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LCQ9: Elder abuse in elderly homes
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     Following is a question by the Hon Wong Kwok-kin and a written reply by the Secretary for Labour and Welfare, Mr Matthew Cheung Kin-chung, in the Legislative Council today (January 6):

Question:

     A spate of cases of residents of residential care homes for the elderly (RCHEs) being abused have occurred in recent years. In this connection, will the Government inform this Council:

(a) of the number of complaints received in each of the past three years by the authorities which involved residents of RCHEs being abused; the major types of such complaints; the respective numbers of subvented and private RCHEs as well as those which have participated in the Bought Place Scheme involved in such cases; among such cases, the numbers of those which had been substantiated, and whether the authorities had imposed penalties on such RCHEs; if so, of the details; if not, the reasons for that;

(b) given that elder abuse cases have still occurred from time to time, whether the authorities will review afresh in what aspects the regulatory system for RCHEs are inadequate and adopt improvement measures; and

(c) whether the authorities will request the various types of RCHEs to employ additional staff so as to improve the staff-to-resident ratio, with a view to upgrading the quality of services and reducing the occurrence of elder abuse cases?

Reply:

President,

(a) During the period from January 2007 to the end of December 2009, the Social Welfare Department (SWD) received six complaints relating to suspected elder abuse in RCHEs.  All six complaints involved suspected cases of staff negligence or inappropriate care, causing injury to residents.  Among these complaints, one involved a subvented RCHE, two involved private RCHEs participating in the Enhanced Bought Place Scheme while the remaining three involved private RCHEs.

     Upon receipt of the above complaints, the Licensing Office of the Residential Care Homes for the Elderly (LORCHE) of SWD immediately arranged inspectors to conduct unannounced investigation at the concerned RCHEs, to inspect on-site the services provided by the RCHEs, review relevant records and interview the staff, residents and relatives concerned.  After investigation, three complaints were found substantiated, one was found not substantiated while the other two complaints were found not pursuable because only limited information could be collected and there was a lack of substantive evidence.  After concluding the investigations, LORCHE issued advice or warning to the RCHEs concerned.

(b) The Residential Care Homes (Elderly Persons) Ordinance (Cap 459) (the Ordinance) and the Residential Care Homes (Elderly Persons) Regulation (Cap 459A) (the Regulation), which came into full operation in June 1996, provide for the regulation of RCHEs through a licensing system administered by the Director of Social Welfare.  The licensing requirements cover aspects such as health, sanitation, staffing, safety, location, premises design, structure, equipment, fire precautions and size of RCHEs.

     LORCHE is responsible for enforcing the Ordinance to ensure compliance with the licensing requirements.  Every year, LORCHE conducts, on average, seven unannounced inspections of each RCHE.  These inspections are very comprehensive, covering aspects such as drug management, personal care services, infection control, handling of accidents, environmental hygiene, meals, staffing, social care, management, building safety and fire safety, etc.  Furthermore, LORCHE's inspectors will also interview elderly residents and their relatives in order to directly collect their feedback on the services provided by the RCHEs.  Apart from regular unannounced inspections, LORCHE will immediately inspect the RCHE concerned without prior announcement to conduct targeted investigation upon receipt of a complaint, as mentioned in the reply to part (a) above.

     As stipulated in the Regulation, RCHEs are also required to maintain a comprehensive set of service records, including elderly residents' health records, medication records, log book of daily happenings and records of accidents and deaths.  LORCHE's inspectors will examine these records during inspections and will, where appropriate, require the RCHEs to make necessary rectifications.  Depending on circumstances, LORCHE will also issue advice or warning to the RCHEs concerned, or even take prosecution action.

     Apart from monitoring RCHEs through licensing control, SWD has been encouraging elderly residents and their family members or carers to provide feedback on services of RCHEs.  The public may contact LORCHE or call SWD's 24-hour hotline if they are not satisfied with the services of RCHEs.  Indeed, the six complaints above were lodged with LORCHE by the public or family members of RCHE residents.  This reflects the effectiveness of the existing complaint mechanism.  SWD will review the current complaint mechanism from time to time, with a view to further improving the mechanism.

     In addition, the Visiting Health Teams of the Department of Health, the Community Geriatric Assessment Teams and the Community Nurses of the Hospital Authority have been referring cases to LORCHE for follow-up actions should they identify any problems in the delivery of care services in RCHEs.  Follow-up actions include inspection and supervision of the RCHEs concerned to carry out remedial action, as well as issuance of guidelines on topical issues, with a view to helping the whole RCHE sector enhance its service quality.

(c) On the issue of manpower ratio, Schedule 1 of the Regulation sets out the minimum staffing requirements of various types of RCHEs under the licensing system.  Nonetheless, RCHEs may, having regard to their individual situation and actual circumstances, increase their staffing provision so as to ensure smooth operation and provision of appropriate care to their elderly residents. According to information available to SWD, a significant number of RCHEs have a manpower ratio higher than the basic staffing requirements set out in the Regulation.

     Apart from stipulating the minimum staffing requirements, SWD has been providing support to RCHEs for enhancing their care capability and quality, including the provision of regular training and organisation of topical seminars for RCHE staff, as well as the issuance of guidelines on major aspects of care in the RCHE setting for their reference.  Furthermore, to alleviate the shortage of nurses in the welfare sector, SWD has been offering, since 2006, a two-year full-time programme to train enrolled nurses for the welfare sector with a view to further enhancing the care quality of RCHEs.

Ends/Wednesday, January 6, 2010
Issued at HKT 12:02

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