern is that care homes do not get the same supports as those available to HSE-funded nursing homes. This is because the fair deal scheme covers only long-tern nursing home care. It is important to note that the south east is the only area in the country in which there are care homes. This is an unusual situation, and we are lucky to have these facilities in the region. However, the current situation creates a gap in funding for the homes and increased costs for residents. It is causing a range of problems in general. From speaking to the people involved in the different homes, it is clear there are huge challenges now that were not seen before.

I welcome the announcement this week of once-off funding of €635,000 to assist vital voluntary and community health service providers in Carlow with energy inflation costs. Among the section 39 groups that received some of this funding are Holy Angels Day Care Centre, BEAM Services, St. Laserian's House and St. Fiacc's House. This funding will help towards meeting the increased costs that have arisen. These community-based, voluntary health and social care providers play a vital role locally in providing front-line services to some of the most vulnerable members of our society.

It is important that they are not just supported with once-off funding during these challenging times. They will continue to struggle beyond the current energy crisis. I know I have the support of the Minister of State, Deputy Butler, on this issue. Care homes fall under the remit of different areas. I have spoken to her about the situation at St. Laserian's House and St. Fiacc's House in Carlow. Management staff at those facilities were told, following a HIQA request, that they could apply to the local authority for bathroom adaptation grants. However, they were subsequently told that they could not apply for them. That needs to be looked at. This issue does not come not under the Minister of State's remit but I know she will support me on it. It is hard for care homes to find all the extra funding they need.

It was great to see €35 million being allocated for nursing homes, but I was a little taken aback regarding what is happening with the €81,000 that is being divided between ten nursing homes, including some in the Minister of State's area. The care homes in the south east provide excellent community-based care. For many of the residents I speak to, the facilities are like a home away from home. The Minister of State knows this because she also visits them regularly. If they cannot be funded under the fair deal scheme, can we look at whether they might qualify for local authority grants, including adaptation grants and older persons' grants? I ask the Minister of State to join me in again speaking to the Minister for Housing, Local Government and Heritage, Deputy Darragh O'Brien, about this issue. Following inspections, these facilities are faced with big bills to meet compliance requirements, including provision of extra bathrooms and increased staffing levels. They are really feeling the cost of things right now.

Another important issue is that many of the services rely heavily on volunteers. Those volunteers go out bag-packing to raise funds and run draws, raffles and events. The services are really dependent on their volunteers. They are also reliant on community employment scheme participants to service the facilities. I am concerned about their funding and capacity. They do a really good job but facilities that rely on community employment scheme participants are having a massive issue recruiting for their vacancies, which must be urgently addressed. I know the Minister of State is aware of the ongoing issues around pay and conditions in respect of community employment schemes.

I have raised a lot of issues. I thank the Minister of State for taking this matter.

Mary Butler (Waterford, Fianna Fail)
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I thank the Deputy for raising this issue. I am pleased to have an opportunity to speak about the ten supported care homes in the south east. It is not often that I get to put the information on the record of the Dáil. There are ten supported care homes in community healthcare organisation, CHO, 5. These provide accommodation and support services to older people with low to medium dependency levels. They are not nursing homes and they will never fall under the fair deal scheme because they work with people who are free to come and go and who receive support in accordance with their low to medium dependency needs. The residents cannot be maintained independently at home but do not require 24-hour nursing home care. That is the difference.

The ten supported care homes across the south-east community healthcare area provide supported and-or assisted living accommodation for up to 236 people with low to medium dependency needs. It is well documented that these services are highly valued across the wider community, as the Deputy said, and within older person services in CHO 5. The supported care homes remain uniquely positioned in the region, with little to no comparable or equivalent services available to the older person population elsewhere in the country. There has always been, and continues to be, a strong and positive working relationship between the HSE, older person services in CHO 5 and the supported care homes, with ongoing support and engagement provided by the HSE in respect of financial, governance and operational management issues.

Two of the supported care homes are located in Waterford, namely, Holy Ghost Residential Home in Waterford city and St Carthage's House in Lismore, which provide 102 beds between then. Carlow has two homes, namely, St. Laserian's House in Bagenalstown and St. Fiacc's House in Graiguecullen, providing 36 beds. I recently visited both of those facilities with Deputy Murnane O'Connor. The other six homes, all in County Kilkenny, are: Prague House in Freshford; Mount Carmel Supported Care Home in Callan; St. Joseph's Supported Care Home in Kilmoganny; Rosedale Residential Home in Kilmacow; Gahan House in Graiguenamanagh; and O'Gorman Home in Ballyragget. Between them, these six facilities support 89 beds, with Rosedale also supporting own-door housing for older people.

Supported care homes are an integral part of each community, with local people working in and supporting the residents, many of whom they already know. Having visited many of these homes, the model is one I completely endorse. At a time of loneliness, rural isolation and, for many, bereavement, these homes are, as the Deputy said, a home from home. They support residents to live independently and to be free to come and go as they wish.

Due to a combination of factors, including the Covid-19 pandemic and the unprecedented rise in operational costs in the current economic climate, the supported care home sector is challenged like many other health service providers in regard to work force planning, increased staffing costs, staff recruitment and retention, and capital investments in premises to meet HIQA environmental requirements and improve infrastructure to meet residents' needs. Even though they are not nursing homes, they come under the HIQA regulations. I thank the voluntary boards of management of all ten care homes and the local communities for their help, support and fundraising.

On Monday of this week, I announced funding to support the ten care homes as part of the inflation fund of €81 million announced by the Minister for Health, Deputy Stephen Donnelly.

These homes received €99,251 between them to support them in meeting financial inflationary challenges in the context of energy costs for 2022. That was money for last year. I am pleased to announce that it is my intention that these ten supported care homes will also be able to avail of the temporary inflation payment scheme put in place to support private nursing homes with energy costs. Each home can claim up to €31,500, minus the amount received under the inflation fund, from July to December 2022. The details of this package for 2023 are being finalised.

Jennifer Murnane O'Connor (Carlow-Kilkenny, Fianna Fail)
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I thank the Minister of State for her reply. I am delighted with that extra funding. It is great for the care homes, as she stated. She has visited many of them, including in Carlow, Kilkenny and her home town of Waterford. I know the passion and commitment she has to ensure care homes are the life and soul of the community and that they will always have funding to keep them open. The biggest issue at the meeting to which I refer was the need to ensure sure the ten care homes in the south east are secure and that the residents and their families feel secure. They know the great work the Minister of State has done, including through working with the HSE and other agencies. I am delighted that she has announced that scheme this morning. I will certainly be letting all the care homes in my area of Carlow-Kilkenny know that they will be able to apply for this extra funding. I thank the Minister of State. That is excellent.

Mary Butler (Waterford, Fianna Fail)
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I thank the Deputy for her continued support for and interest in supported care homes. In fairness to the Deputies representing the three counties in question, we all come together to support these care homes. They are unique facilities. Older persons who can no longer live at home but do not need nursing home can go into one of these facilities, where there are plenty of staff and they can come and go. They can go to the shop for a newspaper. They are provided with three meals a day. The majority of residents have their own rooms. Their medication needs are looked after. That is important.

I point out that the current cost to the State of the care is approximately €200 per resident per week, making this a very cost-effective model of which I am completely supportive. Many years ago, these homes were known as welfare homes but they are now run by community boards and voluntary organisations and get significant support from local organisations. There will always be a cohort of people who present with low to medium dependency needs and may not have family nearby. They may experience poor social networks and be socially isolated. The Sláintecare principle of the right care in the right place at the right time is underscored by these homes.

There are challenges, however. I will not pretend that is not the case. There are challenges in the delivery of financial supports. Last year, I asked CHO 5, which is very supportive of these homes, to compile a report. I have received that report. There was a shortfall in funding for last year. That matter will have to be addressed. I am proposing that the HSE engage in a full and detailed review of a viability study to carry out a full appraisal of supported care homes. If the ten homes were to work together, they would have better economies of scale in the context of governance, insurance and costs, and that is where I will go next.