There is currently no legislative framework for the regulation or inspection of homecare services provided for older people in the Republic, a conference in Dublin heard yesterday.
Dr Virpi Timonen, director of social policy and the Ageing Research Centre at Trinity College, warned that if regulations were not introduced soon, scandals and abuses similar to those that occurred in the nursing home sector may arise in the homecare sector.
She complained that staff employed to assist elderly people to live in their own homes were not subject to Garda vetting.
At an international conference on homecare for older people held at Trinity College, she said there was currently no register of care workers and minimum training requirements for homecare workers were not defined.
"The proposed nursing homes inspectorate does not seem to extend to homecare. This is paradoxical in the face of the stated policy ambition to ensure that older persons can stay in their own home for as long as possible," she said.
"It is imperative . . . to introduce legislation which will cover both institutional and homecare. Despite the increasing amounts of money going to formal homecare or domiciliary care, there is a complete absence of a framework to govern and to regulate and to inspect the care that takes place in the older person's home where they are even more vulnerable than in a nursing home setting because this is care that happens in a private dwelling behind closed doors.
"Obviously the vast majority of these care workers are wonderful dedicated carers who are delivering very, very high quality care, but what we would call for is a framework that would put in place a registration system for homecare agencies as well as nursing homes, put in an inspection system for homecare agencies and organisation as well as for nursing homes . . . some of these elements don't have to cost a lot of money," she said.
Prof Andrew Scharlach, professor of social welfare at the University of California at Berkeley, said US homecare workers were vetted, there was monitoring of their work and the agencies that provided the care were licensed.
The conference also heard how in Denmark it was now prohibited to build any more nursing homes, free homecare was available all older people, and 25 per cent of all persons aged 65 or older were in receipt of homecare supports.
The Department of Health said it was vital that the HSE was in a position to monitor effectively and evaluate the implementation of homecare packages, their impact on the older population and quality and effectiveness of delivery.
"This in turn, will inform Government over the coming years and is crucial in order to enable effective long-term planning," it said. "To this end, it is proposed to complete a formal evaluation of these packages by mid-2007 which will include quality measures."