It says those funding services need to take a greater role in accountability
A new report says nursing homes, residential centres and foster care services must take stronger measures to protect vulnerable people in their care.
A review of regulations by the Health Information and Quality Authority (HIQA) says better measures are needed to protect those in care against abuse, harm and exploitation.
The review found some services must take safeguarding more seriously, particularly having garda vetting in place for all staff and volunteers.
It also says there are "clear links" between good governance of services and better outcomes for people using the services.
And it says those who fund the services need to "take a greater role in holding those services to account."
Mary Dunnion is chief inspector of social services and director of regulation with HIQA: "In general, many of the people using services that we spoke with in 2016 were happy with their service and felt that they were receiving good care.
"Nonetheless, a considerable number of people told us that they were not satisfied; that the services were not person-centred; and that services were failing to meet their needs."
On the issue of safety and garda vetting, Ms Dunnion said: "In 2016, some services were still not taking the issue of Garda Síochána vetting sufficiently seriously and were thereby failing in their legal responsibility to safeguard adults and children.
"In addition, in a range of disability services, we found that leadership and practice in recognising, preventing and protecting people from harm was deficient.
"HIQA believes safeguarding needs to be further strengthened by introducing new legislation to better protect those who may be at risk."
The report also says the absence of a "clear plan" for the future of the health service is impacting on the delivery of services and reform is "clearly needed" in this area.
"The 2016 overview report shows there is a requirement for clear national policy direction, policy implementation and timely decision-making in terms of health and social care services.
"This was a key finding in both of the reviews conducted by the healthcare team in 2016 in relation to the country’s ambulance services and the services at Midlands Regional Hospital, Portlaoise", Ms Dunnion added.
During 2016, 735 inspection reports were issued on residential centres for people with disabilities, 63 were published on acute hospitals and 608 inspections of nursing homes were produced.
The chief inspector issued 11 notices to refuse the application to register, and cancel the current registration status, of designated centres for people with disabilities.
In older people's services, a total of 38 nursing homes had restrictive conditions applied to their registration.
Nursing Homes Ireland (NHI) has reiterated its call for Government to bring stakeholders around the table to plan for challenges in meeting the health and care needs of older people.
NHI CEO Tadhg Daly said: "Now the regulator of health services is identifying a policy deficit, it must serve as a further wake-up call for the State.
"HIQA, which has overseen regulation of the nursing home sector since 2009, has recognised necessity for clear national policy direction."
"For many years, NHI has been advancing requirement for the State to bring stakeholders around the table through a forum that would input to the planning and policy development to enable and support provision of older person care.
"The Department of Health must lead in bringing policy stakeholders together to support it in addressing the significant challenges being presented in meeting older persons healthcare needs. Headline challenges include policy, workforce planning, and resourcing."
Read the full report here