Today, the Health Information and Quality Authority (HIQA) has published 16 inspection reports on designated centres for people with disabilities. HIQA inspects against the Health Act 2007 (Care and Support of Residents in Designated Centres for Persons (Children and Adults) with Disabilities) Regulations 2013 and the National Standards for Residential Services for Children and Adults with Disabilities, which apply to residential services for people with disabilities in Ireland.

These are the first 16 reports on HIQA’s new thematic inspection programme focusing on the use of restrictive practices in services for people with disabilities. The programme is part of a quality improvement approach which aims to drive improvements in practice. During these inspections, inspectors look for evidence that people’s fundamental human rights are upheld, that their voices are heard, and that they are free to live in accordance with their choices and preferences.

These 16 inspections found good practice in relation to the management of restrictive practices in all centres operated by Daughters of Charity Disability Support Service; Health Service Executive (HSE); L'Arche Ireland; Muiríosa Foundation; Peter Bradley Foundation; Redwood Extended Care Facility; RehabCare; Resilience Healthcare Limited; Rosshaven Services; St Joseph's Foundation; St Michael's House; The Cheshire Foundation in Ireland and The Children's Sunshine Home (operating as LauraLynn Children's Hospice).

Examples of good practice observed in relation to restrictive practice at the time of inspection included:

• residents in a L’Arche Ireland centre, who had previously lived in institutional settings, told inspectors that life is much better now for them in their current home as there are no restrictions in place.
• in a Peter Bradley Foundation centre, staffing arrangements were flexible to facilitate residents to engage in their local community,  to deliver positive behaviour support and to promote a restraint-free environment.
• in a Redwood Extended Care Facility residents were involved in the development of smoking reduction plans with their medical practitioners. These plans were discussed and agreed with residents before being put in place; respectful of their wishes.
• inspectors found that the ethos and culture of a Rosshaven Services centre was focused solely on the wellbeing of the residents and, where a restrictive practice, was implemented it was done so with thorough consideration.
• Some inspections found that while residents received a good, safe service their quality of life would be enhanced by improvements in the management and reduction of restrictive practices. These included:
• residents living in a HSE centre were subject to a number of restrictive practices due to the layout of their home and their dormitory bedrooms. The HSE was aware of this and was planning to provide alternative accommodation by December 2019 which aimed to reduce the use of some of the restrictive practices, positively impacting on residents’ rights and dignity.
• residents in a Cheshire Foundation in Ireland centre required staff support to access certain parts of their home. A reduction in these environmental restrictions would enhance residents’ quality of life and their ability to do what they choose.