Study by National Centre for the Protection of Older People, UCD found that 2% of older people who were victims of elder abuse named the perpetrator as their home help.
65,000 older people in the State receive homecare services either from HSE or from growing number of private companies.
There are now about 150 private companies providing homecare up from 10 a decade ago. But there are no statutory regulations or standards governing this huge industry. Anyone can set up a homecare company. Anyone can set up a website and say all their staff are trained and experienced.
The cases highlighted on the programme all involved homecare provided by private companies. But some private companies undoubtedly provide good quality care to older people. The problem is nobody knows which ones to trust in the absence of agreed standards.
The H.S.E. in responding to the disturbing programme tried to reassure us by saying it provided 90% of homecare services to older people itself. But, however well intentioned, this was not reassuring because neither the private nor the public sectors are regulated. The reality is that we don’t actually know if the public home help services provided by the H.S.E. are safe either, though the executive says it does ensure that all new staff get Garda clearance.
We will never be sure homecare services, be they public or private are properly monitored until an independent outside agency is given the job of policing the sector. The task must go to the Health Information and Quality Authority which must be adequately resourced to do the job. It now inspects nursing homes but these only cater for 5% of the over-65 population. Homecare services cater for more than double that but do not come under its remit.
The Commission on Patient Safety in 2008 and the Law Reform Commission on Legal Aspects of Carers in 2009 both recommended regulation of the sector. So too did a report from the Irish Private Home Care Association earlier this year, a body which represents about 50 of the private homecare companies in the country an has its own standards which members must meet.
And the National Economic and Social Forum, in a report published more than a year ago expressed concern about lack of training and supervision as well as a lack of Garda vetting of some people providing homecare services under the homecare package scheme. It also drew attention to the fact that there were no set standards for the care being provided and little monitoring of outcomes.