Campus-based or congregated settings reported more rapid outbreaks of COVID-19.

Residents living in campus-based or congregated settings experienced disparities in the quality and safety of their care and in their ability to independently exercise their rights. 

The Health Information and Quality Authority (HIQA) has today published an overview of its inspection and regulation of designated centres for people with disabilities in 2020.

HIQA carried out over 750 inspections in disability services in 2020. Inspections found that the majority of centres provided a good quality of care and support to residents and there was increased compliance in key areas, such as safeguarding and positive behavioural support, across centres since 2019. However, there continues to be significant variance in the level of non-compliance in congregated settings compared to community-based settings.

HIQA’s Deputy Chief Inspector of Social Services (Disability), Finbarr Colfer, said: 

“While we found that there were improvements in compliance in congregated settings, the level of non-compliance remains significantly higher at nearly double the level of non-compliance found in community-based settings. Many residents living in campus-based or congregated settings experienced inequalities in the quality and safety of their services, control over their own lives and their ability to independently exercise their rights and choices. Those who lived in smaller homes often had more control and choice around their day-to-day routines, including important aspects of everyday life that many take for granted such as engaging in their local community, going for exercise and participating in the preparation and cooking of their meals.”

The report also outlines what residents told inspectors about their experience of services and regulation as well as the unique challenges of COVID-19. It recognises the resilience of residents, their families and staff in managing the risk of infection in centres and highlights how centres with better governance arrangements were more effective in limiting the risk of transmission of COVID-19 in their services. 

Mr Colfer continued: “The absence of emergency provisions to support the sector in opening up additional capacity at short notice remains a critical weakness in the current legislation and this became more apparent during the pandemic. In addition, during 2020, the focus of regulation was on verifying that providers had developed contingency plans to manage any infection outbreaks in each centre. Where outbreaks did occur in centres which were well managed, while there were significant challenges, these centres tended to have better infection control systems in place, better supplies of critical resources and timely access to additional staffing resources to support continuity of service and isolation arrangements. Overall, inspectors found that providers worked together and with the HSE to minimise the risk of infection for residents”.

HIQA will continue to inspect designated centres through ongoing vigilance in relation to managing the risk of COVID-19 infection, but also considering how the quality of life and human rights of residents are protected and promoted in designated centres. Further work is required to ensure that the use and reliance on congregated or campus-based settings continues to be reduced. During 2021, inspectors have continued to focus on the management of the risk of infection in centres, the everyday experience of residents and how their rights are upheld by providers during these times.

Notes to Editor:

• HIQA regulates designated centres for people with disabilities against the Health Act 2007 (as amended), associated regulations and nationally mandated standards. Regulation sets the minimum level of service a person can expect to receive.

• As at 31 December 2020, there were 1,340 registered designated centres for people with disabilities, providing places for 9,166 residents.

• HIQA’s findings are based on inspections, receiving and monitoring information, and speaking with residents and their families. In 2020, outside of inspections, HIQA met with 178 residents as part of 18 resident groups.

• In April 2020, the Chief Inspector established an Infection Prevention and Control Hub (the Hub).
  • Between 6 April 2020 and 10 July 2020, the Hub managed and responded to 617 infection prevention and control queries, of which 31% (191) related to disability services.
• From 27 March 2020, the Chief Inspector implemented a series of ongoing regulatory assurance telephone calls by inspectors to each designated centre. 
  • 7,116 calls were made and used to monitor and assess the providers’ preparedness for potential outbreak and management of COVID-19 in each designated centre. 

• In 2021, the Chief Inspector will be commencing a programme of inspections on the National Standards for Infection Prevention and Control in Community Services.