€120m home care scheme suffering from flaws: report

A €120 million state home care packages scheme — which provides food and care to 8,000 elderly people who would otherwise be placed in long-term care — is riddled with problems and unable to function because of chronic failures in the system.

A report by the National Economic Social Forum (NESF) has found that the vital service is suffering from a series of structural flaws in the HSE.

According to the NESF, elderly people are facing different eligibility criteria for services depending on where they live, resulting in repeated means testing for applications.

Despite the existence of national guidelines on how services should be implemented, the NESF document also found that local health office staff tasked with implementing the policies are not involved in the decision-making process.

And it added that due to a “weak focus” on learning and accountability in the system, “inconsistencies, inequities and duplication of work” in the home care package scheme are proving unavoidable.

“Despite the existence of national strategy and guidelines, this scheme is implemented in different ways in different HSE local health offices,” the independent report found.

“The national guidelines on the home care package scheme, which included standard eligibility criteria, were never put into action. Additional guidelines relating to rights, protection staffing, governance and management of home care work are still not fully agreed.

“The absence of co-ordinated procedures is leading to inconsistencies, inequities and duplication of work, with double or even triple assessments of the care needs of an older person often carried out.

“Little data is collected on the outcomes of home care packages so it is difficult to learn from local implementation practices... [And] there is very little focus on accountability in the policy documents,” the NESF report concluded.

Among the recommendations put forward by the independent group behind the report include:

nA closer link between the number of home care packages and the resources available.

nClear lines of responsibility and accountability.

nSustained focus on detailed delivery plans.

nAnd a “rigorous” review of the schemes available.

Releasing the findings, NESF chairperson Dr Maureen Gaffney said it was vital the concerns were taken on board by those in control of the service.

“The home care package policy was, like many public service policies in Ireland, well designed but shows unnecessary weaknesses in its implementation.

“The connection between the national policy, decision-making and local working practices is poor,” she said.

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