Home help services need to be regulated, says Hiqa chief

The country’s home help services need to be regulated as many people receiving such care are “markedly vulnerable”, according to the health watchdog, Hiqa.

Hiqa chief executive Pheilim Quinn said statutory regulation in the homecare sector was promised in the Programme for Government, but “this does not appear to be a priority for the current Government”.

In a wide-ranging speech at the National Federation of Voluntary Bodies’ national conference on safeguarding vulnerable people held in Portlaoise, Mr Quinn also said delays in moving people with special needs from outdated institution-style settings to community settings is inexcusable.

“Accommodating people in poor-quality environments and in cultures that are not compliant with modern standards could in itself be viewed as abusive,” he said.

“A large number of services had systems in place that worked against the principles of safe, person centred, integrated care.”

This failure to roll out the Government’s ‘decongregation’ policy suggests that this country believes that vulnerable people can make do with “well enough” care rather than best practice, he said.

Due to the number of substandard care centres for older and dependent persons, he noted it will be 2021 before services for the elderly and disabled meet full environmental compliance.

Many of the people to be moved from larger ‘congregated’ settings will become more dependant on homecare — the sector that Hiqa urgently wants regulated.

“Homecare regulation should include care provided in emerging service models, such as supported or assisted living services, whereby personal care is provided on an individual or group basis,” said Mr Quinn.

He also raised questions about ‘checks and balances’ in place around Section 38 and 39 service providers. These organisations, often charitable and philanthropic groups, are paid “substantial money” by the State to look after the disabled and elderly, yet some have been found repeatedly wanting in Hiqa audits.

“In recent times, Hiqa has identified services that have demonstrated significant non-compliance with basic standards of care; however, these service providers have not had to fear the threat of conditions being placed on their contractual arrangement with the funder, i.e. the State,” said Mr Quinn.

He said the HSE must take greater responsibility for the organisations it funds to carry out its work.

Calling for a commissioning framework to be introduced, the Hiqa chief said this would ensure “agreed strategy, assessed need, best available evidence, service efficacy, value for money, and the capacity and capability to deliver a safe and effective service”.

Mr Quinn also said that a state entitlement to ‘safe care’ should exist for the most vulnerable including the homeless, prisoners, migrants or asylum seekers in direct provision.

Adult safeguarding legislation should be put in place to prevent and stop abuse and neglect in these vulnerable groups, Mr Quinn added.