Tuesday, 2 February 2016
Department of Health
Services for People with Disabilities
77. To ask the Minister for Health his views on survivors of severe acquired brain injury depending on a maintenance programme in nursing home care rather than in proper rehabilitation therapy; and if he will make a statement on the matter. [3944/16]
The HSE has informed the Department that there are currently 1,047 people under the age of 65 years who are resident in nursing homes under the Nursing Homes Support Scheme. A diagnosis is not required under the Nursing Home Support Scheme, so we are not in a position to clarify how many of these have an Acquired Brain Injury. Although most families would prefer to be able to care for their loved ones at home, hospital/nursing home care is at times necessary and it forms part of the continuum of care. The Nursing Home sector is used in developing options to meet the needs of young adults with a disability where no other alternatives are possible. The HSE need to regularly review these individuals to see if through their care plan a more appropriate option might be available. In the longer term the policy is to develop a more tailored service suitable to meet the needs of these service users.
The Health Service Executive provides for the health needs of those affected by brain injury through a range of measures. Brain injury health services are provided across a range of settings, by different organisations and by many health professionals and carers. The HSE Clinical Strategy and Programmes Directorate have a number of clinical programmes that are working in the area of neurology, including Neurology, Epilepsy, Stroke and Rehabilitation Medicine. The clinical programmes are focusing on reducing waiting times/lists, addressing disease specific pathways and models of care with a view to developing a national framework for the management of long-term neurological conditions. The HSE also provide services for those with brain injury through Primary Care Teams with community based therapy services and personal social services. Substantial funding is also provided to a number of organisations such as Acquired Brain Injury Ireland, Headway Ireland, Enable Ireland, Spina Bifida Hydrocephalus Ireland among others, to provide supports and services to people with a neurological condition.
Last year, the Government, announced an additional €15 million for the redevelopment of the National Rehabilitation Hospital in Dun Laoghaire. This allocation will enable the National Rehabilitation Hospital and the HSE to proceed with a new 120 bed building on the Dun Laoghaire campus. The redeveloped facility will be purpose built to accommodate integrated therapy services, hydrotherapy and sports facilities.
The Government recognises that neurological illness or injury has significant implications for the individual and their family and impacts on their health, social, educational, vocational and recreational participation. It is important that the continuum of services and supports required are made available by the health system and by those other State agencies to provide specific services, consistent with their statutory remit.
The HSE’s report “Time to Move on from Congregated Settings – A Strategy for Community Inclusion”,(2011) proposes a new model of support in the community by moving people from institutional settings to the community, over a seven year time frame. The plan will be rolled out at a regional and local level and will involve full consultation.
In terms of housing, the Department of Health and the Department of the Environment, Community and Local Government are working in collaboration to support the transition of people with a disability from institutions to social housing in the community under the Government's National Housing Strategy for People with Disability 2011 to 2016.
The HSE Social Care Operational Programme 2015 set a target of moving 150 people from institutions into the community in 2015. I am pleased to note that significant progress has been made in achieving this goal as 137 individuals had moved from congregated settings at the end of December 2015. I understand that the majority of this number, moved to community placements and others moved to alternative appropriate accommodation, including moving in with family and moving into long term nursing home care, in line with their personal care plans.
All such moves require careful care planning by service providers in association with clients, families and communities. The HSE has advised me that there are a number of factors which meant that fewer people than planned moved to the community in 2016. These included:
- a shortage of suitable housing
- difficulties in accessing Capital Assistance Funding (CAS) from the Department of the Environment
- inability of service providers to support individuals with capacity issues to sign tenancy agreements pending the enactment of ‘Capacity Legislation’,
- inability of some service providers to support transition costs
- changes in family and or personal circumstances.
I am pleased to note that Department of Health officials followed up with the HSE, Department of the Environment and the Housing Agency to resolve problems regarding access for people with disabilities to funding from the Capital Assistance Scheme. Arising from this process, the Department of Health and the Department of the Environment developed new Guidelines under the Capital Assistance Scheme to enable housing associations/service providers to apply for funding to acquire suitable accommodation for people moving from institutions in 2016.
I am assured that HSE and local authorities will continue to work together under the structures set up under the Housing Strategy to inform and guide local housing provision for people with disabilities over the next few years.