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LCQ18: Residential care homes
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    Following is a written reply by the Secretary for Labour and Welfare, Mr Matthew Cheung Kin-chung, to a question by the Hon Lau Kong-wah on residential care homes in the Legislative Council today (December 12):

Question :

     Regarding the health of elderly residents in residential care homes for the elderly (¡§RCHEs¡¨), will the Government inform this Council whether:

(a) it knows the number of cases of elderly residents in RCHEs contracting diseases in the past two years, broken down by type of disease contracted;

(b) it has assessed if the occurrence of such cases was related to the hygiene conditions of RCHEs; if it is assessed so, of the number of licensed RCHEs involved in such cases last year, as well as the follow-up actions taken by the department(s) concerned on the hygiene problems of RCHEs; and

(c) additional manpower will be deployed to combat RCHEs operating illegally with poor hygiene conditions, in order to safeguard the health of the elderly?

Answer :

Madam President,

(a) In accordance with Section 18 of the Residential Care Homes (Elderly Persons) Regulation (Subsidiary Legislation of Cap 459 of the Laws of Hong Kong), if a home manager suspects or knows of a case of statutorily notifiable infectious disease amongst the residents or staff of a residential care home for the elderly (RCHE) or suspects or knows that any such person has been in contact with a case of relevant infectious disease, he shall immediately so report to the Centre for Health Protection (CHP) in accordance with the Prevention of the Spread of Infectious Diseases Regulations (Subsidiary Legislation B of Cap 141 of the Laws of Hong Kong) and report to the Licensing Office of Residential Care Homes for the Elderly (LORCHE) of the Social Welfare Department (SWD). At present, there are 32 statutorily notifiable infectious diseases.

     Apart from the aforesaid statutorily notifiable diseases, in the event of an outbreak or suspected outbreak of an infectious disease e.g. acute respiratory tract infection or scabies, among staff or residents, which by the nature of communal living in the RCHE warrants special attention of CHP, the home manager/Infection Control Officer should, in accordance with the Code of Practice for Residential Care Homes (Elderly Persons) (October 2005 Revised Edition), report the case to CHP as well as LORCHE.  

     According to the information provided by CHP, the number of elderly residents in RCHEs who contracted the aforesaid infectious diseases in the past two years is as follows ¡V

¡@                       Year of Notification
                        2006             2007
                                       (As of end
                                        Nov 2007)
Infectious        No. of   No. of   No. of   No. of
Diseases          Cases    Elders   Cases    Elders
¡@¡@¡@¡@¡@¡@¡@¡@  in RCHEs Affected in RCHEs Affected

Statutorily Notifiable Diseases
-------------------------------
Community-associated     0        0         1       1
 methicillin-resistant
 staphylococcus aureus
 infection
Tuberculosis           360      360       356     356
Viral hepatitis          1        1         0       0
Food poisoning*          2       34         0       0

Other Infectious Diseases
-------------------------
Human myiasis           11       11         5       5
Acute respiratory       49      355       173     999
 tract infection*
Acute gastroenteritis* 218    2 231        73     681
Scabies*               105      467        73     263
Others*                  3       28         7      44

Total                  749    3 487       688   2 349

     The number of cases refers to the number of outbreaks; others refer to individual cases.

     SWD and CHP do not have relevant information on other diseases contracted by RCHE residents or staff.  


(b) RCHEs are places of communal living. If stringent infection control measures are not in place, the spread of infectious diseases within RCHEs is possible when there is infection in the homes.  It is therefore essential to ensure the personal hygiene of elderly residents and staff members as well as the environmental hygiene in order to minimize the outbreak of infectious diseases in RCHEs.

     The Administration attaches great importance to the ability of RCHEs in controlling infectious diseases and requires that all RCHEs must have an Infection Control Officer to coordinate and oversee matters related to infection control and the prevention of infectious diseases.  Besides, the Department of Health (DH) has issued Guidelines on the Prevention of Communicable Diseases in RCHEs for reference by RCHEs. DH¡¦s Visiting Health Teams (VHTs) will pay regular visits to RCHEs to provide on-site training and guidance. Apart from that, VHTs have since 2003 conducted annual infection control assessments in RCHEs.  If any room for improvement is identified in respect of infection control, DH will provide on-site guidance and will work closely with LORCHE to follow up the progress of enhancement work.

     When LORCHE notes any outbreak of infectious diseases in a RCHE, it will urge the RCHE to make immediate and corresponding improvements to its environmental hygiene. Besides, LORCHE will issue advice or warning to the relevant RCHE depending on the seriousness of the hygienic problems.

     As mentioned in (a) above, the number of cases of infectious diseases recorded in RCHEs in 2006 was 749 and a total of 3 487 elderly residents were affected. We are not able to provide figures on the number of RCHEs involved as we have not kept record of such information.

(c) SWD has been making strenuous efforts in combating the illegal operation of RCHEs. Apart from reporting by the public, the Social Welfare Offices in various districts and the VHTs of DH will inform LORCHE if they suspect that a RCHE is unlicensed.  

     If LORCHE is aware of any operation of unlicensed RCHEs, its Social Work Inspectorate Team will conduct surprised visits to the concerned RCHEs. If the case is substantiated, LORCHE will request the RCHE to decant all residents within a certain period of time. If necessary, SWD will assist the RCHE in decanting the residents to ensure the latter¡¦s well-being. If the home operator is found to continue operating the RCHE illegally, LORCHE will consult the Department of Justice whether to prosecute the RCHE in accordance with the Residential Care Homes (Elderly Persons) Ordinance.  

Ends/Wednesday, December 12, 2007
Issued at HKT 12:58

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