LCQ14: Service quality of private residential care homes for the elderly

     Following is a question by the Hon Stanley Li and a written reply by the Secretary for Labour and Welfare, Mr Chris Sun, in the Legislative Council today (November 20):
 
Question:
 
     To improve the service quality of private residential care homes for the elderly (RCHEs), the Social Welfare Department (SWD) launched a five-year Accreditation Subsidy Scheme for Private Residential Care Homes for the Elderly (the Subsidy Scheme) in 2019 to provide full subsidies for private RCHEs joining SWD's approved accreditation schemes provided under the Accredited Certification Body of Certification of Residential Care Homes (Elderly Persons) Service Providers' Management System recognised by the Hong Kong Accreditation Service (accreditation schemes). It is learnt that there is an increasing demand for RCHE places in the community, and that quite a number of elderly people have switched to the services in private RCHEs due to the longer waiting time for Government subsidised places. In this connection, will the Government inform this Council:
 
(1) of the current number and proportion of RCHEs joining the accreditation schemes;
 
(2) of the specific measures or plans the Government has put in place to proactively assist those RCHEs that have not joined the accreditation schemes to enhance their service quality;
 
(3) whether it has reviewed the effectiveness of the Subsidy Scheme; if so, of the details; if not, the reasons for that;
 
(4) given that the provisions of the Residential Care Homes Legislation (Miscellaneous Amendments) Ordinance 2023 have come into operation progressively since June 16, 2023, of the Government's plans in place to assist small and medium-sized RCHEs in enhancing their services; and
 
(5) apart from basic statutory regulations and guidelines, whether the Government has other measures to urge private RCHEs to enhance their service quality on their own initiative?

Reply:
 
President,
 
     The Government attaches great importance to the service quality of the residential care homes for the elderly (RCHEs) and has been committed to strengthening the regulation of RCHEs and improving their service standard. The Social Welfare Department (SWD) launched a scheme of around five years in October 2019 to fully subsidise private RCHEs to join SWD's approved accreditation schemes under the Accredited Certification Body of Certification of Residential Care Homes (Elderly Persons) Service Providers' Management System recognised by the Hong Kong Accreditation Service (hereafter referred to as the Accreditation Subsidy Scheme). The Accreditation Subsidy Scheme aims to encourage private RCHEs to improve their service quality through joining independent accreditation schemes for objective assessment of their services by certification bodies.
 
     I reply to the five parts of the question raised by the Member as follows:
 
(1) The Accreditation Subsidy Scheme came to an end on March 31, 2024. A total of 344 private RCHEs (accounting for around 55 per cent of all private RCHEs) had participated in and obtained accreditation under the Residential Aged Care Accreditation Scheme of the Hong Kong Association of Gerontology (HKAG), or the Residential Care Home for the Elderly Certification Scheme of the Hong Kong Quality Assurance Agency (HKQAA).
 
(2) and (4) To assist RCHEs of different scales in enhancing their service standard and quality, the Government gazetted the Residential Care Homes Legislation (Miscellaneous Amendments) Ordinance 2023 (the Ordinance) in June 2023. Major amendments of the Ordinance include strengthening the accountability of RCH operators, enhancing the minimum staffing requirements, increasing the minimum area of floor space per resident and enhancing the regulation of medicine administration. Respective amendments are being implemented in phases in accordance with the legislation, with a majority of the new regulations taking effect starting from mid-2024. The SWD has conducted thematic briefing sessions for RCH operators, management and frontline staff, provided relevant guidelines, and maintained communication with the sector, rendering appropriate support concerning the enhancement to service quality.
 
     Besides, the SWD has launched a five-year Training Subsidy Scheme for Staff of Residential Care Homes (the Training Subsidy Scheme) since March 2019, providing full subsidy for home managers, health workers and care workers of all RCHEs and Residential Care Homes for Persons with Disabilities across the territory to attend training courses, including Training for Home Managers, Advanced Training for Health Workers and Training for Care Workers so as to strengthen their skills in taking care of elderly persons and persons with disabilities and enhance the service quality of RCHs. Having reviewed the effectiveness of the Training Subsidy Scheme and gauged the views of the sector, the SWD has extended the Training Subsidy Scheme for three years to March 31, 2027 so that more RCH staff are subsidised to attend the relevant courses.
 
     In addition, the SWD and the Department of Health have, over the years, jointly organised regular training courses for RCHE staff covering topics related to drug safety, infection control, fall prevention, caring for dementia patients, prevention of elderly abuse, accident management and handling of working stress, etc, with a view to enhancing the service quality of staff and RCHEs.
 
(3) During the implementation of the Accreditation Subsidy Scheme, the SWD issued questionnaires to RCHEs which completed or renewed their accreditation for evaluating the effectiveness of the Scheme. The questionnaire survey showed that over 90 per cent of the RCHEs were satisfied with the services provided by the two Approved Certification Bodies (ACBs) (i.e. HKAG and HKQAA) under the Accreditation Subsidy Scheme, and nearly all the RCHEs indicated that the Accreditation Subsidy Scheme was conducive to enhancing their service quality. The SWD maintained communication with the two ACBs from time to time to learn the implementation progress and effectiveness of the Accreditation Subsidy Scheme. The two ACBs also collected feedback from RCHEs on the Accreditation Subsidy Scheme through questionnaires. Overall speaking, according to both ACBs, many RCHEs considered that the Accreditation Subsidy Scheme facilitated their service quality enhancement, including assisting them in establishing a more systematic staff supervision and training system, and conducting further review of their health and care services and procedures.
 
(5) The SWD has purchased places from private RCHEs under the Enhanced Bought Place Scheme (EBPS) since 1998, with a view to upgrading the service standard of private RCHEs through enhanced standards in staffing ratio and area of floor space per resident, and increasing the supply of subsidised residential care places. Apart from complying with the statutory requirements of the Residential Care Homes (Elderly Persons) Ordinance (Cap. 459) and the Residential Care Homes (Elderly Persons) Regulation (Cap. 459A), a private RCHE operator participating in the EBPS is also required to operate the RCHE in accordance with the requirements stipulated in the Agreement for the EBPS for Private RCHEs as signed with the SWD, including participating in and obtaining accreditation from an SWD's approved accreditation scheme throughout the contract period. This accreditation requirement helps raise the service quality and management efficiency of the RCHEs participating in the EBPS.
 
     Moreover, the SWD carries out the Residential Care Service Voucher Scheme for the Elderly (RCSV), adopting the principle of "money-following-the-user", to offer an additional choice to elderly persons waitlisted for subsidised residential care services. Under the RCSV, the Recognised Service Providers (RSPs) should take part in the Service Quality Group Scheme co-ordinated by the SWD in accordance with the signed Service Agreement. To encourage the RSPs (including private RCHEs joining the RCSV) to continuously improve their service quality, the SWD will reimburse part of the accreditation fees to the RSPs when they first join an SWD's approved accreditation scheme.