HIQA is calling for a complete overhaul of homecare services.
The watchdog wants to see regulations introduced and says it's prepared to act as regulator.
Research by HIQA has found the current home care system is unsustainable, as the population lives longer and thus has more complex care needs.
Chief Inspector of Social Services Carol Grogan says the lack of formal oversight is an issue.
"The absence of regulation or independent oversight means that people receiving services, their families and the public can't be assured of the quality and safety of the care," said Carol Grogan.
Home and Community Care Ireland represents the majority of private home providers and holds them to its own standards.
But CEO Joseph Musgraves says some providers operate completely independently.
"And that's really a black mark when it comes to regulation and needs to be addressed really quickly," he said.
HIQA wants to see a review of existing services conducted to address the uneven geographical distribution of providers. it's also calling for the development of regulations that ensure person-centered, quality services nationwide.
