Frequently asked questions

Questions about Nursing Homes

Questions about Residential Services for People with Disabilities

Questions about Nursing Homes

Q. Who is responsible for the registration and inspection of nursing homes and residential centres?

From 1 July 2009, the Authority became responsible for the registration and inspection of all public and private nursing homes and residential care services for older people. This was the first time, HSE-run centres, as well as, private and voluntary nursing homes became subject to independent registration and inspection.

Q. Do all nursing homes have to be registered?

Yes. By law, all nursing home services in the public, private and voluntary sectors have to be registered (to ensure they are able to provide such services in the first instance) and inspected (in order to ensure they are compliant with the relevant legislation, maintaining standards required to operate and are continuously upholding high standards) by the Authority.

Q. Why are you conducting inspections?

Inspections occur to check that residents in nursing homes are safe and are well looked after. Inspections also provide information to residents, their families, and the general public about the standards of care in individual nursing homes. The aim of inspection is to make sure that poor services are not allowed to operate, and to recognise those nursing homes that provide good, person-centred care.

Q. Are there standards of care that nursing homes and residential centres should comply with?

Yes. The Authority has developed specific standards for the operation of nursing homes and residential centres in consultation with those who use services and those who provide them. These are called the National Quality Standards for Residential Care Settings for Older People in Ireland. We  inspect against these standards and against regulations set by the Department of Health.

Q. Who carries out the inspections?

Inspections are carried out by inspectors from the Authority. All inspectors are fully trained staff and have a wide range of relevant professional experience.

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Q. How are inspections carried out?

Inspections are announced or unannounced and can be held during the day or night. Inspectors talk with managers, staff and with residents (residents who do not wish to speak to inspectors do not have to) and their families. Inspectors focus on the experience of the resident living in the nursing home and what it is like to live there. An inspection report is produced by the Authority after each inspection.

Q. Is the inspection process totally independent of the Health Service Executive and private nursing home operators?

Yes, inspectors report to the Chief Inspector of Social Services within the Authority.

Q. What kind of information is contained in inspection reports?

Inspection reports give factual information and highlight where standards of care are well met, as well as where improvements are required. They are published on the Authority's website. Inspection reports give the residential care centre’s location, and outline the number of places there and general facilities. They also outline the findings of the inspection and comment on all areas of the service. Any necessary actions required on the part of the provider are clearly indicated in the report. The reports are fair and reflect all aspects of the service that is being provided. These inspection reports provide information to the residents themselves, their families and the general public about the standards of care in individual centres.

Q. Can I read your inspection reports?

Inspection reports are published on the website shortly after each inspection.

Q. What actions can be taken if a nursing home is not meeting your standards or the regulations?

As outlined in the Health Act 2007, we have the power to seek legal enforcement of our requirements and sanctions in the event of non-compliance. Actions which can be taken in the interests of the residents living in the nursing home include:

  • Requiring that changes to the service be made and then checking that these improvements are carried out.
  • Changing the operating conditions of that centre (the number, type or category of resident they may accommodate).
  • Prosecuting for offences under the Health Act 2007, such as failing to comply with a condition of registration.
  • Cancelling registration of a centre - so it is no longer able to operate.

If inspectors come across a situation which poses an urgent risk to residents, which the provider is unwilling or unable to correct urgently, we can take immediate action to address the situation. Every effort is made to ensure residents of nursing homes are not inconvenienced. However, if a nursing home does not comply with laws, arrangements may have to be made for residents to be moved to a different nursing home, which does comply with these laws and provides safe quality care.

Questions for Providers (Nursing homes)

Go to the Providers section here.

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Questions about Residential Services for People with Disabilities

Q: Which types of services are covered by regulation?

HIQA regulates all residential services for children and adults with disabilities, including residential respite services, provided by the Health Service Executive (HSE), private organisations, and voluntary groups. A residential service is where someone lives most or all of the time. For some, this will be five days a week; for others, seven days a week. A residential respite service is where somebody goes for a short stay, either as a planned break or in an emergency.

The residential services may include:

  • institutions, which usually provide accommodation for 10 or more people
  • clustered housing, or housing associated with an institution (it may be on the grounds of or near the institution)
  • supported community living, which is houses within an ordinary neighbourhood that may have individualised supports to meet the needs and wishes of people with disabilities living there
  • residential respite services.

Q: Are respite services covered by regulation?

Yes. All residential services for children and adults with a disability, including respite centres, will be regulated by HIQA. Each centre must have a Statement of Purpose, which is a document that clearly sets out what type of services are provided in the centre. This is very important where a range of different services are provided, for example, residential respite, on-site day services, etc. This information is then taken into account when registering and inspecting the centre to make sure that the service is running the types of services is says it is, to the highest quality possible.

Q: What Standards must residential services meet?

HIQA have written National Standards for Residential Services for Children and Adults with Disabilities which outline what a good quality, safe residential service for children and adults with disabilities should look like. HIQA will then continually check residential services to make sure that they are meeting these Standards. The Standards focus on outcomes which empower people with disabilities at the different stages of their lives to participate in, and contribute to, activities which help them realise their full potential. The Standards are available in various formats on our website, www.hiqa.ie. Each service must meet the Standards and legislation to be allowed to operate.

Q: What does registration involve?

Providers (those running a service) must register with us and keep us informed about how their service is run. By law they must provide details such as the type of care they provide and to whom, the type of accommodation they provide and the number and type of staff employed there. We register each centre based on this (and other) relevant information. We monitor and inspect to ensure that services are provided to the right people in the right way on an ongoing basis.

Q:What happens on an inspection visit?

All inspections can be announced or unannounced and may take place at any time of day or night. The only exception to this is the registration inspection, which will always be announced. The inspection visit is only part of our inspection process. The process starts with each service providing us with information about the centre and finishes when the inspection report is published on our website.

On an inspection visit, inspectors talk with managers, staff and interested people. They also talk with residents and their families and give out confidential questionnaires to get feedback. Residents who do not want to speak to inspectors do not have to. Inspectors also look at routines, quality of life, accommodation, food and other aspects of daily life to get a full picture of what it is like for those living there.

Q: What kind of information is contained in inspection reports?

Inspection reports give factual information about where standards of care are well met, as well as where improvements are needed. They are published on our website www.hiqa.ie. Inspection reports outline the findings of the inspection and comment on all areas of the service. Any actions which the provider must take to meet legislation are clearly set out in the report. The reports are fair and reflect all aspects of the service being provided. These inspection reports provide information to the residents themselves, their families and the general public about the standards of care in individual centres.

Q: How will inspections of services for children with disabilities differ?

Centres that provide residential services for children will be inspected against the relevant Regulations and the National Standards, which take into account the different needs of children with disabilities as they grow. Inspectors with a particular background in regulating services for children will generally be involved in such inspections.

Q: Responding to concerns in designated centres for children and adults with disabilities

Find out more about responding to concerns in designated centres for children and adults with disabilities.

Questions for Providers of Residential Services for Children and Adults with Disabilities

This document was developed in response to questions received by the Authority in relation to the commencement of the regulation of residential services for children and adults with disabilities. It is intended that the document will be updated on a regular basis. Read the frequently asked questions here.

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