Brian Stanley: Home care under strain, calls for stronger supports

paula uh the debate around this is very important minister uh and i want to welcome uh generally welcome to home support providers bill 2025 uh you know legislation is important uh safeguards for users and for providers are important uh and obviously the care for the elderly and those with disabilities that it covers both that's that's really uh that's really the crux of this however you know there's issues around provision and there's standards as well that we need to uh that we need to have an eye on and the availability of of um of home help and home care hours uh what we do know is we have senses and we have them for a reason because it allows it allows the state to plan what's coming down the tracks and we know everyone knows that we have an increasing age profile in our population uh we will have by 2030 we'll have over a million people over the age of 66. in county leash we now have it's estimated between 13 and 14 000 people over that age uh if you go by the 2022 census uh there was 11 978 people over that age in 2022 and that's four years ago and we know that the population of the county overall has increased and certainly the population of the elderly in the county has increased rural isolation is a problem in leash uh we have big rural areas across the sleeve blooms and sleeve margie uh to the east and west and to the south of the county down onto ballick moore and places like that back across to errol and we know it's affecting loneliness is affecting mental health isolation is affecting health uh and is damaging to both mental health and physical health uh cases i've had a number of cases where there's a shortage of home care hours people are what's called waitlisted and they will get word that gesture you're entitled to it and we're granting hours but we're not in a position to provide them um and the emphasis has been minister and i have to say this to you because your party's been in power now for 15 years uh the emphasis has been on uh nursing home care private nursing home care but people in general in general people want to be at home nursing home should be a last resort uh and only if people really want that and if there's no if the level of care required requires them to be in a residence private nursing homes um you know have been the number one government option and they've mushroomed and we've seen the scandals in county leash in the residency for example around not too far from my own house we've seen the drumnean situation and there's more that's on foot that's an unfolding story we've seen difficulties in kilminchy lodge now some private nursing homes have been good and ballard lodge is one that unfortunately has been closed uh due to hickway but that was one of the ones where it was good good reports from there and good satisfaction from residents and families was being reported so we need to enable people to continue to live independently and to do that minister there's a few basic things you know having homes adopted to meet people's needs is obviously important you know and the county council and i want to uh pay tribute to the housing section of leash county council in my experience any money that comes and is matched by it's matched by the county council in terms of alterations or stair lifts and uh extensions and uh making a making a house wheelchair accessible that's really important the provision of daycare centers is important it's important that people go you know somewhere one day a week or two days a week uh where they have a meal with other people and to meet or to meet their contemporaries and they have a socialize have a social event etc it's really important the meals on wheels is very important you know that's the other part of it and but the most important thing is the home helps and those do it they're they're the four legs of the stool take away one of them and it'll heal over you know that's the best way of saying it to you we also recognize the right of the people to have a level of care in their own home and to continue living there all of these are far less expensive than nursing homes or acute hospitals and the preferred option of the majority and one particular problem want to highlight to your minister is that i get situations where people are being discharged from hospital uh but the home care package is not in place and i've had to intervene i remember one particular case i intervened in where an elderly woman was being sent home on the friday evening you know and there was absolutely nothing where she was going home to uh and the ambulance was on its way with her the ambulance was subsequently turned around and brought back she wouldn't have lived she wouldn't have survived over the weekend without the care you know and she hadn't got what she needed at home in her own home at that stage you know and that needs to there needs to be a proper joined up thinking between the hospital and the home care services and that needs to be sorted out and we need to be ensured that we have to set that we have the home care package that the person needs when they go home i also want to say to you the stopwatch approach you know that there's 15 minutes given for this and 15 minutes for that and you've half an hour and you've home helps racing around in rural areas and county leash you know sizeable rural county and you know i've outlined to some of the areas you know uh some of the extensive rural areas in the in the in the county and if you have people racing from one place to another they're not able to provide adequate care you know uh there's not time to carry out those tasks uh and that needs you know there needs to be a flexibility there for people to allow and how the home help or the home care workers are now being called to uh to provide that level of care a half an hour you'll do very little we all know if you try and do half an hour in your office and try and get something done you get very little done sometimes you mightn't deal with one issue could take an hour an hour and a half so home help going in to look after an elderly person we need to be mindful of that the other thing i want to say to you is about the quality of employment there's a shortage there's a labor shortage in that sector we still have a lot of people who are not not implied and under implied and i find it very frustrating that some of them aren't trained up to provide a level of care and i would say to you as well and i noticed from the time in the public accounts committee that direct hse employees are cheaper in the long run and in the short run than private companies yes there's private companies providing it or doing a good job you know but they uh there's only about there's less than 40% now being provided directly by the hse and that needs to be looked at and that needs to change um you know those directly implied by the hse have better terms and conditions and we need to make sure that that's upheld so the quality of jobs in the sector is really important it's important that all people have a proper living wage whether they're involved whether they're implied by the private or the public sector and travel times as well minister and travel costs in rural areas that needs to be looked after because you could have a person going to six seven or eight people in the day uh now it's also important that we have trained staffed and vetted staff because the safety and well-being of the service user has to be paramount but we need we need there's need for clarity regarding how home care will be funded you know because this is going to be we need to this is going to be there's a bill coming uh and we need to make sure that you know that this is uh that this can be paid for uh and that you know that the people who need it regardless of whether they can pay or not that that shouldn't prevent them from getting the home care just on the bill itself you know the overall provisions you know required in it are you know the registration which is a positive move for both the hse voluntary and private ones the having a chief inspector of social services and one of the things i noticed that in england you have a social services department and they're very local they're based in the local council areas which is very interesting and they organize home helps and home care and have huge powers here we don't have that and that's something i think that the state's going to have to look at how it's done is the big hse model the best model for doing it does that need to be separated i don't know i don't want to create another quango i'm not going to tell you to do that i'm on for reducing uh obviously a lot of these bodies are needed and i'm not going to get into the populist argument about doing away with pangos but i think the area of who provides it needs to be examined the regulation of providers and the minimum requirement and standards and that's really really really important um the inspections of of businesses and homes i mean the bill has provisions for this and private homes i think that you know that needs to be very sensitively handled uh as does the interviews with service users and home helps and plus their family now that could get into a real tricky area right and i think that you know without running away with ourselves i think we could see you know that would need to be handled in a very very careful way because you could get bogged down very easily in that but obviously it's important that there is interviews with the service users um the exemption for the providers with with four or less i just i'd urge caution on that i i'm not i'm not going to come down on it completely uh but i think it's an area that may need to be looked at um i know what you're trying to do you're trying to allow you don't have to do away with the informal pieces as there i think uh deputy ward's okay if i take another minute or two um i think that the um you know i think that the informal informal care what you're trying to cater for there i don't want to kill that off altogether and uh but i do think that it may need to be examined i'm not not totally sure about that so look it it makes sense to have informal arrangements so overall i want to welcome the bill um you've heard what i said in in regard to um you know the labor shortage that's directly related to the quality of the jobs uh the hse is the cheapest way that's been proven you know go look at the figures yourself you'll see it um you know i think the private providers are something like 30 the last i seen were 34 euros an hour uh or thereabouts that figure um that's two years ago now um i think the um i think what's important here is that we increase the number of people in it and one of the areas uh surely within that five percent that's unemployed at the moment that we can find some people in that within that grouping that can be trained up to provide care in their local communities we need to be able to keep this local you know a few people driving across the county from bally lining over to cameras or somewhere like that that's not going to work you need to be able to keep it within local areas it doesn't work other way for the home helps and i think i hope that you can look at that area thanks very much deputy warren