Ms Catherine Cox:

Not at all. While I work for Family Carers Ireland, I am representing the Home Care Coalition today. The Home Care Coalition is a group of more than 20 charities, not-for-profit organisations and campaigners that was established with the aim of ensuring the implementation of an adequately resourced, person-centred statutory home care scheme in Ireland, with equality of access and availability across the State regardless of age or condition. Care should be based on need rather than means.

Members of the Home Care Coalition have identified a number of challenges regarding home care, which I will outline. We are looking specifically at recruitment and retention. To begin with, we believe an urgent review is required to provide a balance between State, NGO and private sector providers. This would mean an equality of approach to the pay and terms and conditions of employment for home care workers. The constant transfer of the NGO home care workforce to the HSE is a critical factor for the retention of staff because of this inequality of terms and conditions between the State and the NGO sector, in particular with regard to pay for travel. This is a primary obstacle in recruiting people and also retaining them within the home care sector.

Staff in the NGO sector can only be offered low-hour contracts due to organisations not having certainty over the number of hours they are required to deliver by the HSE. This in turn leads to lack of job and income security and significant challenges for home care workers and individuals applying for loans and mortgages. This uncertainty also impacts on organisations' ability to adhere to the Employment Act 2018, which enables part-time employee to request their employer to place them on a particular band of working hours. Additionally, if a home care worker is issued with a banded hours contract and the client goes into hospital or long-term care, the provider must shoulder the financial burden by paying for these hours to ensure compliance with the banded hours. Home care workers do not receive payment for missed hours if a client goes into hospital. This means they are not guaranteed payment if they are not on these banded hours.

Many home care workers work part time on short-hour contracts, with some in receipt of welfare and other benefits such as the medical card. Government Departments need to take this into account and acknowledge the impact that increased working hours could have on a lower paid sector and employment. An issue that is particularly relevant is that under social protection rules for jobseeker's benefit, casual workers can currently work three days or less in order to receive jobseeker's part payment for the days they have not worked. In plain terms, a person can work three full days, which is 22.5 hours, and still get jobseeker's benefit for the other two days. Where a home carer works only one hour per day for five days or even two hours per day, which would be ten hours per week, he or she cannot get jobseeker's benefit because the payment is based on the three-day rule rather than hours.

The coalition believes that workforce planning measures must be established to ensure the workforce has enough skilled staff to support the demand for home care, with particular consideration needed in the areas of dementia and palliative care. We need to clarify the different skill levels within the home care workforce and identify training and education requirements for each of these levels.

The pandemic has meant there is a much smaller workforce to draw from. People in Ireland have been supported to work from home during the pandemic. This was not an option for home care workers. They served on the front line of the Covid 19 pandemic, supporting people who were receiving care and their family carers through times of immense pressure, frustration and stress. Like many front-line workers, burnout is common and the pandemic had impacted on home care staff in a very personal way. Home care organisations have learned that a personal response is important to support their staff through this, and to reflect incidents so that all in the organisation have an opportunity to input and learn from them and maintain quality care provision. Further time and investment are needed for similar initiatives.

The issues I have outlined, as well as many others, such as the non-payment of travel and mileage by the HSE when outsourcing home care hours and the issue of work permits for non-EEA workers in the home care sector, present significant challenges that are impacting on the lives of people receiving care, their family carers and home care workers in the sector. The Home Care Coalition is calling or a clear plan of action that addresses these key issues, particularly around recruitment and retention of staff and also training and development of our home care workers.