SINGAPORE: Legislation aimed at improving the quality of care for residents in social residential homes was passed by Singapore’s parliament on Tuesday (Apr 8).
Social residential homes refer to facilities that provide accommodation to people who require care, support or social intervention, such as those with disabilities or destitute adults.
Under the Social Residential Homes Bill, the Ministry of Social and Family Development (MSF) will introduce a licensing framework, starting with homes that provide long-term and round-the-clock residential care to highly vulnerable residents.
They are children’s homes, children disability homes, sheltered homes, welfare homes, adult disability homes and adult disability hostels.
In total, 61 homes with about 4,000 residents will come under the Bill. This is an increase from the 35 homes with about 1,100 residents that are currently licensed, Mr Eric Chua, senior parliamentary secretary for social and family development, said in parliament.
The law is targeted to be implemented in 2026.
MSF and the National Council of Social Service (NCSS) will introduce a S$33 million transition support package for the social residential homes moving to the new licensing framework.
This will help fund investments in training and capability building of staff, as well as to defray associated costs to meet requirements under the Bill, said MSF.
Crisis shelters and transitional shelters will not be licensed under the Bill for now as clients enter or exit the premises on a daily basis and are not reliant on the provider for round-the-clock care, MSF said.
The Bill includes new training requirements to equip staff with skills like fall risk assessment and suicide intervention.
It will also be mandatory for social residential home operators to install closed-circuit television cameras (CCTVs) for the safety, well-being and welfare of residents.
Under the new legislation, a new Codes of Practice will be issued to codify standards of care.
The code will outline regulatory requirements relating to governance of social residential homes, management of the premises, resident management and incident management.
MSF said these requirements were being developed in consultation with the homes and will provide clarity on expected standards of care.
The new Bill will also introduce stronger safeguards to improve residents’ safety and well-being, the ministry announced.
All employees involved in management or day-to-day operations of social residential homes will be screened by MSF to ensure residents will not be placed at undue risk of harm.
Some residents in these homes may exhibit aggressive behaviour due to psychiatric conditions and other factors. The legislation will hence set out clear parameters on which staff in social residential homes may use “reasonable force” and restraints on residents for the safety of both residents and staff, MSF said.
A board of visitors will conduct independent checks on these homes to ensure that residents reside in safe and sanitary premises, MSF said, adding that some homes have already found this practice helpful.
The ministry has also introduced an enforcement framework to deter errant operators, where it may take regulatory action and pursue criminal penalties against errant or failing operators.
Previously, operating a home without a licence may warrant a fine of no more than S$5,000 (US$3,700), or imprisonment for no more than two years, or both.
Under the new legislation, operating a home without a license may warrant a fine of no more than S$100,000, with no change to the maximum jail term.
MSF may issue step-in orders to temporarily take over operations of a “failing” home to ensure continuity of care.
Such “last resort” orders may also be considered if there is an imminent risk to residents’ safety and well-being, and regulatory actions have failed due to an operator’s non-compliance, said MSF.
“We must therefore have a fallback plan to minimise disruption and ensure the safety, welfare or well-being of the residents in the home. This is when step-in powers will be activated,” said Mr Chua on Tuesday.
With Singapore’s population ageing rapidly and family sizes shrinking, the Bill was introduced to “prepare for the future”, Mr Chua said.
Calling it a “proactive” step, MSF said the legislation was not being introduced in response to any instances of abuse or neglect in the homes.
“To be clear, we are not coming from a position of deficit. Incidents of a serious nature are rare, and our homes are upholding good standards,” Mr Chua said.
The Bill will give operators a clear, common licensing framework to guide their operations and standards of care for residents, said MSF.
Apart from increased training of staff, MSF is making other sector-wide moves to improve capabilities.
These include awards or scholarships to attract new talent, programmes to attract mid-career professionals, review of salary guidelines and job redesigning.
Member of Parliament (MP) Melvin Yong (PAP-Radin Mas) on Tuesday asked for the rationale behind the 20-fold increase in the maximum fine for unauthorised operation of a home, and whether such a hefty sum was “reasonable with respect to the level of harm done”.
He also asked for data on social residential home staff members who have been investigated and taken to task for the use of excessive force over the past 10 years.
In response, Mr Chua said the penalties under the Bill were commensurate with comparable offences under other legislation.
One example is the Healthcare Services Act, which licenses the provision of nursing home services.
“Residents in nursing homes are vulnerable and reliant on the home for 24/7 care … The safety and well-being of our (social residential) homes’ residents are no less important,” he said.
He said that to provide the various parties, such as board members, with greater clarity of their duties, MSF will set out the roles and responsibilities in the subsidiary legislation and codes of practice, and “will not be punitive from the outset”.
On the use of force, Mr Chua said that over the 2020 to 2024 period, MSF received an average of six reports per year on resident abuse, including that of excessive use of force.
“Several were not substantiated, and where substantiated, staff were taken to task,” he said. “MSF adopts a zero tolerance approach towards the use of excessive force on our residents, and will thoroughly investigate these allegations.”
MP Dennis Tan (WP-Hougang) asked about staff-resident ratios, and how the government was going to provide more manpower support “critical to the requirements and improvements expected under this Bill”.
Mr Chua said MSF was working with social services agencies to develop “stronger organisational capabilities and a supportive workplace environment to attract and retain talent in the sector”.
He added that the ministry has also embarked on a job redesign pilot with selected homes.
“Through this pilot, we hope to enhance the value proposition of a career in the sector, specifically by improving the working conditions and supporting the career development of care staff.”
He added that MSF would continue to work with the Ministry of Manpower to ensure that homes have sufficient work pass quota and flexibility to recruit foreign care staff, while also ensuring opportunities for local staff.
MP Yip Hon Weng (PAP-Yio Chu Kang) asked if there were enough social residential homes to meet the growing demand in the next decade.
With capacity limits on the number of residents in the homes, Mr Yip asked how the ministry planned to ensure people were not turned away because there “simply aren’t enough beds”.
In his closing speech, Mr Chua said the ministry would ensure sufficient capacity to meet projected demand over the long term.
“We expect a slight increase in demand over the next decade,” he said, adding that MSF and the Ministry of Health are increasing support for persons with disabilities and seniors to age in place, and for those in homes to be reintegrated “more quickly” back into the community.
Mr Chua said the key objective of setting capacity limits was to ensure that quality care can be provided to residents.
“These limits are determined based on practical considerations, which include physical space requirements, infrastructure capabilities and staffing ratios,” he said, adding that MSF would continue to monitor demand and supply trends to ensure sufficient capacity.
Beyond the Bill, MSF and NCSS will continue to work closely with the sector to develop a strong and resilient social service workforce, said Mr Chua.
“To all the dedicated staff, we want to express our deepest gratitude because we know your work is not easy,” he said.
“The residents rely on you and your care, and I want to assure you that your contributions are appreciated every single day, and even though the residents may not say it.”
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