HIQA: People in congregated settings have poorer quality of life

People with a disability living in congregated, or institutional, settings had a poorer quality of life compared to residents who live in community settings, with little choice in how they spent their day, according to a new report from health watchdog HIQA.

The Health Information and Quality Authority has published its Overview of Regulation in Disability Services in 2019 and said while overall, compliance with regulations was high, non-compliance rates were higher in centres of 10 or more people and residents there were at greater risk of a poorer quality of life.

The report said there were 1,268 designated centres around the country for 9,064 adults and children with a disability. 

There were 1,016 inspections last year, 71% of which were unannounced.

It said 2,914 people lived in congregated settings, where more than 10 people live in the same building or group of buildings on the same campus.

"These centres had higher non-compliance with the regulations and many residents had a poorer quality of life than those who lived in community-based centres," it said.

"People living in congregated settings are at greater risk of having a poor quality of life."

However, inspections found that the majority of centres overall provided a good quality of care and support to residents and there was increased compliance in key areas, such as protection and social care, across centres since 2018.

HIQA’s Deputy Chief Inspector of Social Services (Disability), Finbarr Colfer, said: “One in three residents continue to live in large institutions or campuses and are at greater risk of having a poor quality of life compared to residents who live in community settings. 

"Residents in congregated settings were often separated from their local communities and continued to live in unsuitable, outdated accommodation. 

"Important aspects of everyday life and person-centred care, such as the privacy of your own room, being able to have local friends, and having access to your own kitchen or laundry facilities are often compromised or unavailable to these residents.” 

Separately from the inspections HIQA also met with 18 residents groups last year attended by 178 residents.

It said there was "a critical link between good governance and safety and a good quality of life of residents" and that HIQA would continue to promote service improvements and the rights and quality of life of people with disabilities living in designated centres — particularly those in campus and congregated settings.

HIQA’s Chief Inspector of Social Services and Director of Regulation, Mary Dunnion, said: “While regulation has made a significant contribution to improving the lives, experiences and human rights of people living in these centres over the past six years, further work remains to be done. 

"Regulations are the basic minimum standard of care that should be provided to people, and it is disheartening to continue to find people with disabilities living in designated centres who could not fully exercise their basic human rights. 

"While primary responsibility for providing a safe and a good quality service to people with disabilities rests with the service providers, it is also imperative that the funders of these services ensure that public finances are being used to deliver a good quality and safe service.” 

The full report is available at www.hiqa.ie