The Statutory Home Support Scheme Progress Report 2024
HCCI report examines 3-year delay to Statutory Home Support Scheme
Unpublished independent report casts doubt on suitability of interRAI assessment for home care needs and HSE’s commitment to the Statutory Scheme
Dublin, 11th June 2024: A Home & Community Care Ireland (HCCI) progress report on the Statutory Home Support Scheme highlights why the Scheme has been delayed by three years and shows little prospect of the Scheme being implemented soon. The HCCI report includes an analysis of an independent evaluation into the HSE’s trial of the ‘interRAI single assessment tool’ which casts serious doubt on the usability of interRAI for assessing home care support.
The previously unpublished evaluation report by the Centre of Effective Services (CES) examines the performance of four pilot schemes of the interRAI single assessment tool. interRAI is intended to support the development of the Statutory Home Support Scheme by ensuring that assessments and allocation of hours are standardised across the country. The CES Evaluation Report highlights regional variations in the allocation and delivery of home care and sheds light on barriers to the rollout of interRAI assessment tool. The report’s findings include:
- significant variations in the length of time between receipt of an application and approval of home care – ranging from 1.5 weeks in one CHO to 8.5 weeks in another CHO and significant variations in the average hours allocated to a client – ranging from 5.7 hours to 9.4 hours and further variations in the average hours delivered – ranging from 2.2 hours to 6.7 hours.
- a lack of buy-in to using interRAI from HSE medical professionals.
- interRAI assessments are considered too lengthy, taking 90 minutes followed by four to five hours of administrative follow up. This makes the tool particularly challenging in acute and palliative settings.
- Most troubling is that interRAI did not lead to a standardised allocation of home care hours despite the fact that fairness in accessing home care support is the key aim of using such a single assessment tool nationwide.
HCCI’s progress report highlights factors that have led to the Statutory Home Support Scheme being delayed by three years and shows that we are no closer to implementation than when this Government took office. HCCI’s report argues that a lack of buy-in from the HSE is the key inhibitor to the development and implementation of the Scheme.
Joseph Musgrave, CEO, HCCI said “The interRAI pilot was half-baked; understaffed with insufficient training and preparation. There is an ongoing failure in HSE leadership to drive the use of interRAI by assessors and primary care teams, and deliver the cultural change necessary for the Statutory Scheme to happen. It is very concerning, but unsurprising, that the HSE has attempted to hide themselves from scrutiny by sitting on this report for nearly a year. This progress report raises serious questions about transparency and accountability.
“It is an indictment on the HSE that it has failed to properly test interRAI, open a National Home Support Office, recruit assessors or upgrade their IT systems despite having funding to do so for the last three years. All we get from the Government is rehashed updates and timelines that have been consistently missed without any explanation. This report reveals outright resistance from parts of the HSE to developing a fair Statutory Home Support Scheme.”
“We should remember the original purpose of the Statutory Scheme was to introduce a transformative new social scheme to enable people remain living in their homes and communities. Discussion in 2017-2019 focussed on ways to fund home care and give people a legal right to home care but somehow, in recent years, these big ideas have been forgotten and we are mired in a bureaucratic nightmare of technicalities and regulations development.
“The current system is unfair; where a person lives is more a predicator of how much home care support they receive instead of their actual home care support needs. We will continue to have an unfair system until the home care assessment and interpretation process is consistent and every home care support assessor is using the same assessment tool. Without a fair, transparent and user-friendly assessment tool we won’t have a usable and equitable Statutory Home Support Scheme.”
HCCI’s report shows deadlines for the development of the home support scheme have been consistently missed and are rarely given anymore. HCCI’s paper suggests a number of reasons for the delays including lack of ‘buy-in’ from the HSE to the Statutory Scheme, suitability of the interRAI Single Assessment Tool, shifting political priorities, lack of wider Government support, staffing in the Department of Health, recruitment issues in the care sector and the Covid-19 Pandemic.
This CES report into the pilot scheme was delivered to the HSE in Summer 2023, who have not published it. HCCI have received a copy through a freedom of information request.
ENDS//
For further information:
Louise Cassidy 086 383 5727 louise@ckcomms.ie
Claire Keane 087 121 4140 claire@ckcomms.ie
Editor’s notes:
- According to the HSE, interRAI is used so that all older people are assessed for Home Support or Long Term Care the same way, using the best assessment available. The assessment will also be used for care planning. It shows opportunities for improvement and potential areas of decline in health. It also helps to gather an individual’s relevant health information in one place so that the information can be shared between hospital and community settings.
- HCCI received the CES report from the HSE through a Freedom of Information request. The HSE had redacted most of the report, however, HCCI found that it was incorrectly redacted and so could access the document in its entirety.
About HCCI:
HCCI is the representative body for the home care sector. It currently represents 32 member companies (with 100 offices nationwide) who among them employ 12,000 carers and provide a managed home care service to over 20,000 older and vulnerable people in Ireland. HCCI advocates for the highest standard of regulated home care services to be made available to all on a statutory basis, enabling as many people as possible to remain living independently within their homes and communities.
About the Report:
This report provides a comprehensive overview on the progress made on developing and implementing the Statutory Home Support Scheme. The report uses Oireachtas statements, media reports, public consultations and relevant stakeholder publications to highlight the motivations, challenges and delays to the progress of the Statutory Scheme. The report examines the progress made between 2016 to 2024 and offers an analysis of the factors that have led to significant delays in developing the Scheme.
Importantly, this report offers an analysis of an independent report which examines the performance of four pilots of the interRAI single assessment tool intended to support the development of the Statutory Scheme. This report, completed by the Centre of Effective Services, was delivered to the HSE in Summer 2023, who have not published it. HCCI have received a copy through a freedom of information request.
