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The Assembly's Public Accounts Committee has recommended changes in domiciliary care for older people.
Care packages for older people must be tailored to meet individual needs, the Assembly’s Public Accounts Committee has said. It was responding to a report last October by the NI Audit Office
In its report Older People and Domiciliary Care the Assembly group argues that institutional care should be used only in cases where care at home is not a feasible option.
Read the full report here: http://www.niassembly.gov.uk/public/2007mandate/reports/report24_07_08r.htm
The vast majority of older people want to remain independent, in their own homes and in control of their own lives for as long as possible. If these objectives are to have a significant impact on the future development of care services for older people, the committee would expect to see a substantial shift in funding from institutional to domiciliary care,” says the report.
The committee is disappointed that good practice in trusts in the southern area has not been translated to other areas and recommends that the Department of Health, Social Services and Public Safety ensures that any good practice is rolled out across all boards and trusts promptly.
It voices alarm that the review of funding to boards based on their population and age profiles, carried out in 2004, has not yet been implemented and urges action on this.
Given the invaluable contribution of informal carers, it is sensible and cost-effective to take full account of their needs for respite care support, the PAC adds.
It also urges the Department to raise the status and esteem of the social care profession to prevent a shortfall in the standard and supply of domiciliary care services for older people.
More should also be done to improve links with the private and voluntary sectors and to encourage a full range of providers.
A system of regular, confidential and independent surveys of users would help the care system to identify any causes of dissatisfaction and to provide assurance that decision making is informed by the views of users.
The committee states that the lack of information provided to users and their families is unacceptable. It noted that a survey by the Comptroller and Auditor General showed that 20% of older people involved believed that their views were not taken into account and over half of them considered that they did not have enough input into their care.
It was also concerned by revelations that “one third of respondents considered they did not have enough information on the services available” and only half had a copy of relevant documents. “The committee views these as fundamental weaknesses in the system,” the report says.
Only five witnesses were called to give evidence and none were from the voluntary and community sector or older people in care.
Dr Andrew McCormick, permanent secretary at the DHSSPS, told the committee that the voluntary sector is very active.
Approximately 440 voluntary and community sector organisations are involved in the health and social care arena, and their total turnover is about £120 million.
Although many of those organisations employ their staff directly, we could not avoid mentioning the 8,000 volunteers who freely give their time. That is all part of the rich pattern of activity that supports our elderly colleagues’ ability to continue living independently in their own homes,” he said.
Dr McCormick said there is no evidence of a specific recruitment and retention issue, but agreed that pay rates and other factors must be monitored carefully so that we ensure that there is a viable workforce.
It is important that we do not procure merely on the basis of lowest cost. The importance of sustainable and sustained provision of a workforce for the sector needs to be recognised.We need to ensure that the market is built, strengthened and secured so that long-term availability is provided. We all hope that the care sector will be a source of growing employment, because we will all depend on carers – on the kindness of strangers, as it were – in the future,” he added.
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