Families fearful of speaking out about standard of some home support services says Offaly TD

Independent TD for Offaly Carol Nolan has said there is an urgent need for Government to prioritise the enactment of legislation aimed at setting out a registration framework for providers of home support services.

Deputy Nolan was speaking during a Dáil debate on the Health (Amendment) (Home Support Providers) Bill 2025, under which the Chief Inspector of Social Services at HIQA will have responsibility for establishing and maintaining a register for home support services operating in Ireland.

The legislation is currently at the committee stage where the bill is examined section by section and amendments may be suggested following input from the elected members. This process must be carried out before moving onto the report stage where the amendments will be carefully considered. 

As part of the health bill, the Chief Inspector will also be responsible for monitoring and assessing compliance by registered home support providers against Ministerial regulations and national standards that are to be developed by HIQA.

The bill will provide for criminal liability to be assigned for unregistered home support services and the ability to cancel registration of a provider where serious non-compliance is established.

The HSE currently operates under its non-statutory Home Support Authorisation Scheme (AS) established in 2023. Approved Providers are merely obliged to adhere to the Authorisation Scheme Service Specifications and associated Standard Operating Procedures.

READ MORE: Offaly monastic human remains are carbon dated to early Christian period

Deputy Nolan said: "This is not about pointing the finger at any individual home support service provider, many of whom provide compassionate care every day and who along with their staff do incredible work under very difficult conditions."

She continued: "But increasingly what I am seeing from constituents is the sense that they are caught between a rock and a hard place when it comes to the care delivered by staff that appear to have very little training or who are in some case literally unable to communicate with either the person receiving the care or their families because of language barriers."

The Independent TD says that changes have to be made in the process around home support in order to find the best solution for all parties. She explained: "Oftentimes the staff are visibly under enormous pressure to get in and get out and on to the next house. This can be very upsetting for everyone including the staff member."

She also emphasised the importance of having the right legislation in place so that the highest level of care can be achieved. Nolan TD insisted: "We need to ensure that we have national home support service capable of delivering care according to the highest standards. That is why we need national statutory legislation to be introduced as a matter of urgency. Reliance on guidelines and what are effectively voluntary codes is not ideal and it needs to be changed.”

Deputy Nolan concluded: "I have engaged with the Minister for Health and the HSE on this matter and I am assured that the Department of Health is progressing the development of a regulatory framework and licencing system for home support providers.

However, the fact remains, that we need to respond far more effectively to the concerns of those families who can clearly identify failings in the standard of care delivered to their loved ones, but who are at the same time fearful of speaking out because of the risk of having what minimal care time they do receive withdrawn."