In its annual overview report for 2015 on the regulation of such centres, the Health and Information Quality Authority (Hiqa) said regulation has brought a cultural change to the sector and has “steadily led to improvements” in the standard of care provided to residents.
Hiqa said that, in 2014, initial inspections showed a lack of understanding within the sector on how to meet the requirements of the regulations and the standards.
In particular, it found that residents living in many large congregated settings were not being “adequately protected or kept safe”. These institutionalised care practices that had been ongoing for years were having an adverse impact on the quality of life for residents, it reported.
However, Hiqa said the inspection process had contributed to a greater understanding of the poor standard of care and support in some large, congregated settings.
“This has been recognised by the Government, and in 2016 there was a commitment of resources to escalate the movement of residents from inappropriate, congregated setting to more appropriate living arrangements,” said the report.
Hiqa inspected 561 of the 937 designated centres for adults and mixed centres for adults and children with disabilities in 2015. There were 741 inspections in total.
Overall, Hiqa inspectors found evidence of a high standard of care in 2015, with some providers found to provide an excellent standard of care.
Of inspection reports published in 2015, 49 inspections did not identify any actions required while a further 208 inspections required less than 10 actions.
However, Hiqa pointed out that it was forced to take formal enforcement procedures in respect of four centres during 2015.
In one of the centres, it applied to the court to cancel the registration of the centre. The HSE then became responsible for the operation of the centre.
Hiqa applied to the court to have additional restrictive conditions on the registration of three other centres.
During 2015, providers submitted 10,422 notifications to Hiqa relating to incidents and concerns about centres for adults and mixed adults and children with disabilities.
Of these, 1,799 related to any allegation, suspected or confirmed, of abuse of any resident with 1,310 referring to any serious injury to a resident which required immediate medical or hospital treatment.
Fianna Fáil spokeswoman on disability, Margaret Murphy O’Mahony, said the report highlighted that speedier action was needed in relation to people with disabilities living in a congregated settings.
“The recommendations made through the 2011 HSE report on congregated settings are yet to be implemented. This Hiqa report again recommends that ‘congregated settings’, or institutions with 10 residents or more, should be replaced with supported placements in the community,” said the Cork South West TD.
“It’s estimated that approximately 3,000 people with a disability were living in congregated settings as of December 2014. Not much has been achieved in moving people into a community-based environment since then.”