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LCQ8: Day care services for the elderly

     Following is an oral reply by the Secretary for Labour and Welfare, Mr Matthew Cheung Kin-chung, to a question by the Hon Leung Kwok-hung in the Legislative Council today (May 6):


     In reply to my question earlier, the Government advised that support had been provided to facilitate elderly people to age in the community, and as long as there was sufficient community care and support, elderly people who had long-term care needs could also age at home without the need to live in residential care homes for the elderly.  However, I have learnt that while the enrolment rates of various day care centres for the elderly (D/Es) in the 2008-2009 financial year have reached 110%, the Government has neither provided sufficient funding for the D/Es nor assisted them in acquiring more activity space to relieve the overcrowded situation.  In this connection, will the Government inform this Council:

(a) of the number of elderly people in each District Council district currently waiting for day care services and the average waiting time; whether the Government will publish such information on the government web site for information of the public; if it will, when it will be implemented; if not, of the reasons for that and whether there are secrets behind it;

(b) whether it has regularly assessed if the number of existing D/Es in each district is sufficient to meet the demand; if so, who is responsible for conducting such assessments, of the criteria adopted and frequency of conducting the assessments, and whether the assessment outcome is recorded; if the assessment outcome indicates that there are insufficient D/Es, why the Government has not allocated sufficient resources to improve the present situation; if no assessment has been conducted, of the reasons for that and whether it has reviewed if there is maladministration;

(c) whether the Government will, in the next three years, allocate the premises of the several dozens of primary and secondary schools which have ceased operation to non-governmental organisations for operating D/Es, and fully subsidise the costs of the conversion works and operating costs concerned; if it will, when it will be implemented; if not, of the reasons for that;

(d) among the current D/E users and those in each of the past ten years, of the respective numbers of demented elderly people and those suffering from severe level of impairment, and the respective percentages of the D/E places taken up by these two categories of elderly people; of the ten D/Es which admitted the highest numbers of these two categories of service users in 2008-2009; whether the Government will set up centres specialising in providing services for demented elderly people; if it will, when they will be set up; if not, of the reasons for that;

(e) of the respective ratios, as stipulated by the Government, of nurses, occupational therapists, physical therapists, social workers and personal care workers to the service places in each D/E; whether the Government will immediately allocate additional funds to improve such manpower ratios; and whether it will simplify the contents of the D/E schedule of accommodation so as to relieve the heavy workload of social workers; if it will, when it will be implemented; if not, of the reasons for that; and

(f) whether the additional elderly people taken in are covered in the current insurance policies taken out by the various D/Es; if so, whether they are fully protected under the insurance policies; if not, whether the Government will bear all the risks concerned; and whether it has assessed if the overcrowded situation in various D/Es at present has breached the Fire Services Ordinance (Cap. 95); if the assessment outcome is in the affirmative, of the solution to the problem?



     It is the wish of most elders to age in the community.  At present, the Government is providing a range of subsidised community care services (including home-based care services and centre-based day care services for the elderly) to facilitate elders with long-term care needs to age in the community with which they are familiar.

     Regarding day care services for the elderly, elders can choose between full-time or part-time services based on their own conditions and needs.  As such, the Social Welfare Department (SWD) has set the registered enrolment rate (i.e. the enrolment rate as mentioned in the question) of day care centres/units for the elderly (DEs/DCUs) at above 100%, with the average being 110%.  This is to encourage the centres to fully utilise their resources to serve more elders.  According to the statistics as at December 2008, the average daily enrolment rate of DEs/DCUs was about 90%.  Currently, there are about 2895 elders using day care services.

     My reply to individual parts of Hon Leung Kwok-hung's question is as follows:

(a) At present, the Standardised Care Need Assessment Management Office (Elderly Services) of SWD is responsible for coordinating applications for subsidised community care services (including day care services), conducting assessments and allocating services.  As at end-March 2009, there were a total of 1044 elders waiting for subsidised day care services.  The waiting time of different districts varies but is less than ten months in most districts, with an average of about 7.6 months.

     The waiting time for day care services for the elderly varies under different circumstances.  For instance, the waiting time will be directly affected by the number of places in individual DEs/DCUs made available through natural wastage, the number of waitlisted elders in the same district and the fact that some applicants may choose to wait for specific DEs/DCUs, etc.  Owing to the above factors, the number of waitlisted elders and waiting time of different districts often vary significantly.  

(b) The Labour and Welfare Bureau and SWD assess from time to time the elders' demand for subsidised day care services, and have been allocating resources to increase the provision of day care services for the elderly.  All relevant factors, including the existing service capacity in various districts, the number of waitlisted elders, the allocation of resources and the availability of suitable sites, etc will be taken into consideration.

     As a matter of fact, the Government has been increasing the allocation of resources on day care services for the elderly in recent years, with a view to facilitating elders to age in the community.  From 2007-08 to 2008-09, we have provided a total of 259 additional day care places for the elderly in Kwun Tong, Yuen Long, Eastern District, Shum Shui Po, Shatin, Tuen Mun and Kwai Tsing, bringing the total number of day care places to 2234, representing an increase of 13%. Besides, SWD will further provide 80 additional day care places for the elderly in 2009-10 through redeployment of internal resources, bringing the total number to 2314.  These additional places will be provided in Tsuen Wan, Southern District, Shum Shui Po and Tai Po; and will provide 40 additional places in two DCUs attached to contract residential care homes for the elderly (RCHEs) from now till 2011-12.  Besides, SWD has earmarked sites in six development projects for the construction of DCUs attached to contract RCHEs, with a view to further providing a total of 120 places.

(c) SWD will continue to identify suitable sites for the construction of DEs/DCUs throughout the territory, including exploring the feasibility of redeveloping primary and secondary school premises which have ceased operation, and in-situ expansion of existing DEs so as to serve more elders in need.  However, we must point out that the factors pertaining to site selection for DEs/DCUs are different from those for general community facilities.  Given that all the service users are frail elders, DEs/DCUs should be located on the ground floor or lower floors of a building in order to be easily accessible to the users.  Should they be located on lower floors, they should not be at a height over 24 metres above ground and should be accessible by lifts.  Proximity to open space or playground is also preferred.  Besides, SWD has specific requirements on the area of floor space and facilities of DEs/DCUs.  As such, not all primary and secondary school premises that have ceased operation can be redeveloped into DEs.

(d) The service targets of DEs/DCUs are frail elders of a moderate or severe impairment level, including those with cognitive impairment (eg those suffering from dementia).  As at end-March 2009, there were 2895 elders using day care services. Of these, 234 elders were assessed to be severely impaired under the standardised care need assessment, representing about 8% of the total number of day care service users.  SWD does not separately record the number of elders being severely impaired or demented in individual DEs/DCUs.

     In respect of the care for demented elders, SWD launched from 1999 to 2002 a three-year pilot on ˇ§Day Care Centres for Demented Elders and Dementia Units in Residential Care Homes for the Elderlyˇ¨.  A consultancy study was commissioned to evaluate the effectiveness of the pilot and to put forward recommendations on the long-term mode of service operation.  The consultancy report concluded that demented elders, like other frail elders with special care needs, should be served in an integrated manner whereby services are provided in a spectrum and in continuum to meet their care needs at different stages.  To better integrate the dementia care services into the mainstream services, SWD invited operators of DEs and that of the pilot day care centres for demented elders to participate in an in-situ expansion exercise in 2003.  Under the in-situ expansion exercise, SWD allocated additional resources to increase the number of places and strengthen the capability of the centres in caring for demented elders.

     SWD has also implemented various improvement measures in the past few years to provide better support for demented elders and their carers.  These measures included increasing the manpower, equipment and supplies for the care of demented elders, e.g. anti-wandering system and multi-sensory facilities, etc.  Moreover, day respite services were provided in all DEs to relieve the stress on carers.

     DEs/DCUs in various districts are providing services for frail elders, including demented elders.  The Government has no plan to set up DEs/DCUs designated for demented elders for the time being.

(e) Under the Lump Sum Grant (LSG) Subvention mechanism, non-governmental organisations (NGOs) can, according to their actual service needs, flexibly deploy the subvention under LSG to employ suitable staff for providing services in DEs/DCUs.  Also, the operators of DCUs attached to contract RCHEs can also flexibly deploy the contract sum to employ suitable staff for providing the services.

     SWD has also set a Schedule of Accommodation (SoA) for DEs/DCUs.  SoA lists out the area of floor space and equipment required in DEs/DCUs in light of the needs of the service users and those of staff members in respect of work, space and accommodation.

(f) NGOs or operators of contract services are required to take out insurance policies for public liability and employees compensation, as well as any other insurance policies pertaining to their contracts or other items that are regarded as necessary by the operators throughout the entire service or contract period.  The relevant insurance policies shall remain valid and be renewed upon expiry of the validity period.

     NGOs or operators are responsible for providing the insurers with adequate and accurate information, and have to abide by the terms and conditions of the insurance policies.

     DEs/DCUs premises shall comply with relevant fire safety legislations.  The operators should take all reasonable steps to ensure a safe environment for their staff and service users; provide and effectively maintain fire service installations and other necessary safety equipment; enhance the awareness of their staff and service users on the emergency response procedures and conduct fire drills regularly.

     As mentioned in (e) above, SWD has set the SoA for DEs/DCUs.  If the area of floor space of DEs/DCUs is below the standard set, SWD will, subject to the availability of resources and suitable premises, consider reprovisioning the concerned DEs/DCUs.

Ends/Wednesday, May 6, 2009
Issued at HKT 15:22


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