Hiqa: Many residential centres for disabled do not meet standards

Health watchdog Hiqa has warned of the potential of “new hidden populations” who could be vulnerable to abuse, including the homeless, migrants and those in direct provision.

Its CEO, Phelim Quinn, also warned that many residential centres for people with a disability are still failing to meet the required regulatory standards, in particular regarding garda vetting for staff.

In his opening statement to the joint committee on health, Mr Quinn said currently there are just over 1,100 designated centres for people with disabilities, providing approximately 9,000 beds, and 26% of these designated centres remain to be registered. Of those, 209 are governed and provided by non-statutory providers, while 71 centres are run by the HSE.

As for centres which fail to reach the required levels of compliance with regulations, Mr Quinn said this was due to a number of reasons, including inadequate safeguarding measures, poor governance, inadequate physical infrastructure and inappropriate placements.

“We have seen a gradual improvement over the past few years and most providers have a positive attitude to regulation,” he said, adding that he expected standards to rise further in the coming years.

However, he also warned that some centres are not doing enough to safeguard residents, and highlighted shortcomings when it came to garda vetting in particular.

“In terms of safeguarding, it is quite apparent that some services must take this issue more seriously, particularly by ensuring that Garda vetting is in place for all staff and volunteers,” he said.

“Legislation introduced in 2016 strengthened the requirements for service providers to ensure that their staff are appropriately vetted; however, some services are neglecting to do so and are thereby failing in their legal responsibility to safeguard residents.”

Mr Quinn also said Hiqa was working with the HSE to develop what he called an oversight framework, claiming: “The State distributes large sums of money to various organisations in exchange for the provision of services. However, there is often insufficient oversight of how this money is used or the outcomes it achieves.”

He also warned of the need to safeguard the rights of others currently outside Hiqa’s remit, such as the homeless, prisoners, migrants or asylum seekers.

“The continued absence of assurance in respect of the rights and needs of these vulnerable groups has the potential to create new hidden populations in our country,” he said.

His colleague Finbarr Colfer, Hiqa deputy chief inspector of social services, said inspections of congregated settings had uncovered “quite startling issues” regarding safeguarding, including “ongoing institutional practices based on organisational needs rather than needs of people in the services”.

Mary Dunnion, Hiqa director of regulation, said these issues had been addressed in other centres, often because the person in charge “led by example” and “did not accept that type of practice, and secondly had the courage to address poor behaviour in staff”.

Mr Quinn also referred to the potential for some “emerging models of care” such as homecare and sheltered housing, to remain outside regulation as they do not for the current legal definition of a designated centre for people with disabilities.

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