Regulation of professional home carers recommended

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THE HEALTH Information and Quality Authority (Hiqa) should be given the power to set standards and regulate professional home care services, according to the Law Reform Commission.

In a report to be published today, the commission recommends that both public and private providers of home care services should be included in the regulatory regime.

It also recommends that the Social Services Inspectorate establish a registry of all professional home help carers.

These are among a list of 29 recommendations made by the commission.

Such regulation should not, however, include individuals such as relatives who provide informal assistance to elderly or vulnerable people living in their homes, it added.

The need for regulation was highlighted again last month when information released to The Irish Times under the Freedom of Information Act revealed the types of problems which can arise with home help services, going on complaints submitted to the Health Service Executive (HSE) by families. In one case in Donegal, an elderly woman’s daughter complained that when the home help showed up for work, the complainant and her sisters could smell alcohol from the home help and knew she had been drinking by the way she “bounced off the walls”.

A HSE disciplinary investigation was carried out, and while the HSE said disciplinary action was taken against the home help in question, it would not specify what form this took.

In another case, in Limerick, a client of a private home care company complained to the HSE last January that a home help had told him to “f**k off, and [said] that it was because of him that she had to travel out in 4ft of snow”.

The Law Reform Commission points out in the report that the proportion of people living in Ireland who are aged over 65 has been increasing in recent years and is projected to increase at an even greater rate over the next few decades.

The overwhelming majority of people aged over 65 wish to continue living in their own homes for as long as possible.

The Government has committed to supporting this approach and has done so through home care support, primarily though the HSE.

Commercial home care providers have also emerged who can be contracted by the HSE to provide care.

However, no regulatory regime exists either for public or private home care providers.

Hiqa is the regulatory and standard-setting body under the Health Act 2007 for residential nursing homes, and in 2009 published standards to apply to them. However, they only deal with the 5 per cent of those aged over 65 in residential care.

The Act does not give Hiqa the power to set comparable standards for the provision of health care in the home, which would cover the remaining 95 per cent of the over-65 category, though they do not all require such care. The commission is therefore recommending that the 2007 Act be extended to allow Hiqa to regulate home carers.

The commission noted the importance of funding arrangements for professional home care but did not make any recommendations in this area, as this is a matter of ongoing Government policy development.

CAROL COULTER, Legal Affairs Editor

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