Today, the Health Information and Quality Authority (HIQA) has published 22 inspection reports on thematic inspections of restrictive practices in 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.

HIQA’s programme of thematic inspections of restrictive practices in designated centres for people with disabilities focuses on assessing physical and environmental restraints as well as other forms of restrictive practices, and aims to promote quality improvement across services.

All 22 centres were found to be compliant, with good practice identified in ensuring residents’ rights were promoted, their privacy and dignity were respected and their care was person centred. The centres are operated by: Avista CLG; Brothers of Charity Services Ireland CLG; Camphill Communities of Ireland; Delta Centre Company Limited by Guarantee; Nua Healthcare Services Limited; Praxis Care; S O S Kilkenny Company Limited by Guarantee; Saint Patrick's Centre (Kilkenny)/trading as Aurora-Enriching Lives, Enriching Communities; St Joseph's Foundation; St Michael's House; and Stewarts Care Limited.

Examples of good practice included:

• In a centre operated by Avista CLG in Co. Limerick, no restrictive practices were observed to be used. Residents had keys to their homes and bedrooms and there were no locked presses in the communal areas. One resident, who required a wheelchair to mobilise, explained that the transport vehicle that was available to them was better suited to their needs than the one that had previously been used in the centre. All residents were supported to have money available to them, and staff were familiar with the preferences of residents relating to the management of their personal finances. 
• In a centre operated by Praxis Care in Co. Waterford, residents were informed about restrictive practices that were used in the centre and easy-to-read information had been provided to the residents about why a specific restrictive practice was in place. Regular staff meetings were also held and restrictive practices were an agenda item. Staff discussed and reviewed these at each meeting, to promote a restraint-free environment for residents.
• In a centre operated by Brothers of Charity Services Ireland CLG in Co. Cork, residents spoke positively of the support that they received from staff, and that they were able to do the things that they wanted to do, such as going for walks and going out for meals. The inspector noted the presence of a bed leaver in the centre, however this appeared to be more of a standing aid for the resident and did not impact their ability to independently use their own bed.
• At a centre operated by Stewarts Care Limited in Co. Dublin, inspectors observed that some environmental restrictions were implemented within the centre, including the use of bedrails, bed bumpers and a sensor mat. Such restrictive practices were found to be in line with the organisation’s policies and procedures. These practices had an accompanying risk assessment and they were implemented for the least amount of time possible and only to manage a specific risk. Inspectors also found that the provider had initiatives in place to try and reduce the number of restrictions in the designated centre.

Read all reports at www.hiqa.ie.