LCQ4: Service quality of residential care homes for elderly
22.6.2022

Following is a question by the Hon Doreen Kong and a reply by the Secretary for Labour and Welfare, Dr Law Chi-kwong, in the Legislative Council today (June 22): Question: Recently, a member of the public has complained to me that her mother, when staying in a government-subsidised residential care home for the elderly (RCHE), was slapped and pushed out into the corridor by a care worker for no reason. As the incident had been uncovered, this member of the public was made aware of it and reported it to the Police for assistance. Some members of the public are concerned that this incident is just the tip of an iceberg, and there may be an elderly version of the suspected child abuse incident of the Children's Residential Home. Regarding the service quality of RCHEs, will the Government inform this Council: (1) whether it has conducted regular inspections and unscheduled surprise inspections on subsidised RCHEs, and whether it has required such RCHEs to install closed-circuit television cameras in residents' rooms and other areas to facilitate the monitoring of the service quality of such RCHEs; (2) as the Government is putting forward proposals to increase RCHE places, how the Government ensures that RCHE services will be able to focus concurrently on quality and quantity; and (3) whether it has formulated a code of practice for the work of care workers (including penalties against those care workers whose service performance is unsatisfactory), or drawn up a blacklist of care workers, so as to ensure that care workers with poor service quality will not be employed? Reply: President, The Social Welfare Department (SWD) regulates the operation of residential care homes for the elderly (RCHEs) in accordance with the licensing regime of the Residential Care Homes (Elderly Persons) Ordinance (Cap. 459) (the Ordinance). A person issued with a licence must comply with the Ordinance, the Residential Care Homes (Elderly Persons) Regulation (Cap. 459A) (the Regulation) and the Code of Practice (CoP) for RCHEs issued by the Director of Social Welfare (the Director) under section 22 of the Ordinance in the operation, keeping, management, or other control of the RCHE. (1) The Government attaches great importance to the service quality of RCHEs, and strives to strengthen the monitoring and improve the service quality of RCHEs. In May 2017, the SWD established the Licensing and Regulation Branch, which has formulated and continuously implemented various enhancement initiatives mainly covering such areas as stepping up monitoring and law enforcement on residential care homes (RCHs), enhancing information transparency, strengthening training for staff of RCHs and promoting professionalism of the sector, enhancing care services directly for the RCH residents, and upgrading the quality of RCHs. The four professional inspectorate teams of the Licensing Office of Residential Care Homes for the Elderly, namely the Social Work Inspectorate Team, Health Inspectorate Team, Building Safety Inspectorate Team and the Fire Safety Inspectorate Team, set up under the Licensing and Regulation Branch, conduct surprise inspections to RCHEs at different times during office and non-office hours, so as to monitor and regulate the operation, management and services of the RCHEs. If an RCHE is found to have failed to comply with licensing requirements or had issues of nonâcompliance, the SWD will issue advisory letter, warning or written direction to the RCHE according to the nature and severity of the nonâcompliance issues. If the RCHE continues to fail to make any improvement, the SWD will consider instigating prosecution actions according to the aforementioned legislation. In addition, to ensure the safety of the residents, the CoP for RCHEs advises that the RCHEs should provide suitable security facilities, e.g. installation of closed-circuit television (CCTV) system in compliance with the Guidance on CCTV Surveillance and Use of Drones issued by the Privacy Commissioner for Personal Data, to step up monitoring of the operation of RCHEs. (2) In response to the public call for enhancing regulation and quality of RCHs, the SWD set up the Working Group on the Review of Ordinances and Codes of Practice for Residential Care Homes (Working Group) in June 2017 to review the Ordinance, the Regulation, the Residential Care Homes (Persons with Disabilities) Ordinance (Cap. 613), and the Residential Care Homes (Persons with Disabilities) Regulation (Cap. 613A) and relevant codes of the practice. The Working Group was chaired by the then-Director and comprised the then-Legislative Council (LegCo) members, nonâgovernmental and private organisations operating RCHs, the Elderly Commission and the Rehabilitation Advisory Committee, academics, service users/carers, independent members, and representatives of the Hong Kong Council of Social Service and the Labour and Welfare Bureau as its members. The Working Group completed the review in May 2019 and put forward 19 recommendations. The SWD took forward some of the recommendations by revising the relevant codes of practice, which took effect on January 1, 2020. A few other recommendations confirmed that the prevailing requirements did not require any change. The remaining recommendations which involve staffing of RCHs, area of floor space per resident, accountability of the operators, registration systems for home managers and health workers, provision of care services, and penalties, need to be implemented by amending the aforementioned legislation. The Government introduced the concerned amendment bill into the LegCo for the first reading and second reading on May 25, 2022. The LegCo has formed a Bills Committee on the aforementioned bill. We will fully collaborate with the LegCo in scrutinising the bill. (3) The Regulation stipulates the minimum staffing requirements for each type of staff, including nurses, health workers and care workers. Among the different types of staff, health workers must have completed a training course approved by the Director in writing in accordance with the Regulation, in order to apply to the SWD for registration as a health worker for the purposes of employment at a RCH. If the Director ceases to be satisfied that the health worker is competent or is fit and proper to be registered as a health worker, the Director may cancel the person's registration as a health worker. In addition, the CoP for RCHEs stipulates that home operators and home managers should arrange continuous on-the-job training and supervision for staff, including nursing care training, stress management, infection control, and drug management, so that the staff get to know the latest development of nursing care skills for elderly persons. The SWD has also encouraged the RCH staff to enhance their service quality through continuous training, and has organised nursing care workshops for RCH staff (including care workers) every year. To enhance the management and service quality of the RCHEs, the SWD has implemented a five-year scheme since March 2019 to provide full subsidies for home managers, health workers and care workers of all RCHs to enrol in Qualifications Framework-based training courses. The SWD is conducting investigation into the incident an RCHE's alleged improperly taking care of a resident mentioned in the question and will certainly handle the matter seriously should there be any proven case of nonâcompliance.