The COVID-19 crisis has resulted in a significant lapse in provision and resourcing of the Home Support Service and family carers. Since the beginning of the crisis there has been an estimated 20% reduction in the provision of home supports. This drop is partly due to instruction to service providers to redeploy support to the nursing home sector. This is also in part driven by fear on the part of home care recipients who want to minimise their risk of contracting the virus. Contributing to this fear is the lack of clear guidance for home care workers and family carers on the wearing of PPE, and the lack of availability of the equipment itself.
The COVID-19 crisis has left older people, people with disabilities, family carers and home care workers without the support they need. The Home Care Coalition calls for the implementation of the below actions to help to rectify this.
Service provision and resources
A commitment by the HSE to ensure that home support services will be resourced to continue to provide support to current recipients who want to receive it.
A commitment by the HSE to reinstate all services that have been suspended or reduced to at least the same level once the pandemic has passed.
The HSE must clarify what is appropriate PPE provision for home care work and provide an adequate supply of PPE for services in the community as required.
Support for those receiving home care
COVID-19 has forced the closure of many routine services family carers and their loved ones rely on including respite and day care services. Efforts should be made to provide in-home alternatives where practical.
In home support also needs to be made available in cases where a family carer has contracted COVID-19.
Clear messaging in plain English is needed to inform those receiving home care regarding standards and risk and to clarify what is appropriate PPE provision for this task.
While procedures and guidelines may reflect an ethical approach, care must be taken to avoid the systematic exclusion of people who may be particularly vulnerable, such as those with dementia. Additional vulnerabilities must be addressed and planned for.
Safeguarding issues arise where supports have been withdrawn or scaled back, and measures must be introduced to address these. We are concerned that people who need care are not being provided with it in a safe way and that there is a potential safeguarding issue arising for some who are reliant on extended family or volunteers to deliver a service which had been provided by trained personnel.
In times of crisis and with cocooning measures introduced, service users may also be at increased risk of domestic violence from partners or family members. All health care services, including home care workers, should be equipped to respond to these issues for those receiving care. Information should be provided on contacting the Garda if in immediate danger or call 999 or 112. Supports and helpline information should also be included.
Support for family carers
Family carers should be named and recognised as a ‘vulnerable group’ by the Public Health Emergency Committee.
A guidance document for family carers should be produced giving advice on how to prevent the spread of Covid-19 in caring situations, setting out protocols and steps to be taken.
Service users who are at-risk and family carers should be prioritised for testing and for results.
Contingency plans and protocol must put in place for when a family carer is diagnosed with COVID-19 or is in self-isolation.
Support for home care workers
A supplementary payment should be put in place for home care workers who have had their hours of work significantly reduced, but are not eligible for the COVID Unemployment Payment as they have not been laid off. While the Department of Social Protection advise that people whose hours of work have been reduced due to COVID 19 can apply for a Short Term Work Payment, many home care workers are not eligible for this either as they do not satisfy the requirement that they must have been working fulltime (at least 35 hrs per week) before their hours were reduced.
Undocumented workers in Ireland who are working across the country in essential jobs including healthcare and home care should be regularised. Measures should be put in place to support undocumented carers to fill staff shortages by granting them immigration status.
Home care workers should be supported with their childcare, accommodation and other care needs to ensure they can provide vital services during the pandemic.
Support for service providers
Funding must be sustained for all not for profits though delivery models may have changed.
The COVID-19 crisis has further highlighted the immediate need for the development of a statutory homecare scheme which would provide a legislative basis for equitable access to home supports across the country. This must be a priority for the next Government. It is crucial that a new care system is introduced which involves older people themselves in its planning and review, is fairly funded and ensures full integration across home care and nursing home care and all forms of accommodation in between.
About the Home Care Coalition
The Home Care Coalition is a group of 23 charities, not-for-profit organisations and campaigners, established with the aim of ensuring the implementation of an adequately-resourced, person-centred statutory home care scheme with equality of access and availability across the country.
Acquired Brain Injury Ireland
Age and Opportunity
Alzheimer Society of Ireland
Care Alliance Ireland
Cystic Fibrosis Ireland
Disability Federation of Ireland
Family Carers Ireland
Irish Association of Social Workers
Irish Heart Foundation
Irish Hospice Foundation
Irish Motor Neuron Disease Association
Irish Senior Citizens’ Parliament
Irish Wheelchair Association
Migrant Rights Centre Ireland
National Women’s Council of Ireland
Neurological Alliance of Ireland
Northside Home Care Services
Third Age Ireland