Dementia facility in Shankill under threat over lack of funding

Ireland’s largest dementia-specific nursing home has revealed today that it will be forced to cease its vital day-care service facility from next January, and gradually wind down the entire facility unless proper public funding is forthcoming for 2020. Saint Joseph’s Shankill is home to 60 people living with dementia and provides two respite beds and an additional 120 day care places per week but has been operating at a significant and unsustainable deficit for over seven years. Management have today been speaking with its 100 staff and with families of its service users about the current funding crisis facing the organisation.

Saint Joseph’s Shankill is a private not-for-profit nursing home that is owned and managed by Saint John of God Hospital. Hospital Management and Board members have been engaging with the National Treatment Purchase Fund (NTPF) and the Department of Health in recent months on the need for a significant increase to both in-patient and day-care reimbursement payments.

Saint John of God Hospital has been covering the €7m financial shortfall in Saint Joseph’s from its own resources since 2012. This has mainly arisen due to essential capital investment for the upgrading of facilities and increased staffing ratios in line with HIQA’s regulatory requirements. A further subvention of €1.2m will be required to offset the 2019 deficit. The Hospital says this is not a sustainable or fair way to fund such important services for people living with dementia.

Speaking about the financial crisis, Chief Executive, Emma Balmaine, said “People living with dementia have very different needs to elderly people living in care facilities without dementia. We deliver intensive person-centred, dementia-specific care every day to the 60 people that live in one of the six in-house lodges in Saint Joseph’s and to the people who utilise our 120 day care places and 2 respite beds each week. Dementia care is an end-of life palliative process and we simply cannot continue to offer this specialist long-term care based on the current funding model applied by the NTPF and the HSE. We are paid at considerably lower rates than equivalent public facilities and no account is taken of the added costs associated with meeting the high-dependency needs of the people we care for.

Most resident places in Saint Joseph’s are funded through the Fair Deal (NTPF rate) but the rate is insufficient as it does not take account of the dementia-specific and palliative care needs of these residents who have a terminal diagnosis. Added to that, the day-care rate which is set by HSE has not been increased since 2006 and just last month we were informed that there is still no funding available, despite our warning of potential cessation of the service.

Saint Joseph’s Shankill has endured such significant shortfalls since 2012 that we are now at a stage where we must very regretfully consider winding down our service, which would be devastating for the people who live here, and their families who depend on this vitally important service, as well as our highly dedicated staff and volunteers. We dearly hope it won’t come to this but we are now obliged to make our service users staff and volunteers aware of the very challenging financial scenario we all now face.” concluded Ms Balmaine.

A robust financial case has been presented to the HSE and NTPF warning that unless a financial solution is urgently agreed, Saint Joseph’s faces the real risk of closure.

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