The Health Information and Quality Authority (HIQA) has today published 11 reports on residential services 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 and respite services across all disability services in Ireland.

Today’s reports relate to centres which are provided by the Health Service Executive (HSE). In relation to five of these centres, inspectors found evidence of a good quality of life for residents. The provider was found to be ensuring a high level of compliance with the regulatory requirements and providing a good standard of support and care to residents.

Residents in one centre told inspectors that they were very happy living in their home. Inspectors found evidence of care practices that supported residents to exercise choice, and residents were consulted with on the running of the centre. In another centre, the HSE had reduced the number of residents and had introduced changes to care practices which had resulted in significant improvements in the quality of life for residents in that centre since the previous inspection.

In another centre, the HSE had made arrangements for a different provider, Muiriosa Foundation, to operate the centre on behalf of the HSE. Muiriosa Foundation has since applied to be the registered provider for that centre. Inspectors found that there had been significant improvements in residents’ quality of life since the introduction of these arrangements, and the registration process for Muiriosa Foundation was progressed on that basis.

The previous provider of two centres, the Irish Society for Autism, had taken court action to appeal HIQA’s decision to cancel the registration of these two centres. The appeals were withdrawn in court and the HSE became the provider of these services. These inspections were carried out to ensure that there had been improvements to the safety and the quality of life of residents following this action. The HSE had made arrangements for Gheel Autism Services to operate the centres on its behalf, and inspectors found significant improvements had been made in safety and quality of life for residents. The HSE was monitoring these services to ensure that improvements were sustained.

Four inspection reports relate to centres that are located in large congregated settings. Inspectors found strong evidence of very poor management and oversight arrangements in these centres. Management was not effective in ensuring improvements in the quality of life for residents, or in ensuring that the rights of residents were promoted and protected. There were significant issues in areas such as the safeguarding of residents from risk of abuse, supporting residents with choices and providing residents with a daily routine based on their preferences rather than staffing arrangements.

The HSE had become provider for one of these centres following court action taken by HIQA to cancel the registration of the centre because of significant failings by the previous provider to ensure the safety and care of residents. Inspectors found that residents continued to receive a poor quality service, and the HSE had failed to address the safety, health and social care issues for residents. In another centre which was the subject of court orders during 2015, inspectors found that while there had been some improvements for residents in a number of areas, there continued to be a high level of non-compliance in areas such as healthcare and risk management in the centre.

Inspectors also found poor oversight arrangements in two small community-based houses operated by the HSE. The HSE had failed to ensure that there were adequate arrangements in place to ensure the safety of residents. Issues were identified in areas such as arrangements to safeguard residents from the risk of abuse, the management of restrictive practices, and risk management in these centres.

HIQA continues to monitor these centres closely, and will take further regulatory action in relation to them if the provider does not bring about improvements for residents in those centres.