Concern over slow progress in regulating home helps

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TENS OF thousands of older people across the State depend on home help services to help them to stay in their own homes.

It is a service which facilitates the earlier discharge of older persons from acute hospitals back to their own homes and a life of near independence. It also puts off the requirement for them to enter costly nursing home care by having someone help them with basic tasks like washing, dressing and cooking. But it is an entirely unregulated sector, which could put older people at risk. Dozens of complaints made about home help services to the HSE last year and released to the The Irish Times under the Freedom of Information Act illustrate why. They give a snapshot of the problems which arise in the sector, and while many older people will no doubt have wonderful experiences of their home help service, it is also almost certain that others who have difficulties never complain.

A year ago a Prime Time Investigates programme illustrated clearly what can go wrong in a sector with no inspectorate. Using undercover cameras it exposed staff from private homecare companies threatening older people in their care. There were instances of theft and force-feeding. It also raised issues surrounding the lack of vetting and training of staff.

The programme prompted the then taoiseach Brian Cowen to say that statutory regulation on home help provision in Ireland would be looked at as quickly as possible. Yet, one year on and despite the election of a new Government, nothing has changed.

There are still no statutory standards, regulations or inspections in place in the homecare sector. Draft national quality guidelines for homecare support services developed in 2008 were never implemented.

Age Action spokesman Gerry Scully described the lack of procedures as “frightening”. “Regulation needs to happen and it needs to happen as soon as possible,” he said.

“It is totally unacceptable that large numbers of older people are receiving care which is totally unregulated. There are no protocols, no inspections or spot checks of care situations in the home.”

Dermot Kirwin of Friends of the Elderly said that while reputable private companies had been calling for Health Information and Quality Authority (Hiqa) standards to be imposed on the sector, there were other private companies which were not on the authoritie’s radar as there was no requirement on them to register. Statutory inspections were needed in all sectors – private, public and voluntary – to ensure that vulnerable older people were being protected in their own homes.

Ed Murphy, president of the Home Care Association, which has 55 member companies and which has self-imposed regulations, said that, as the largest provider of home help services the HSE itself had the “longest way to travel” if inspections become mandatory.

The Minister of State with responsibility for Older People, Kathleen Lynch, said the Government was “examining the options of introducing statutory regulation for home care providers”.

The Department of Health say that they are examining possible changes to legislation relating to home help services including regulation and inspection, which would be undertaken by Hiqa.

However, apart from indicating that this forms part of the 2011–2016 programme for government, the department said “it not possible at present to give details in relation to costs or timeframe”.

The HSE said it provides training and induction for its home help staff. A HSE spokeswoman said it is currently conducting a national procurement process for the provision of enhanced home care services, which, when completed will result in a range of “approved providers” for home care services being in place in every HSE region who will have to meet required minimum standards. As of September the HSE was providing 51,166 persons with home help services and 10,752 people with home care packages.

This year the HSE will spend €211m on home help services and €138m on home care packages

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