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Clarecare in High Court crux

MORE elderly people with high-dependency needs are waiting longer periods for specialised home care packages due to a High Court crux.
There are at least 170 local people on a public waiting list who are medically eligible for home help hours but cannot access them following successive cutbacks in funding, totalling an estimated €1 million, for Clarecare in recent years.
Since the cuts started in 2009, the reduced funding allocated to Clarecare has seen its annual home help delivery drop by about 30,000 hours annually from a peak of over 200,000 in 2009 to about 170,000, which is now delivered by 370 home helps this year.

Fiacra Hensey
Fiacra Hensey

Clarecare general manager, Fiacra Hensey, said the delay in finalising a High Court case, taken by private home care providers in relation to the provision of home care, is creating a waiting list.
The HSE Mid-West said it is not in a position to comment on a matter relating to a legal challenge, while a Department of Health spokesperson also noted that as this issue involves legal proceedings, it would be inappropriate for the department or the minister to comment.
Clarecare won the right to provide home care packages to clients, who require assistance to live independently in their homes, after a tender process was initiated last year. However, it has been unable to provide any home care packages to new clients, unless private providers are not in a position to deliver a specific package.
Despite investing about €20,000 on additional training and upskilling, Clarecare is not the preferred choice for home care packages.
The court case crux has meant the HSE is working from a list from the first tender process, which private providers won after Clarecare didn’t participate in that particular competition.
The private operators have united to take a case to try and compete for all home care business, including that provided by home helps, which is Clarecare’s core business.
Mr Hensey expressed concern that the current case is leading to further delays for those who urgently need home care packages.
He claimed Clarecare could help a lot more families if it was given an extra €1 million to fund home help hours. With Clarecare experiencing a 3% cut in its overall funding every year, he confirmed this had left them with no option but to cut home help hours, which has created a large waiting list.
He said if funding is allocated to provide more home help hours in Clare, it would reduce the need, in the medium and long term, for more expensive home care packages.
He said the allocation of more funding for home help would be money well spent, as it costs six to eight times more to provide care for a person in a residential institution rather then their own home.
“The difficulty with home help is there is no money and no new hours,” Mr Hensey commented.

“Clarecare has 170 people on a waiting list, who have already been assessed as needing home help but we don’t have an hour to give them. That has been an issue for a few years. In my time, in over 10 years, we never have had a surplus of hours over need. Every older person wants to stay at home,” Mr Hensey continued.
“The decision-makers don’t seem to be taking this on. We had hoped this High Court case would have been dealt with before the summer.
“Clarecare prioritise the needy. We are also trying to facilitate discharge from hospitals. The difficulty is that many of the people that are being discharged are older people and once you introduce the concept of home help, you can’t wean them off of it,” he explained.
Stressing the need to resolve the High Court case as quickly as possible, Mr Hensey said Clarecare should be allowed to deliver new home care packages.
He said the majority of home help people may be paid for just an hour but stay on longer if needed. Stating that Clarecare is completely overstretched, he confirmed that some staff members are out on stress-related leave because they were simply burned out and were effectively victims of the cutbacks.
“There is a special type of person who works as a home help and they are brilliant.
“Home help orgainsers are meeting with more and more families looking for home help hours and they don’t have any hours to give. Eventually, it wears you down,” he noted.
“We don’t mislead anyone. We listen to death notices and if hours are released, we farm them out again. It is a harsh reality. You can’t bank hours as there is an immediate need for them across the county.
“If you don’t have an early intervention with home help, more people will deteriorate and will need a home care package. Early intervention really works but it isn’t funded. If we had more home help hours, you would need less home care packages. Happier people lead healthier lives.
“We have appealed for more funding and apart from token funding for hospital discharges, we haven’t received any significant new funding,” he added.
When the for-profit operators cannot deliver a home care package, Clarecare is asked to deliver it and have provided about 50 this year.
Deputy Michael McNamara recently expressed concern about the smaller number of home help hours that are being funded in Clare, compared to Limerick and North Tipperary.
The Mid-West HSE outlined there has, historically, been an uneven distribution of home help services in a number of counties across the country. This has been associated with the origins of the service and the different emphasis placed on approaches to care by the former health boards.  In many cases, it was also linked to the funding available.
In more recent years, local and national approaches have sought to address or mitigate some of this imbalance.
“The Mid-West HSE recognise that further improvements need to be made, especially in Clare, which has been prioritised with the retention of existing service and no reductions in funding even where same apply nationally,” a HSE West spokeswoman stated.
It confirmed a commitment to prioritise Clare if any new home help development funding becomes available to the Mid-West.
“It is important to stress that the situation requires consideration of the total picture for older people. The totality of resources for older people in a given locality must be considered and not simply confined to the single issue of home help which, although important, is only one part of the overall spectrum of care, which includes day centres, home care packages, primary care team development and the provision of public residential facilities.
“As part of the estimates for service requirements for 2016, the HSE Mid-West has submitted a request for additional funding for home support services in Clare,”the spokeswoman concluded

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