Frances Fitzgerald (Dublin Mid West, Fine Gael) | Oireachtas source

I am taking this Adjournment matter on behalf of the Minister for Health, Deputy Leo Varadkar.
Government policy recognises that most older people would prefer to stay at home. We seek to facilitate this through various community-based supports aimed at ensuring older people receive timely, safe and appropriate care and treatment at the lowest level of complexity. Services can be provided by the HSE, voluntary agencies or private operators. Government for National Recovery 2011-2016commits to developing and implementing national standards for home support services, which will be subject to inspection by HIQA. Nursing homes have been registered and inspected by HIQA since 2009, as the Senator knows.
During the course of this Government HIQA's function has extended to residential services for those with disabilities and child protection services. However, primary legislation and resources will be required for the introduction of a statutory regulation system for home care services. This will be progressed, but in the context of overall legislative and resource priorities and will take into account the points the Senator has made about the recommendations of the Law Reform Commission. Many of the commission's recommendations have informed current standards and will continue to inform our deliberations on the regulation of home support services. I would like to emphasise, however, that statutory regulation or licensing is only one way of improving quality and safety. Earlier this month the national policy and procedures for safeguarding vulnerable adultswas launched. This builds on the existing elder abuse policy. It applies to all statutory and publicly-funded non-statutory service providers who are providing health and social care services to vulnerable persons. It is underpinned by a number of principles including respect for human rights, person-centredness, culture, advocacy, confidentiality, empowerment and collaboration.
Staff training and awareness will be vital aspects of the implementation of this policy and since 2007, about 39,000 people have received training on elder abuse. The HSE has progressed a range of measures - with which the Senator is familiar - to improve home care provision overall, to standardise services nationally and to promote quality and safety. The home help service is monitored on an ongoing basis mainly through the public health nursing service and the home help co-ordinators in each area. Monitoring involves an assessment of the needs of clients on application for the service as well as an ongoing evaluation of the time allocated and the care provided to each client. Staff receive training in areas with which the Senator will be familiar.
In 2012 the HSE as part of a procurement process introduced standards of care for all external providers of enhanced home care. They are monitored through service level agreements with the HSE to ensure that standards are being met. They have to provide a prescribed range of information and they are supervised through regular local operational meetings and care plan reviews. Audits are completed and quarterly reports are requested and reviewed. However, the HSE is currently undertaking a full review of home care services with a view to improving services generally and the executive has developed national quality guidelinesfor home help services for older people which will apply to all home support services. The guidelines will set out what a quality safe service should be with underlying criteria showing how the service can be judged. One has to take all of these measures together because they are aimed at ensuring that a safe and high-quality service is delivered nationally across the home support service.