Duncan Smith (Dublin Fingal, Labour)
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637. To ask the Minister for Children, Equality, Disability, Integration and Youth his Department's policy for people between 20-65 years of age currently in nursing homes to transition to independent living; and if he will make a statement on the matter. [24780/23]

Anne Rabbitte (Galway East, Fianna Fail)
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I wish to thank the Deputy for raising the matter,

I recognise that nursing homes can, at times, be appropriate care options where the person concerned has a clinically assessed complex medical and social care requirement that cannot be supported in the person’s home.

Nonetheless, for some people under the age of 65, nursing homes are not an appropriate setting, and alternative, more sustainable supported living solutions are needed to give them greater independence and choice in their daily lives.

There is a clear Government commitment to reduce and provide a pathway to eliminate the practice of inappropriately accommodating young people with serious disabilities in nursing homes and to facilitate where appropriate, people under 65s who wish to live elsewhere. In this context, work has been ongoing between my Department and the HSE to address nursing home care of people under 65 who wish to live elsewhere.

Ombudsman's Report. Published in May 2021, the Ombudsman's Wasted Lives: Time for a better future for younger people in Nursing Homes looked at the appropriateness of the placement of people under 65 in nursing homes.

The Ombudsman’s report recommendations cover a range of themes including funding, informed consent, quality of life, access to services, navigating the system and policy and human rights. Of the 19 recommendations in the Ombudsman’s report 17 of the recommendations are led by the HSE. 2 recommendations in the report are led by the Department DCEIDY and the Department of Health.

In response to the Ombudsman’s report, the HSE is co-ordinating a programme of work to review and implement the report’s recommendations for which the HSE has accountability.

In October 2022, the HSE established a national Implementation Steering Committee (ISC) This group has representation from HSE Acutes, Community Operations and service users with lived experience. The aims of this steering committee are to; oversee the implementation of the recommendations set out in the Ombudsman’s report, provide a level of assurance regarding the health, safety and dignity of residents aged under 65 years living in nursing home settings, and, ensure the efficient transition to alternative care settings where appropriate.

In order to ensure completion of the programme of work to the highest possible standard, the Steering Group established a Stakeholder Reference Group, with representation and engagement across the wider health, social care and disability sector.

Five workstreams, comprised of membership from the sector with the relevant expertise and people with lived experience are being established to carry out distinct recommendation implementation work.

1. Quality of life and model of Service development2. Funding and personal finances3. Services access and navigation4. Informed consent policy and human rights5. NH U65 survey (previously SRF project)

Work has commenced under each of these workstreams.

InvestmentThe ‘Wasted Lives’ report recommended an annual budget to assist young people with disabilities inappropriately placed in nursing homes to leave, if that is their preference, and to support and enable them to enter into more appropriate living arrangements.

In 2023, Specialist Community-Based Disability Services received funding of c. €2.5 billion to provide a range of services and is spent in line with nationally agreed policy for disability services. Services include Residential and Respite Services, Day Services, PA and Home Support Services, and Therapeutic Supports.

In 2021 this Government provided for a Pilot Scheme as part of the HSE National Service Plan (NSP) to enable 18 people, with an investment of €3m, under the age of 65yrs to move from nursing homes to move to more appropriate homes in the community. To end 2021, 14 had moved into the community.

Budget 2022 provided a further allocation of €5.5m (part-year funding) to address the situation of people with disabilities who may be inappropriately placed in nursing homes, thus commencing the move of a further cohort of individuals. In 2022, 22 transitions took place.

The transitions to the community have been to own home (adapted), family home (adapted), new council house (adapted) and specialised residential services.

In addition to supporting individuals who wish to transition into the community, the HSE is also funding enhanced quality of life supports for individuals who through either will and preference and/or assessment of need will be continuing their placement in the Nursing Home. For these individuals, the aim of these supports is, to improve the daily life of these younger people, while they are still in a nursing home or to help them prepare for a future transition.

The HSE has informed me that as of February 2023, 6 individuals have moved from nursing homes to more appropriate homes in the community, and 34 individuals have received enhanced quality of life supports, to support continuing their placement in a Nursing Home.