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HIQA Regulation and Inspection

The Health Information and Quality Authority (HIQA) is now responsible for the registration and inspection of all residential services for children and adults with disabilities, including respite services, run by the Health Service Executive (HSE) and private and voluntary services. It is the first time any of these services will have been subject to independent inspection.

 It is the first time that residential services for people with disabilities will be subject to independent scrutiny. From now on, children and adults who use disability services and their families will know what they should expect, and service providers will know what is expected of them in delivering a person-centred, high quality and safe service.

Residential services will be inspected against the National Standards for Residential Services for Children and Adults with Disabilities, published by HIQA in May 2013, and against relevant legislation and regulations. Services must register with the Authority and will be inspected to ensure that all services are of a consistently high quality, regardless of which provider is running them.

The registration and inspection process will be completely independent and reports will be published after every inspection. Inspections will begin across the country in the coming months and will take place at any time and may be either announced or unannounced.

HIQA aims to ensure a smooth transition to the new regulatory process for all and is working with people providing services and with advocacy groups to ensure that everyone is ready for regulation. The sector is new to regulation and the aim will be to promote improvement and therefore there has been ongoing engagement with providers of residential services and with advocacy groups representing those living in the residential services, including a series of information sessions and focused engagements.

All inspection reports will be available to download from the Health Information and Quality Authority’s website, www.hiqa.ie.

Landscape

There are approximately 9,800 people with a disability who live in residential care services for people with disabilities in Ireland. These services are provided in approximately 1,300 residential services run by 88 service providers across Ireland, including a mix of State (HSE), private and voluntary providers. Respite services for children and adults with a disability are also covered by regulation and subject to inspection and registration with the Authority.

Engagement

The Authority has initiated a process of engagement with providers of residential services (including Cheshire Ireland) and with advocacy groups representing those living in the residential services. A series of information sessions and focused engagements have already taken place with providers, with further focused meetings planned to cover such topics as preparing for inspection, responding to inspection reports, action plans and submitting notifications. Regular meetings with the advocacy groups representing people with disabilities and their families are also ongoing to ensure that their views are taken into account.

The Standards

The National Standards for Residential Services for Children and Adults with Disabilities were published in May 2013 and focus on the outcomes to be achieved for the adults and children receiving services. The Standards are grouped under eight key themes and cover a number of areas including respecting peoples’ autonomy, privacy and dignity and promoting their rights. They are aimed at ensuring the facilitation of choice and safeguarding and protecting people from abuse. The Standards and Regulations can be downloaded in various formats at www.hiqa.ie.

Registration

In order to be granted a registration certificate to operate as a residential service for children and adults with disabilities, providers will have to undergo a rigorous registration process to ensure that the service they are providing is able to meet the needs of their residents. HIQA may apply conditions to a provider’s registration, that is that a service is only allowed to legally operate under certain conditions. These may include running a particular type of service (such as residential respite) or accommodating a certain number of people. Providers are not allowed to operate services that are outside these conditions.

Inspections

The Authority will inspect residential services for children and adults with disabilities on a phased basis from November 2013, and will re-register each residential service every three years. The Authority already inspects children’s residential care centres and residential centres for older people, and similar to these, inspections of residential services for children and adults with disabilities will be a mixture of both announced and unannounced. These will happen by day and also in the evenings, at weekends and at night.

During an inspection visit, inspectors will talk to the people living in the residential service along with their families and with managers, staff and interested people who wish to speak to them. Inspectors will focus on the experience of the person living in the residential service and what it is like to live there. They will also observe daily routines, quality of accommodation and meals, and other aspects of daily life. In cases where the person living in the residential service has difficulty with communication, the provider will arrange assistance to ensure their views are fully included. Inspectors will always check to make sure that the information and records they receive or read, or what they observe, is an accurate reflection of what happens in practice.

Inspection reports

Following an inspection, a report will be produced, based on the findings from the inspection, and will be published on the Authority's website. These reports will give factual information about the residential services, the number of places and general facilities. They will also outline the findings of the inspection and will comment on all areas of the service. Reports will highlight where standards of care are good as well as where improvements are required. Any necessary actions required on the part of the provider will be clearly indicated in the report. The reports will be fair and will reflect all aspects of the service that is being provided.

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