Press Release

Minister Brady publishes report on Evaluation of Home Care Packages

Áine Brady, T.D., Minister for Older People, today (03 December, 2009) published a report by PA Consulting Group on the Home Care Package Initiative operated by the Health Service Executive (HSE).

The independent Evaluation has found that the Health Service Executive was successful in implementing the policy vision to make HCPs a viable option to support a highly dependent cohort. It indicates, for example, that the majority of HCP recipients are over age 75 years and that around 80% of those surveyed had a medical card. All the objectives of Home Care Packages are being met to varying degrees of success. For example while packages are strong in supporting older people to live at home and in preventing inappropriate admission to residential care, improvement could occur to relieve pressures on certain acute hospitals around the country. A positive finding of the report was that the majority of the 300 posts filled around the country to underpin the Initiative involved Nursing, Therapy or related front line staff.

There are over 20 recommendations in the report to improve this service in the future. These revolve around the need for the HSE to standardise various aspects of planning and delivery, and that management and financial information systems are developed to better support existing HCP provision. The Executive is already working on implementing the key recommendations from the report and is in on-going discussions on these with the Department of Health and Children. Producing national standardised guidelines for the operation of the Home Care Package Scheme is a priority for the Executive in this context. The HSE is also finalising work in relation to the development of Home Care Quality Guidelines, and in relation to Home Help/Support services, which it has been working on with voluntary and private providers and will introduce these as a key component of service delivery in 2010

Minister Brady indicated that “a priority for me as Minister for Older People is to ensure that the improvements recommended in this report are undertaken in 2010 by the HSE. A main feature of Government policy in recent years has been to develop services to allow older people to remain living at home and in their communities for as long as possible. Where this is not feasible, older people should have access to quality, affordable long-term residential care. This evaluation, which gives effect to a recommendation of the Long Term Care Working Group and a Government commitment under “Towards 2016”, reaches a number of important conclusions on how the HSE has rolled out the Home Care Package Initiative.”

HCPs, first introduced in 2006, are packages of care tailored to the needs of individuals whose needs cannot be met by mainstream Primary, Community and Continuing Care (PCCC) services. They could range from some therapy and nursing support for a few weeks after a hospital stay to ongoing, daily visits from a home care assistant to help the client get out of bed, washed and dressed. HCPs can include a variety of services, such as public health nursing, day care, occupational therapy, physiotherapy, home help, home care and respite care, that are shaped around each client’s individual needs. HCPs can either be provided through a cash grant, which the recipient can use to purchase the care and support they need or through the organisation of care services by the HSE

Home Care Packages (HCPs), are enhanced supports over and above existing mainstream community services, with the objective of maintaining older people at home and in their communities. They are also targeted towards those at risk of inappropriate admission to long-term care or acute hospitals, or those who require discharge home from acute hospital. At present, the HSE provides in the region of €120 million per annum to cater for approximately 8,700 clients at any one time, or around 11,500 over the course of a full year.

This Evaluation was overseen by a Steering Committee representative of the Department of Health and Children; the Department of Finance; the Department of Social and Family Affairs, and the HSE. Services at HSE national and local levels, including a sample of 1,000  anonymised case files in eight different Local Health Offices (LHOs), were examined in depth. These local offices ranged from three in Dublin, to South Lee in Cork, Kerry, Galway, Laois/Offaly and Donegal.

View the report here