Health watchdog calls for 'complete overhaul' of homecare
In its position paper on the regulation of homecare, Hiqa said it was well accepted that the preferred place of care for many people is in their own home, something that takes on added focus when considering the country's aging population. File photo
Health watchdog Hiqa has called for a "complete overhaul" of homecare, saying the current situation is "unsustainable" and urging new legislation based on need and adequate level of services for those who need it.
In a new position paper on the regulation of homecare and in an accompanying It pinpointed a range of issues with the current unregulated nature of homecare, including "problematic and inconsistent" funding, that homecare visits are often rushed due to the pressures on homecare workers to travel between service users’ homes, and to risks associated with the current homecare landscape.
"For people receiving homecare services, receiving a poor quality or unfulfilled service was cited as the most prominent risk," the Health Information and Quality Authority said. "Lone working was cited as the greatest risk for people delivering homecare services."
It called for a full ‘root and branch’ review of homecare to be undertaken before underpinning legislation is drafted, ahead of a "business as usual" or "directionless or bandage scenario", which it said would be in line with the objectives of Slaintecare. This would include engagement with all key stakeholders, at all levels across the sector, and for for the development of homecare standards and regulations.
Homecare can be funded publicly through the HSE or by private agreement between homecare providers and individuals or families. In its position paper on the regulation of homecare, Hiqa said it was well accepted that the preferred place of care for many people is in their own home, something that takes on added focus when considering the country's aging population.
"it is no longer viable to apply a directionless lens towards the provision of homecare," it said. "Rather, there needs to be a complete overhaul of the homecare sector.
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"Essentially, homecare was and remains a discretionary but demand-led service where need often outstrips supply. As such, the current homecare system is not sustainable and is not meeting the needs of people."
To illustrate the scale of the issue, it said 23.67 million older persons home support hours would be delivered to 55,675 people this year, with more than three million hours provided for home support and over 1.7 million personal assistant (PA) hours provided to adults who fall under the disability remit, as well as 533 packages of care for children with complex needs and approximately 18,000 hours per year.
"Hiqa firmly believes that there is only one opportunity to get this legislation right and is therefore advocating for an inclusive homecare scheme that protects all people who are receiving care in their own home.
Carol Grogan, recently appointed as Hiqa's new Chief Inspector of Social Services, said: "Most people in Ireland would prefer to age and receive care in their own home. However, homecare operates in complex conditions influenced by funding, availability and geography."
"The current homecare system is not sustainable and is not meeting the needs of people, with some vulnerable people unable to avail of support in their home. Furthermore, homecare services are not currently regulated to establish and ensure their quality and safety."
It said the registration of homecare workers was in place in countries such as Wales, Northern Ireland and New Zealand, in contrast to the "indistinct" nature of it here, while the HSE does not have capacity to monitor services intensively due to finite resources.
