Déirdre de Búrca (Green Party)

I welcome the Minister of State to the House and thank her for her statement. I welcome the opportunity to make a statement on the nursing home support scheme and the standards for residential care settings for older people.

There is much concern about the issue of care for the elderly. Many of our population are ageing and this presents people with questions about how best to look after their elderly relatives and, for the elderly people themselves, where they will receive the best care and whether it is affordable. Issues of quality and affordability are very much on the minds of older people and their families. Some of the scandals that were made public in recent years have heightened people's concerns. The nursing home support scheme and the standards for residential care settings for older people will go a long way towards alleviating some of that anxiety and making it clear what people can expect from the residential care provided for older people in this country.

In regard to the nursing home support scheme, I welcome in particular the care needs assessment that forms the early part of the process by which a person is supported by the State in accessing nursing home care and receiving subventions. The care needs assessment examines in a comprehensive way the individual person and his or her care needs. Most of us would accept that the optimal situation is for an elderly person to be looked after at home and that residential care should be required only when this is not a possibility. The advantage of the care needs assessment is that the needs of the older person can be assessed and a care plan drawn up. This could help to ensure a spectrum of services is provided, from the personal and social care services provided in the community to the supports and care provided in a residential setting. I hope many elderly people who have the care needs assessment will not need to enter residential care but may be able to access personal and other supports in the community.

When an older person has the care needs assessment, a clear process is set out for them and they then have a means assessment which looks at the key issue. The issue that causes much concern for older people is how much they can contribute to the cost of their care. A clear system has been proposed under this draft legislation that the applicant's means will be assessed as 50% of a couple's combined income and assets. The assessment will not take into account the income of other relatives, such as that of the applicant's children.

As the Minister of State mentioned, there will also be safeguards in place to ensure the person's spouse or partner who remains at home retains the maximum State non-contributory pension and that the person also has a sufficient personal allowance.

These details are all very important to older people and their families, who may be considering availing of residential care. I propose that the Minister of State provide information leaflets for older people and their families through citizens advice bureaus, on the scheme so all the information people want will be provided. If that was done the families would be empowered to identify the different stages of the process and the eligibility of their relative before needing to move through the process.

One of the effects of the system is, as the Minister of State highlighted, that it will create equality in the treatment by the State of older people who access private or public residential care. That could be positive if it means the equalisation of standards across the public and private residential nursing home sector. The result will be a sense of equality. The individual will be supplied with a list of public and private nursing homes and the older person and his or her family decide which approved nursing home to access.

The legislation will deal with people in existing nursing homes that are not approved and the individual wants to avail of this scheme and consider what his or her options are. I commend the role of the care representative. The person appointed to this role, when an individual does not have full legal capacity and wants to apply for ancillary State support, will be in a position to act in the person's best interests at all times. The legislation is very clear on who is eligible to act as a care representative in place of an older person.

The standards for residential care settings for older persons is based on the idea that older people must receive appropriate levels of care in residential surroundings of a high standard. This must be based on evidence-based standards. I agree with Senator Butler on the positive developments that have happened in nursing homes in areas such as recreation and stimulation of older people. We too often find older people in nursing homes and residential care settings sitting in chairs watching television, with very little real stimulation. It is to be hoped the new standards for residential care settings will include the idea that older people have a need for stimulation, recreation and occupational therapy, with some variety in their day. There are existing models in some newer nursing homes. It is to be hoped that the residential care settings will encourage these types of practices to become more widespread across all nursing homes.

I welcome the standards and the support scheme, and I congratulate the Minister of State on producing them.