The home care sector here in Ireland is on the cusp of significant regulatory transformation aimed at enhancing the quality and safety of services provided to people in their homes. Historically unregulated, the sector is set to undergo comprehensive changes through forthcoming legislation and national standards. It has been a long wait, and many providers have been lobbying for these changes for a long time. Their concerted efforts reflect a collective wish for reform, to ensure the sector can meet the evolving needs of our ageing population through improved quality, workforce stability and financial viability. As a healthcare professional, I welcome regulation in the home care sector because I believe it will help to ensure higher-quality care, clearer accountability and transparency. I trust it will protect our service users, improve workforce conditions, promote sustainability, and I hope, build greater public confidence in the system.
Legislative Developments
In May 2024, the Department of Health introduced the General Scheme of the Health (Amendment) (Licensing of Professional Home Support Providers) Bill 2024. This proposed legislation seeks to amend the Health Act 2007, to establish a licensing framework for home support providers. Under this new framework, it will become an offence to operate a home support service without a licence. For existing providers, transitional arrangements are planned, and once the legislation is enacted, a 12-month commencement period for the Health (Amendment) (Licensing of Professional Home Support Providers) Bill 2024 will begin. During this time, Ministerial regulations and the Health Information and Quality Authority’s national standards will be formalised. It is these standards that will set the criteria that providers must meet to obtain a license.
Following the commencement period, existing providers will have two years to work towards compliance, aligning their operations with the new standards and completing the licensing process.
It’s worth remembering the Chief Inspector of the Health Information and Quality Authority (HIQA), will be empowered to grant, amend, and even revoke licences, so it is crucial for providers to meet the prescribed standards. Ultimately, these powers will safeguard service users and is expected elevate the consistency and quality of care nationwide.
National Standards for Home Support Services
In November 2024, HIQA launched a public consultation to seek feedback on the draft standards. The consultation ended in December 2024, and HIQA is currently finalising the standards using the feedback received. Structured around four core principles (a human rights-based approach, safety and wellbeing, responsiveness, and accountability), the standards set out the expected outcomes for service users and the responsibilities of service providers. We don’t know for sure when the standards will be finalised and come into force, but it is thought likely to be during this year, 2025.
Implications
The upcoming regulatory changes will require providers to ensure they take the following steps to ensure compliance and uphold service quality:
- Conduct Comprehensive Assessments: Evaluation of current operations against the forthcoming standards to identify areas requiring improvement
- Strengthen Governance Structures: Establishment of clear governance frameworks with defined accountabilities at all levels of the organisation
- Enhance Staff Training: Implementation of robust training programmes, focusing on safeguarding, risk management, and person-centred care
- Develop Risk Management Protocols: Creation of comprehensive risk assessment and mitigation strategies, to ensure the safety and wellbeing of service users
- Engage Stakeholders: Fostering open communication channels with service users, their families and supporters and staff, to gather feedback and promote transparency
By proactively addressing these areas, providers can align with the new standards, thereby enhancing the quality of care and ensuring compliance with regulatory expectations.
In summary, I believe upcoming regulation and the HIQA standards represent a welcome and critical shift in Ireland’s home care sector, one which will help to standardise and elevate the quality of home support services across the country.
It’s so important, therefore, that providers stay abreast of developments, and start now to take proactive measures (if they haven’t already) to adapt to this new, evolving landscape.
I am hopeful that regulation will promote delivery of safe, effective, and person-centred care, and that over time, the professional carers delivering those services will come to be better recognised, respected and valued for the valuable work they do each day.
