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Following is a question by Dr Hon Elizabeth Quat and a written reply by the Secretary for Labour and Welfare, Mr Matthew Cheung Kin-chung, in the Legislative Council today (June 17):
Question:
It has recently been uncovered by the press that the staff of a private residential care home for the elderly (RCHE) in Tai Po frequently gathered a group of female residents who lacked self-care skills on the outdoor podium of the RCHE, and stripped them of all their clothes for bathing them in turn. There are comments that since the residents of the surrounding buildings could see the naked residents on the podium, such an act is in total disregard of the dignity of the residents and reflects the authorities' improper supervision of RCHEs. In this connection, will the Government inform this Council:
(1) whether it has studied why the staff members of the Social Welfare Department (SWD) all failed to discover the aforesaid situation during their numerous inspections of the aforesaid RCHE in the past; whether the authorities will review the existing mechanism for inspecting RCHEs; if they will, of the details; if not, the reasons for that;
(2) as the aforesaid RCHE reportedly converted part of its premises into a supermarket early this year, thus allegedly contravening the licensing conditions for RCHEs, whether the staff members of SWD discovered this situation during their inspections of the RCHE; if they did not, of the reasons for that;
(3) whether it will review if the provisions of the Residential Care Homes (Elderly Persons) Ordinance (Cap. 459) and the Code of Practice for Residential Care Homes (Elderly Persons) regarding the manpower ratios, area of floor space per resident, the service needs of the elderly persons, as well as the methods for regulating RCHEs and the relevant penalties are outdated, and amend the outdated provisions; if it will, of the details; if not, the reasons for that;
(4) whether it will consider establishing an official accreditation system for the service quality of RCHEs and making public the results of such accreditation for the reference of the public in their selection of RCHEs; if it will, of the details; if not, the reasons for that;
(5) whether it will consider introducing a demerit points system for RCHEs and formulating corresponding penalties, so as to step up the deterrent effect against contraventions; if it will, of the details; if not, the reasons for that;
(6) as some members of the social welfare sector have pointed out that the service quality of quite a number of RCHEs has declined due to manpower shortage, yet SWD is unable to supervise RCHEs properly due to the shortage of inspection staff, of the authorities' measures to resolve this problem; whether the authorities have plans to attract young people to join the elderly care industry; if they do, of the estimated number of young people joining the industry in the coming three years;
(7) of the number of people currently waiting for places in subsidised RCHEs; and
(8) as the supply of places in subsidised RCHEs is unable to meet demand but there are surplus places in private RCHEs, whether the authorities will allocate more resources to increase the number of places in subsidised RCHEs and enhance the services of day care centres for the elderly, so as to enable more elderly persons to lead a comfortable life in their twilight years; if they will, of the details; if not, the reasons for that?
Reply:
My reply to the question raised by Dr Hon Elizabeth Quat is as follows:
(1) The Licensing Office of Residential Care Homes for the Elderly (LORCHE) of the Social Welfare Department (SWD) adopts a risk-based approach in conducting inspections on residential care homes for the elderly (RCHEs) and accords priority to inspect RCHEs under complaints for follow-ups. All inspections are of a surprise nature and prior notification will not be given to RCHEs by whatever means so as to continuously monitor compliance by RCHEs with the licensing requirements. LORCHE inspectorate officers will conduct audit checks on randomly selected RCHEs to ensure inspection quality. The Government has taken note of the suggestions from the public on how to strengthen the monitoring of RCHEs. At this stage, the Government keeps an open mind and will review the monitoring mechanism for RCHEs under the existing legal framework with a view to improving the service standards of RCHEs.
(2) SWD received in February 2015 an application from the RCHE concerned to revise the layout plan by excluding part of the licensing area. As the application has not yet been approved, the area under application is still considered part of the RCHE. SWD found that the RCHE had operated a shop for public patronage within the licensing area. In accordance with the Residential Care Homes (Elderly Persons) Ordinance (the Ordinance), SWD issued, on June 4, 2015, a notice to the RCHE to give direction to discontinue the operation of the shop immediately. During LORCHE's inspection to the RCHE on June 5, 2015, it was found that the shop had ceased operation. LORCHE will continue to closely monitor the RCHE.
(3) At present, the Ordinance and the relevant Code of Practice for Residential Care Homes (Elderly Persons) (the Code) set out the requirements on manpower, the minimum area of floor space required for each resident, etc., in an RCHE. Amending the Ordinance entails many complicated issues. The Government will take into account various considerations as well as views from the stakeholders, including the discussion with the sector (such as operators of private and subvented RCHEs), the Elderly Commission, relevant professionals/academia, interest groups, etc. Meanwhile, the Government will examine the mechanisms under the existing legal framework to strengthen the monitoring of RCHEs and enhance the service standards of RCHEs.
(4) The Government has all along been encouraging RCHEs to actively join independent service quality accreditation schemes. At present, the Residential Aged Care Accreditation Scheme (RACAS) launched by the Hong Kong Association of Gerontology (HKAG), the Quality Elderly Service Scheme launched by the Hong Kong Health Care Federation with the support of the Hong Kong Productivity Council, and the Service Quality Management Certification Scheme – Elderly Service launched by the Hong Kong Quality Assurance Agency provide accreditation services for voluntary participation of RCHEs. SWD, in selecting private RCHEs for participation in the Enhanced Bought Place Scheme, has accorded higher scores for those homes which have participated and been accredited under the relevant service quality accreditation schemes for management and service quality enhancement. Since March 2012, SWD has uploaded the information on voluntary participation of accreditation schemes by private RCHEs onto its Homepage for public perusal.
With the support of SWD, the Hong Kong Accreditation Service of the Innovation and Technology Commission launched in June 2013 the service for accreditation of certification bodies for certification of management system of Residential Care Home (Elderly Persons) Service Providers under its Hong Kong Certification Body Accreditation Scheme (HKCAS). Such service provides objective criteria in accordance with international standards for certification of accreditation bodies. RACAS of HKAG was granted the accreditation of HKCAS in June 2014.
(5) The Government has taken note of the suggestions from various sectors on how to strengthen the monitoring of RCHEs, such as a demerit point system, etc. The Government at this stage adopts an open mind in examining different options.
(6) To alleviate the shortage of nurses in the welfare sector, SWD has since 2006 collaborated with the Hospital Authority in organising a two-year Enrolled Nurse (EN) (General)/EN (Psychiatric) Training Programme. Altogether 14 training classes have been organised so far, providing a total of about 1 800 training places. Another 920 training places will be provided in the coming years. The training programme is fully subsidised by the Government. The trainees are required to sign an undertaking to work in the welfare sector for two consecutive years after graduation. Among the graduates of the first nine classes, over 90 per cent have joined the social welfare sector after graduation.
To encourage young persons to join the elderly long-term care service sector, the Government launched in 2013 a "first-hire-then-train" pilot project (the Pilot Project) with an allocation from the Lotteries Fund. Young persons were recruited to take up care work in RCHEs. The Pilot Project was implemented in two phases, providing a total of 200 training places. Given the positive response to the Pilot Project, the Government has earmarked $147 million for the Navigation Scheme for Young Persons in Care Services (the Scheme) to be launched and extended it to cover also rehabilitation services, providing a total of 1 000 places in the coming few years. SWD invited non-governmental organisations to submit proposals on the implementation of the Scheme during the period of February to April 2015. Upon confirmation of the operating agencies, enrolment of the first batch of trainees is expected to commence in the third quarter of 2015.
To enhance the service standards of RCHEs, the Government will examine the mechanisms under the existing legal framework to strengthen the monitoring of RCHEs. The Government will also review the manpower provision of LORCHE to facilitate appropriate monitoring of RCHEs.
(7) As at end-April 2015, there were 31 137 elderly persons on the waiting list for subsidised residential care places. The figure did not include the 8 098 elderly persons who were classified as inactive cases.
(8) SWD strives to provide a variety of subsidised community care services to help frail elderly persons age in place. Among these are day care services and home care services, which cover personal and nursing care, rehabilitation exercise, meal, escort service, etc. While most elderly persons prefer ageing in the community, some frail elderly persons will still need residential care.
The Government is striving to adopt a multi-pronged approach to increase the provision of subsidised community care services and subsidised residential care places for the elderly. In the short run, the Government will purchase places from self-financing RCHEs through the Nursing Home Place Purchase Scheme and make better use of space in subvented and contract RCHEs for the provision of more residential care places for the elderly. In the medium term, the Government will build new contract RCHEs to increase the number of subsidised places, particularly places providing a higher nursing care level. In this regard, SWD has earmarked sites for the construction of new contract RCHEs, and Day Care Centres for the Elderly/Day Care Units for the Elderly. In the long run, the Government will continue to identify suitable sites for new RCHEs, as well as to explore the feasibility of incorporating residential care facilities for the elderly into redevelopment projects and converting vacant buildings (including vacant schools) into RCHEs.
In the meantime, the Government is actively implementing the Special Scheme on Privately Owned Sites for Welfare Uses (Special Scheme). More than 40 non-governmental organisations have submitted over 60 applications in total. Based on the rough estimates of the participating organisations, if the preliminary proposals received under the Special Scheme could be implemented smoothly, about 9 000 new places for elderly services would be provided, including about 2 000 day care places and about 7 000 residential care places for the elderly. This would relieve the pressure on service demand and shorten the waiting time for service.
Ends/Wednesday, June 17, 2015
Issued at HKT 12:55
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