LCQ11: Monitoring residential care homes for persons with disabilities

     Following is a question by Dr the Hon Fernando Cheung and a written reply by the Secretary for Labour and Welfare, Mr Matthew Cheung Kin-chung, in the Legislative Council today (February 17):


     It has been reported that in recent months, a spate of incidents occurred in which staff of residential care homes for persons with disabilities (RCHDs) had allegedly abused RCHD residents. There are comments that as quite a number of RCHD residents have communication and mobility disabilities, it is hard for them to resist or report the abuse inflicted on them. As such, the Government should step up regulation of RCHDs so as to safeguard the rights and interests of persons with disabilities (PWDs). In this connection, will the Government inform this Council:

(1) given that the Residential Care Homes (Persons with Disabilities) Ordinance (Cap. 613) stipulates that unless with a certificate of exemption (CoE) which is for the time being in force issued under that Ordinance or the Residential Care Homes (Elderly Persons) Ordinance (Cap. 459), a person must not operate, keep, manage or in any other way have control of a residential care home for PWDs otherwise than under a licence for the time being in force, of the respective numbers of RCHDs which are currently issued with a licence and a CoE, with a breakdown by their mode of operation (i.e. government-subvented, self-financing and private); a breakdown of the number of the RCHDs concerned by validity period of CoE (i.e. of 12 months or less, more than 12 months to 24 months and more than 24 months);

(2) whether it has drawn up a target timetable for the transition of all RCHDs operating with CoEs to licensed RCHDs, and what new measures are in place to help the RCHDs concerned to meet the licensing requirements;

(3) of the number of inspections conducted on RCHDs by the authorities since the full implementation of Cap. 613 on 10 June 2013, and the number of cases of contravention so uncovered (with a breakdown by type of contraventions), as well as the punishments imposed on those RCHDs which had contravened the Ordinance;

(4) whether it will require RCHDs to provide recognised training courses for their staff of various ranks and introduce a registration system for staff of RCHDs, so that RCHD staff will comply with specified work ethics and their services will meet a specified quality; whether it will improve the grade structure for staff of RCHDs to provide an advancement ladder so as to retain talents; and

(5) whether it has any new measures in place to step up the regulation of RCHDs, so as to raise the service quality of RCHDs and prevent the occurrence of similar incidents of abuse of RCHD residents?



     My reply to the questions raised by Dr the Hon Fernando Cheung is as follows:

(1) As at February 1, 2016, there were a total of 312 residential care homes for persons with disabilities (RCHDs). The number of RCHDs issued with licences and Certificates of Exemption (CoEs) and the validity period of the CoEs are listed in the Annex.

(2) The Social Welfare Department (SWD) has been assisting and encouraging the RCHDs in meeting the requirements as laid down in the Residential Care Homes (Persons with Disabilities) Ordinance (the RCHD Ordinance) through a number of measures. A total of $52 million has been allocated from the Lotteries Fund to assist the subvented and self-financing RCHDs in carrying out improvement works for compliance with the licensing requirements on building and fire safety. In addition, $39 million has been allocated from the Lotteries Fund to launch the Financial Assistance Scheme to provide financial assistance to private RCHDs issued with CoEs for carrying out improvement works so as to meet the licensing requirements. Eligible private RCHDs can receive a maximum grant of up to 60 per cent of the recognised cost of the improvement works. On the other hand, through the Bought Place Scheme, the SWD encourages private RCHDs to upgrade their service standards in order to meet licensing requirements while at the same time providing additional places for rehabilitation services. The SWD will continue to maintain close liaison with RCHDs to examine the feasible options and measures of their improvement works, so as to assist them in meeting the licensing requirements and standards as soon as possible.

(3) The Licensing Office of Residential Care Homes for Persons with Disabilities (LORCHD) of the SWD comprises four multi-professional inspectorate teams, which conduct surprise inspections at RCHDs to check building safety, fire safety, health care and home management, so as to ensure compliance with the statutory requirements on staffing, space and layout, building structure, safety measures and quality of care, etc. If the RCHDs are found to have failed in complying with licensing requirements during inspections, the LORCHD would give comments, advice or warnings as appropriate, requiring the RCHDs to make corresponding improvements within a specific time frame.

     Since the full operation of the RCHD Ordinance on June 10, 2013 to end-January 2016, the LORCHD has conducted 5 430 surprise inspections and issued over 1 160 advisory letters and two warning letters. The RCHD operators and managers receiving advisory and warning letters took follow up actions and improvement measures in accordance with the issues raised in the letters actively. The LORCHD follows a set of stringent standards in vetting CoEs and would take into consideration the service performance of the RCHDs and their progress of improvement measures taken when considering the applications for extensions and the validity period of CoEs.

(4) Under the Service Performance Monitoring System (SPMS) of the SWD, non-governmental organisations (NGOs) operating subvented services shall put in place an induction policy and procedures for new staff, a training policy and a plan for staff training and development, provide on-going supervision and conduct regular performance reviews or appraisal for identifying areas requiring improvement and needs for on-going training and development in accordance with the Service Quality Standard (SQS) under the SPMS. Apart from flexible deployment of the allocated subvention under the Lump Sum Grant Subvention System, NGOs may seek funding from the $1 billion Social Welfare Development Fund to provide training for staff.

     To enhance the skills of RCHD staff in taking care of persons with disabilities and encourage existing RCHD staff to enrol in health worker training courses (HWTCs), the SWD has invited various training institutes, including the Employees Retraining Board, to organise a series of HWTCs suitable for RCHDs in accordance with relevant requirements. As at end-January 2016, over 2 500 health workers have completed the HWTCs and registered under the Residential Care Homes (Persons with Disabilities) Regulation.

     In addition, the SWD, in collaboration with the Department of Health and relevant professionals, has been organising training programmes for RCHD staff on a regular basis, covering subjects such as infection control, management of psychotropic drugs, understanding of the behavioural problems of persons with disabilities, etc. About 800 RCHD staff participated in these training programmes annually. To encourage staff working in rehabilitation services, including the staff of RCHDs, to enhance their skills and knowledge with a view to providing higher quality services to persons with disabilities, the SWD commissioned the School of Continuing and Professional Education of the City University of Hong Kong to run six classes of in-service Certificate Training Course for Rehabilitation Personnel Working for Persons with Intellectual Disability and in-service Diploma Training Course for Rehabilitation Personnel Working for Persons with Intellectual Disability in 2011-2015. Around 230 staff attended these training courses. The SWD is planning to organise similar courses in 2016-17.

(5) The SWD has been monitoring the service quality of the subvented organisations. NGOs are required to properly manage their service units to ensure that their subvented services are in conformity with the requirements of the SWD's Funding and Service Agreement (FSA). These requirements include the Essential Service Requirements, Output/Outcome Standards and the SQSs. The subvented organisations are required to comply with the relevant SQSs, including taking all reasonable steps to provide a safe and protected environment for service users and ensure that their privacy and dignity are being respected.

     The Director of Social Welfare issued the Code of Practice for Residential Care Homes (Persons with Disabilities) (CoP for RCHDs) with the powers conferred by the RCHD Ordinance, setting out the principles, procedures, guidelines and standards for the operation, management and other control of RCHDs. In addition to routine inspections to RCHDs, the LORCHD would adjust the frequency of inspections and increase the number of inspections to some RCHDs having regard to the service performance and the risk levels of individual RCHDs. Inspectors would monitor the service quality of RCHDs through various means, including the collection of views of residents and their family members during inspections. To enhance the monitoring and upgrade the service quality of RCHDs, the SWD has also established a notification mechanism with the Department of Health and the Hospital Authority for early identification of and follow-up on problem areas of RCHDs, organising or promoting various training programmes for the staff of RCHDs, issuing guidelines to RCHDs as necessary for assisting them in improving their management of operation and services, and handling complaints with guidance and advice being rendered to RCHDs as and when required.

     Regarding the recent incidents of improper treatment of residents by the staff of RCHDs, apart from issuing letters to the organisations concerned requiring them to make improvement, the SWD issued letters to all subvented organisations, requiring them to enhance their training of frontline staff and remind their staff to adhere to professional ethics when taking care of persons with disabilities for safeguarding the well-being of service users. Subvented organisations are also required to strictly comply with the CoP for RCHDs and the FSA. The LORCHD will continue to conduct regular surprise inspections to all RCHDs to monitor whether they are operating in accordance with statutory requirements. Moreover, the SWD will comprehensively strengthen the monitoring of residential care homes for persons with disabilities and those for the elderly in 2016-17. Measures include enhancing inspection and supervision, improving the regulatory mechanism and promoting staff training.

Ends/Wednesday, February 17, 2016
Issued at HKT 14:46