Today is a milestone day for Ireland as the independent regulation of residential services for children and adults with disabilities begins nationwide. This will see an extension of public protection measures for those using our health and social care services.

The Health Information and Quality Authority (HIQA) is now responsible for the registration and inspection of all residential services for children and adults with disabilities, including respite services, run by the Health Service Executive (HSE) and private and voluntary services. It is the first time any of these services will have been subject to independent inspection.

Phelim Quinn, Director of Regulation at the Health Information and Quality Authority, said: “This is a landmark moment for children and adults with disabilities and their family members living in Ireland. It is the first time that residential services for people with disabilities will be subject to independent scrutiny. From now on, children and adults who use disability services and their families will know what they should expect, and service providers will know what is expected of them in delivering a person-centred, high quality and safe service.”

Residential services will be inspected against the National Standards for Residential Services for Children and Adults with Disabilities, published by HIQA in May 2013, and against relevant legislation and regulations. Services must register with the Authority and will be inspected to ensure that all services are of a consistently high quality, regardless of which provider is running them.

The registration and inspection process will be completely independent and reports will be published after every inspection. Inspections will begin across the country in the coming months and will take place at any time and may be either announced or unannounced.

HIQA aims to ensure a smooth transition to the new regulatory process for all and is working with people providing services and with advocacy groups to ensure that everyone is ready for regulation. The sector is new to regulation and our aim will be to promote improvement and therefore there has been ongoing engagement with providers of residential services and with advocacy groups representing those living in the residential services, including a series of information sessions and focused engagements.

As with its inspection of residential services for older people, if the Health Information and Quality Authority’s inspectors find that a service is unsafe, or the National Standards and regulations are not being met, it will have the legal power to take a number of actions in the best interest of those living in the residential service. This may include refusal to register the service, prosecution, the placing of additional registration conditions and, in situations where there is significant risk to the life or to the health or welfare of residents, immediate cancellation of the service’s registration.

All inspection reports will be available to download from the Health Information and Quality Authority’s website, www.hiqa.ie.

Ends

Further Information: 

Marty Whelan, Head of Communications and Stakeholder Engagement, Health Information and Quality Authority, 01 814 7481 / 086 244 7623, mwhelan@hiqa.ie.

Notes to the Editor: 

Landscape
There are approximately 9,800 people with a disability who live in residential care services for people with disabilities in Ireland. These services are provided in approximately 1,300 residential services run by 88 service providers across Ireland, including a mix of State (HSE), private and voluntary providers. Respite services for children and adults with a disability are also covered by regulation and subject to inspection and registration with the Authority.

Engagement
The Authority has initiated a process of engagement with providers of residential services and with advocacy groups representing those living in the residential services. A series of information sessions and focused engagements have already taken place with providers, with further focused meetings planned to cover such topics as preparing for inspection, responding to inspection reports, action plans and submitting notifications. Regular meetings with the advocacy groups representing people with disabilities and their families are also ongoing to ensure that their views are taken into account.

The Standards
The National Standards for Residential Services for Children and Adults with Disabilities were published in May 2013 and focus on the outcomes to be achieved for the adults and children receiving services. The Standards are grouped under eight key themes and cover a number of areas including respecting peoples’ autonomy, privacy and dignity and promoting their rights. They are aimed at ensuring the facilitation of choice and safeguarding and protecting people from abuse. The Standards can be downloaded in various formats at www.hiqa.ie.

Registration 
In order to be granted a registration certificate to operate as a residential service for children and adults with disabilities, providers will have to undergo a rigorous registration process to ensure that the service they are providing is able to meet the needs of their residents. HIQA may apply conditions to a provider’s registration, that is that a service is only allowed to legally operate under certain conditions. These may include running a particular type of service (such as residential respite) or accommodating a certain number of people. Providers are not allowed to operate services that are outside these conditions.

Inspections
The Authority will inspect residential services for children and adults with disabilities on a phased basis from November 2013, and will re-register each residential service every three years. The Authority already inspects children’s residential care centres and residential centres for older people, and similar to these, inspections of residential services for children and adults with disabilities will be a mixture of both announced and unannounced. These will happen by day and also in the evenings, at weekends and at night.

During an inspection visit, inspectors will talk to the children and adults living in the residential service along with their families and with managers, staff and interested people who wish to speak to them. Inspectors will focus on the experience of the person living in the residential service and what it is like to live there. They will also observe daily routines, quality of accommodation and meals, and other aspects of daily life. In cases where the person living in the residential service has difficulty with communication, the provider will arrange assistance to ensure their views are fully included. Inspectors will always check to make sure that the information and records they receive or read, or what they observe, is an accurate reflection of what happens in practice.

Legal powers
The Health Information and Quality Authority has the legal authority, under the Health Act 2007, to take a number of actions. If, during the registration process, or later during a routine inspection, the inspectors discover that a service is unsafe or the regulations or National Standards are not being met, the actions that can be taken (in the best interest of the child or adult living there) include:

- requiring that changes to the service be made and then checking that these improvements are carried out
- prosecuting for offences under the Health Act 2007, such as failing to comply with a condition of registration
- cancelling registration of a service – so it will no longer be able to operate.

It is important to stress also that if the Authority’s inspectors come across a situation which poses an urgent risk to residents, and where the provider is unwilling or unable to take the necessary action, emergency steps can be taken to address the situation. The Authority also expects to see a lot of good quality services being provided and these will be acknowledged and highlighted in the inspection reports. Inspections will be fair and proportionate in actions with the focus being on the welfare of those living in the residential service.

Inspection reports 
Following an inspection, a report will be produced, based on the findings from the inspection, and will be published on the Authority's website. These reports will give factual information about the residential services, the number of places and general facilities. They will also outline the findings of the inspection and will comment on all areas of the service. Reports will highlight where standards of care are good as well as where improvements are required. Any necessary actions required on the part of the provider will be clearly indicated in the report. The reports will be fair and will reflect all aspects of the service that is being provided.