The Health Information and Quality Authority (HIQA) has published three inspection reports for centres in Áras Attracta, a large campus-based residential setting for people with intellectual disabilities in Co. Mayo operated by the Health Service Executive (HSE).

Inspections were carried out on 8 and 9 January 2018 to inform HIQA’s final decision on the registration of all three centres on the campus, related to the issuing of a notice of proposal to cancel their registration in September 2017. As a result of the latest inspections, the Chief Inspector of Social Services in HIQA has withdrawn the notices of proposal to cancel registration and is inviting the HSE to apply to register these centres. However, HIQA remains concerned about the sustainability of these improvements and the areas of continued non-compliance.

HIQA found that improvements had been made to residents’ safety and quality of life since the previous inspections in May 2017. The HSE had implemented, or was in the process of implementing, the majority of actions required following previous inspections, within the agreed time frames. Revised management and oversight arrangements had been put in place in all three centres and appropriate action was now being taken in relation to safeguarding concerns.

Inspectors found that residents were now afforded more choice in how they spent their day and in how they decorated their bedrooms. Residents could now take part in activities of interest to them. Residents and their families could now participate in making decisions that affect them through regular resident and family forums. Some residents had recently moved out of the campus into more appropriate housing in the community, while other residents told inspectors that they were looking forward to their move into the community.

However, improvements are required in a number of areas across the campus:

• further improving oversight of the quality and safety of care,
• increasing opportunities for residents to participate in education, training or employment,
• completing fire prevention upgrade work, as required by the HSE’s fire consultant,
• making sure residents have an accessible version of their personal plan,
• providing further training to ensure staff can meet residents' assessed needs,
• ensuring staff files contain all records to verify that they are appropriate to work in the centre, as required under the regulations.

While there continues to be non-compliance in areas such as the workforce, risk management, governance, suitability of accommodation on the campus and aspects of social care provision, the HSE has submitted a satisfactory action plan to fully address these issues and bring the centres into full compliance with the regulations and standards.

On the basis of the HSE’s overall plan for the campus and the action plans submitted following these inspections, HIQA has withdrawn the notices of proposal to cancel the registration of the campus. This will provide the HSE with an opportunity to fully implement their action plans. However, HIQA remains concerned about the sustainability of these improvements and will continue to monitor the campus closely to ensure that the provider continues to improve residents’ care, safety and quality of life. HIQA now expects to receive completed applications for the registration of centres in Áras Attracta and, when received, the Chief Inspector will give due consideration to these.

Notes to Editor:

• 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.
• Áras Attracta campus comprises three designated centres and, at the time of the most recent HIQA inspection, 75 people with intellectual disabilities were living there.
• Currently, the Áras Attracta centres are deemed registered under section 69 (2) of the Health Act 2007, but have yet to complete the registration process with HIQA.
• HIQA’s overview report for the campus in November 2017 found that most residents were experiencing an institutional model of care, with centralised practices and limited or no opportunities for personal development and growth. As a result, on 28 September 2017, the Office of Chief Inspector of Social Services issued the registered provider (the HSE) with notices of HIQA’s proposed decision to cancel the registration of all three Áras Attracta centres.