'Home care regulation urgently needed'

  • Niall Hunter, Editor

New legislation is needed to implement statutory regulation of homecare services, according to the State's health safety watchdog, HIQA.

A HIQA spokesman told irishhealth.com that while it has a statutory remit to regulate and inspect nursing home care, it had no such remit in relation to home care services and legislation would be needed in order to introduce such a system.

Meanwhile, according to one privarte home care provider, draft national quality guidelines for home care support services were drawn up in 2008 but never implemented.

Last night's Prime Time Investigates programme on RTE revealed found appalling standards of care by a number of private home care providers paid by the HSE.

The HSE said it is investigating the cases highlighted in the programme, and is to review the standard of care being provided to thousands of older people in their own homes. The investigation uncovered companies hiring workers with no training, no Garda vetting and no checking of references.

The programme filmed an elderly women being force-fed by a care worker employed by one company.

The documentary found there are an estimated 150 companies providing home care in Ireland yet the area remains unregulated with no standards and no legal obligation on the home care provider companies to vet staff.

According to HIQA, while it has not received specific complaints about homecare provision, it would have no legal powers to investigate such complaints even if it did receive then.

Referring to a statement made by the Minister for Older People Aine Brady yesterday about new initiatives to strengthen the governance of the home care area, HIQA said it had not been made aware of any such initiatives.

HIQA has legal powers to regulate and inspect residential nursing home care, which were introduced in the wake of the Leas Cross Scandal in 2005-2006.

Meanwhile a private home care provider has said draft HSE guidelines for home care support services were developed in 2006 but were never implemented.

Eddie O'Toole, whose company is a member of the Home Care Association (HCA), said he understood that the draft guidelines were delayed following advice indicating there was no legal basis for the introduction of a co-payment for recipients of home care packages.

Helath Minister Mary Harney indicated last week that those in receipt of home care packages may in future be asked to contribute towards the cost of their care, in the same way that those in receipt of nursing home care  contribute under the new Fair Deal scheme.

Mr O'Toole said members of the HCA had been lobbying for proper State regulation of the home care sector for some time.

He said the same regulation that now applied to residential care should apply to home care. Mr O'Toole said his own company, Bluebird Care, currently operated to strict UK standards, in the absence of Irish regulation, and the HCA also undertook independent audits of member companies.

Mr O'Toole said he found Minister Brady's contention on the Prime Time programme that better training, rather than regulation was needed, "quite amazing."

Age Action Ireland said the programme highlighted the urgent and long-standing need for regulation, standards and auditing of the home help service.

"The State has an obligation to ensure that vulnerable people are protected from those who may prey on their vulnerability, and are adequately cared for by those entrusted to care for them," according to Age Action spokesman Eamon Timmins.

Fine Gael's older citizens spokesperson Catherine Byrne said a report by the National Economic and Social Forum over a year ago identified many flaws in the unregulated home care sector but nothing had been done since.

Around 10% of HSE-funded home care is provided by private companies at present. The HSE has spent €120 million on home care services since 2006. There are currently over 50,000 people in receipt of home help.

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