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Regulation improves quality of life for people with disabilities – HIQA report

Regulation of Ireland’s disability sector has had a positive impact on the lives of people who receive services, according to a new report from HIQA.    

Data from the first five years of regulation shows improvements in compliance year-on-year.  Overall compliance with all regulations inspected increased from 59 per cent in year one to 76 per cent by year five.

Ms Mary Dunnion, HIQA’s Director of Regulation and Chief Inspector of Social Services, said: “When HIQA commenced the regulation of residential services for people with disabilities on 1 November 2013, it was the first time such services were subject to independent regulation. Our findings in the first few years were reflective of a sector that was not initially prepared for regulation, with some services providing good services, and poor practice and low levels of compliance evident in others.

“Over the past five years, however, regulation has driven improvements in these services through monitoring, inspections and enforcement action. In particular, our inspection findings show that residents’ rights and dignity are better promoted, and their social care needs are now being met in most cases. Residents regularly tell us how these improvements have positively impacted their lives. For example, moving to houses nearer their families, going on holidays or to concerts, working in their local communities and having more control over what they do on a daily basis.” 

Notwithstanding these improvements, HIQA said “significant challenges remain” regarding the management and oversight of services, addressing infrastructural deficits and safeguarding vulnerable people. 

Ms Dunnion continued: “The governance arrangements in some centres have continually failed to ensure there is adequate oversight of the quality and safety of the service. There are also ongoing challenges for some providers in achieving a safe and high-quality living environment for residents.

“While regulation has brought about increased awareness of the rights of people with disabilities, safeguarding issues continue to be regularly raised by our inspectors. Better protections need to be put in place to safeguard residents from abuse and to extend the protections offered by regulation to other vulnerable people. We await the Minister for Health’s approval of the National Standards for Adult Safeguarding, developed by HIQA and the Mental Health Commission.  

“In addition, the introduction of specific legislation would ensure a legal basis to safeguard people who live in residential care. In supporting this, HIQA is a member of the Department of Health’s steering group to inform the development of the Health Sector Adult Safeguarding Policy and is a member of Safeguarding Ireland. 

“Similarly, we believe that the model of regulation in Ireland needs to be reviewed and expanded to ensure that all people who receive a health or social care package, either in a service or in their home, receive consistently good quality support that is underpinned by regulations.”

The Medical Independent recently reported that HIQA has received legal advice on a section of the Health Act 2007 that specifies it must have regard to the resources available to the HSE when carrying out regulatory work.

This newspaper understands the Department and HIQA have different interpretations of this section of the Act.

The conflict has arisen as HIQA is increasingly concerned that a considerable number of designated centres in the disability and older persons’ sectors will not be compliant with capital-related requirements.

In March, Ms Dunnion told HIQA’s board meeting that if the Office of the Chief Inspector does not take enforcement action, it “is not applying the regulations appropriately as is required by the Health Act”.

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