Call for means-testing criteria

National criteria for assessing the needs of older people in their homes, for means-testing them and for ensuring they are fairly getting the home-care they need must be implemented, the Chairman of the Carers Association has said.

Frank Goodwin was speaking following the publication today of a report from the National Economic and Social Forum (NESF) on the home-care scheme.

Titled Implementation of the Home Care Package Schemeit finds the scheme is implemented differently depending on which local health office is running it .

Home care packages (HCP) provide care in the home, mainly for older people who are at risk of admission to long-term care. A HCP can include nursing care, home-help and/or various services such as chiropody and occupational therapy.

The scheme was established in 2006 and was in 2008 allocated a budget of €120 million, allowing about 8,000 people at a time to benefit from it.

Chairperson of the NESF, Dr Maureen Gaffney, speaking at the publication, said the scheme was well designed "but shows unnecessary weaknesses in its implementation".

"The connection between the national policy, decision making and local work practices is poor."

She said the report revealed a lack of clarity about accountability, slow decision making and a weak focus on learning.

Among its findings are that national guidelines on implementing the scheme have not been been put into action "leading to area-based inequities and inconsistencies" for clients, and there are differences in the eligibility criteria used to allocate HCP funding.

While some local health offices means-test based on income alone, others take account of savings and assets as well.

There are also substantial variations in the budgets local health offices have for the packages, with for example an office in Wicklow having about €92 per week for a person over 65 or older seeking a HCP while the Dublin North Central office has a budget of about €552 per person over 65, per week.

Mr Goodwin said the HCPs had brought great assistance to a lot of people and were much needed, but added: "There is great concern at the lack of a national standardised needs assessment system", which he said would remove much confusion. "There seems to be a plethora of criteria and we really could do with integrated national guidelines."

He also described as "very worrying" the apparent inconsistencies in vetting people to work as care providers in people's homes.

"We employ carers to work in people's homes and all our staff are Garda vetted. There is a great surge in demand for these kinds of services, for vulnerable people in their homes, and I think the private firms providing these services would like guidelines on vetting too."

Gerry Scully, spokesman for Age Action Ireland, praised the scheme but called for it to be made "truly national, properly resourced and administered".

He called for national eligibility criteria and continuous monitoring of the scheme to ensure resources were being distributed fairly.

A spokeswoman for the Taoiseach's office welcomed the report saying the Government noted it.