Governance and management arrangements in disability services need improvement to ensure people with disabilities receive good quality care

Date of publication:

Residents living in smaller, community-based homes experience a better quality of life, live in safer services and are more likely to experience better personal outcomes.

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 2021.

HIQA carried out 1,220 inspections in disability services last year. Inspections found that the majority of centres provided a good standard of care and support to people with disabilities. However, the report also outlines concerns over poor findings in relation to governance and management in a number of settings. One in five inspections completed in 2021 found improvements were required to the provider’s governance and management arrangements, with non-compliance increasing throughout the year, including in centres where providers had good oversight arrangements prior to the COVID-19 pandemic.

HIQA’s Deputy Chief Inspector of Social Services (Disability), Finbarr Colfer, said: “Poor governance and management has a negative impact on the quality and safety of care and support for residents, and impacts on their quality of life. It is critical that providers re-establish effective governance and oversight to ensure that residents receive the quality of support that they are entitled to.”

Furthermore, HIQA found that there continues to be significant variance in the level of non-compliance in congregated settings compared to community-based settings.
Mr Colfer continued: “We found that residents living in congregated settings were more likely to experience a poorer quality of life with notable inequalities in the overall quality and safety of the services being provided to residents. Furthermore, a higher number of congregated settings than in previous years required improvements to the overall quality and safety of the premises. Further work is required to ensure that the use and reliance on congregated or campus-based settings continues to be reduced.”

The report also highlights what residents told inspectors about their experiences of services and regulation and the new challenges presented for services, providers and residents in 2021.

Mr Colfer said: “During 2021, services for people with disabilities continued to adapt as a result of COVID-19. We commenced a new inspection programme to drive improvements in infection prevention and control across services. We continue to inspect designated centres to ensure there is ongoing vigilance in relation to managing the risk of COVID-19 infection, particularly in congregated settings.”

Read the full report and view the infographic from the link at the top of the page.

For further information please contact:
Marty Whelan, Head of Communications & Stakeholder Engagement
085 8055202,

Notes to the 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 2021, there were 1,401 registered designated centres for people with disabilities, providing places for 9,039 residents.
  • HIQA’s findings are based on inspections, receiving and monitoring information, and speaking with residents and their families. In 2021, outside of inspections, HIQA met with 80 residents as part of 22 online meeting.
  • For the first time, the report compares the level of compliance and experiences of children and young people living in or accessing designated centres with adults receiving services. HIQA found that as children transition into adult services, they can experience a poorer level of service; however, this is less likely if they stay in a smaller community-based or non-congregated setting.
  • 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.
  • In response to the COVID-19 pandemic, the Chief Inspector of Social Services commenced a programme of targeted inspections to assess registered providers’ compliance with Regulation 27: Protection against infection. The programme aims to promote continuous quality improvement in infection prevention and control, in line with the National Standards for infection prevention and control in community services, (2018).