Adding Private Homecare to HSE Support - Keeping Care Consistent
Many families use HSE home support as the foundation of care, then look for extra help when gaps appear between visits. Private top-up homecare can make that routine feel more manageable, especially when support is needed later in the day, at weekends, or after a hospital stay.
In this article, we’ll explain how private hours can sit alongside HSE support, what to check around tax relief, and why care coordination matters when more than one provider is involved.
Article highlights:
Private top-up hours usually work best when an HSE home support package stays in place and extra agency time is added around it to cover gaps in the day or week.
Revenue Employing a Carer Relief may reduce the income tax cost of eligible private care at your marginal rate, subject to Revenue rules, records, and annual limits.
Clinical Nurse Manager oversight can help keep visits aligned through clear care planning, simple handovers, and agreed task boundaries.
The proposed Health (Amendment) (Home Support Providers) Bill 2025 points towards HIQA-led registration and national standards for home support providers once enacted and commenced.
Where Gaps Can Still Happen in HSE Support
An HSE home support package can provide valuable day-to-day help for older persons and, in some cases, for individuals with disabilities through local services.
Even so, families can still face gaps between visits, especially in the late afternoon, evening, at weekends, during hospital discharge, or when local capacity is under pressure.
These gaps do not always mean the approved support is wrong. In many homes, they simply reflect the difference between essential scheduled visits and the wider help a person may need to stay comfortable, settled, and safe across the full day. You can read more about the public pathway on Comfort Keepers’ page about HSE-funded Home Support Services.
When Extra Hours Can Help
Busy winter periods can make those gaps feel more noticeable, but the same issue can arise at any time of year. A family may need support with a hot meal, company before bed, short respite, or help after coming home from hospital. Private homecare can sit around the HSE timetable to cover those extra hours without replacing the public package.
How Private Homecare Can Sit Alongside HSE Support
The simplest approach is to keep one joined-up plan. If the HSE visit covers morning personal care, the private visit can focus on lunch, companionship, evening prompts, or mobility support at home. That gives broader cover across the day and cuts down on overlap.
A private provider should still complete its own assessment before care starts. Some families may also come across interRAI during the HSE care needs assessment process, as the HSE is introducing it as a standardised assessment tool in parts of the service.
Keeping Care Aligned Across Visits
Good coordination matters more than paperwork. Everyone involved should be clear on visit times, tasks, changes in condition, and who needs to know if something shifts.
Clinical Nurse Manager oversight can support that coordination. It helps keep handovers clear, sets safe task boundaries, and gives families a point of contact if needs change.
It also supports a calmer transition for those we support after discharge home, when routines often need to be rebuilt quickly.
Private top-up hours can be useful for:
Companionship and social contact during long gaps between visits
Meal preparation and help with a steady evening routine
Short respite periods for family carers
Extra support after hospital discharge, where the wider care team agrees that home is the right setting
Tax Relief and Cost Planning
The cost of extra care is a real concern for many families. Revenue Employing a Carer Relief may help with the private portion of care if the person receiving support meets the qualifying conditions.
Revenue states that relief is given as a deduction against taxable income at your marginal rate, based on the lower of the actual eligible cost or €75,000 per incapacitated person each year. The relief applies to private spending only. It does not apply to amounts funded by the HSE or a local authority.
A few practical points matter:
Keep invoices and proof of payment from the start.
Relief is not available if the person employed works as a housekeeper only.
Claims can be made through myAccount or ROS, and Revenue may ask for Form HK1.
If you claim this relief, you cannot also claim the Dependent Relative Tax Credit or the Incapacitated Child Tax Credit for that same person.
Comfort Keepers also has a guide to tax relief on home help that explains the claim process in plain language.
Comparing Costs - HSE Only vs Hybrid Model
Care Model | Provider | Cost Basis | Tax Relief Eligibility |
Public Only | HSE | Free service | N/A |
Private Only | Agency | Full private rate | Possible if Revenue conditions are met |
Hybrid | HSE + Agency | Funded visits plus private top-up | Possible on the private portion only, if eligible |
A hybrid model can make sense for families who want to keep their HSE support in place and add cover where it matters most.
Regulation and Provider Choice
Provider choice matters now, and it is likely to matter even more as regulation develops. The Government approved the publication of the Health (Amendment) (Home Support Providers) Bill 2025 in December 2025.
The published proposal states that home support providers would be registered and regulated through an HIQA-led framework once the law is passed and commenced.
That makes governance, supervision, and training worth checking today. Comfort Keepers’ clinically-led model, documented care planning, and QQI-accredited homecare training through Elevation Training are relevant trust signals for families who want consistency.
Common Questions on Hybrid Homecare
Will HSE hours change if we add private support?
Adding private support does not automatically cancel HSE support. The HSE can still review the package if needs or circumstances change, so it helps to keep the public plan and the private plan clearly aligned.
Can tax relief apply to private top-up care?
It can, if the Revenue conditions are met. Relief applies to eligible private care costs, not to HSE-funded hours. Families should keep good records and check the current Revenue rules before claiming.
Bringing HSE and Private Care Together
Private top-up homecare can help families build a steadier routine around HSE-funded visits. It can cover the parts of the day that often feel most stretched, while keeping support person-centred, practical, and consistent.
If you want help mapping your current HSE timetable and planning private hours around it, we're here to help!
We can talk through care needs, scheduling, and the records you may need for a Revenue claim, then arrange an initial consultation.
