The Department of Health has recently published the General Scheme for the Health (Amendment) (Licensing of Professional Home Support Providers) Bill 2024 (the “Bill”), marking a first step towards a statutory scheme for the regulation of quality and safety in public, private and not-for-profit home support services.
The lack of a national regulatory framework in this sector is unusual compared with other European Union countries, and there has been growing public pressure for tighter monitoring of home support providers.
The Bill will establish a licensing system for home support providers and to introduce a framework for independent oversight and enforcement of minimum standards to be set by the Health Information and Quality Authority (“HIQA”). These developments conform with the recommendations proposed by HIQA in the Homecare and Support Services Evidence Review published in 2020.
New Obligations for Service Providers
Under the new Bill, home support providers will be obliged to obtain a license to carry out home support services and will have to ensure the provision of these services is compliant with the minimum standards set by HIQA. “Home support service” is defined in the Bill as the service of providing in the home a) personal care and/or b) assistance in the home for an adult who by reason of illness, frailty or disability is in need of such care and assistance. The Chief Inspector of Social Services (the “Chief Inspector”) in HIQA will be responsible for monitoring and assessing compliance of home support providers with the new regime.
Obligation to Register
Home support providers will have to apply to the Chief Inspector for a license and submit evidence in relation to their ability to provide home support services, such as demonstrating appropriate insurance policies and financial resources. The Chief Inspector will have the authority to grant or reject the application based on whether it complies with the requirements set out in the legislation. The Chief Inspector may also attach further conditions they consider appropriate.
Obligation to Meet Certain Standards
Once licensed, home support providers must ensure they are acting in accordance with the minimum standards set by HIQA. To achieve this, the home support provider must ensure compliance with any conditions attached to the license, as well as with Ministerial Regulations and any other applicable enactments. They will also have to display their licence online and in the physical place of business and are prohibited from allowing another person to use their license. Lastly, home support providers will be prohibited from making false or misleading representations in relation to owning a license or any conditions attached thereto.
Enforcement Powers of the Chief Inspector
The Chief Inspector will have the power to inspect home support providers where they have reason to believe a person is operating without a license. The Chief Inspector may also inspect licensed home support providers to ensure they are meeting the obligations set out in the legislation and in the HIQA framework. Where the Chief Inspector finds that a home support provider is not meeting the minimum requirements set out in the legislation, they may issue a compliance notice. Failure to address a compliance notice by the specified date may ultimately lead to the revocation of a home support provider's license. Lastly, the Chief Inspector will be empowered to establish a reporting mechanism in relation to financial matters, safeguarding, workforce, or any other matters that impact the quality of the home support provision.
Offences
Under the new Bill, a home support provider who fails to address a compliance notice by the specified date will be guilty of an offence and shall be liable:
- on summary conviction, to a class A fine or imprisonment for a term not exceeding 12 months or both, or
- on conviction on indictment to a fine not exceeding €70,000 or imprisonment for a term not exceeding 2 years, or both.
A licenced home support provider will also be guilty of an offence under the Bill should they:
- fail to exhibit their license online and in their physical business,
- fail to submit information requested by the Chief Inspector,
- fail to notify the Chief Inspector of material matters which would likely affect the validity of their license,
- allow another person to use their licence,
- present that they can provide a home support that contravenes their licence,
- contravene or fail to discharge a duty imposed on them by Ministerial Regulations, or
- fail to comply with a condition of their registration.
Exemptions
The Bill also contains certain exemptions that mean it will not be an offence to provide home support services without a licence if the person provides home support service to certain classes/ groups of people including persons under 18 years of age, persons in the context of a family or personal relationship, through an individual arrangement with the service user for no financial gain, to three or less service users or by exclusively using health or social care professionals registered with CORU to provide the relevant services.
Next Steps
The contents of the Bill may change as it passes through the Oireachtas. Quality standards will have to be developed by HIQA to complement the obligations set out in the Bill. Pending regulatory oversight, it remains important that home support providers have appropriate practices and policies in place, to ensure the safe and appropriate delivery of services such as policies in respect of safeguarding, complaints, staff vetting and oversight, data protection etc.
This article contains a general summary of developments and is not a complete or definitive statement of the law. Specific legal advice should be obtained where appropriate.