Inspectors will have power to visit patients’ homes to monitor care under new watchdog law

Department of Health official Fiona Larthwell told the Oireachtas Health Committee a visit by inspectors will not be the norm but the proposed new law will allow for it in certain instances.

Home care services are not currently regulated, leading to concerns about standards and safety.

Ms Larthwell said there “are inherent risks for service users in the provision of health and social care services by an unregulated sector”.

“Currently, in vital areas such as infection prevention and control, staff training, and clinical governance, there are no standards or regulations that all home support providers must comply with,” she added.

However, a licensing system will be introduced under the Health (Amendment) (Licensing of Professional Home Support Providers) Bill, the committee was told.

Asked by People Before Profit TD Gino Kenny if people receiving home care can expect calls from inspectors in the same way as nursing homes, she said the chief inspector from the Health Information and Quality Authority (Hiqa) would be given new powers.

The home care business itself would be the centre of inspections, where areas such as process, data and management of complaints would be examined.

“We don’t envisage standard inspection visits to people in their homes but there will be provision in the legislation which will allow for it should it be necessary,” said Ms Larthwell.

She said home support is not just delivered by the HSE and HSE-funded services. People with a range of personal circumstances also pay for private home support.

“Information is very limited on who is delivering services privately, how many hours they are delivering and what types of services this includes,” said Ms Larthwell.

“However, estimates indicate that as much as 25pc of provision may be delivered privately – this would be a further 8.5 million hours being delivered nationwide.”

The budget for HSE-funded care is €730m to deliver 22 million hours of standard home support to older people, with a further 3.5 million hours to be provided to people with a disability.

“At any one time, home support is to be delivered to over 54,000 people aged 65 and over, and 7,000 people with a disability.”

Ms Larthwell said that as home support has expanded and the needs of those at home have increased “it has become more urgent to ensure there is verifiable consistency and quality in the care being provided”.

Under the proposed provisions in the general scheme, Hiqa’s chief inspector will establish and maintain a register for licensed home support services operating here.

The inspector will be responsible for monitoring and assessing compliance by registered home support providers and it will be an offence to carry out the business of a home support service without a licence.