Hiqa finds one in five of inspected disability centres need improvements

The on-going decongregation policy, meaning moving residents from large centres to smaller community-based settings, has lead to residents being “more likely to experience a poorer quality of life”, Hiqa's report concluded. File photo: Sasko Lazarov/Photocall Ireland

One in five inspections of disability centres last year found improvements are needed to how the centres are managed with problems worsening during the year.

The Health Information and Quality Authority (Hiqa) overview of all inspection and regulation in the sector last year, published on Monday, found “the majority of centres” provided good care but raised red flags about some centres.

They warned the deteriorating conditions were in some cases found in centres which had a good record before the pressures of the pandemic hit.

Hiqa’s Deputy Chief Inspector of Social Services (Disability), Finbarr Colfer, said: “It is critical that providers re-establish effective governance and oversight to ensure that residents receive the quality of support that they are entitled to.”

Decongregation

He stressed that poor governance and management have a negative impact on the quality and safety of care and support for residents. Disability centres are also involved in the on-going decongregation policy, meaning moving residents from large centres to smaller community-based settings.

The overview highlights the significance of this policy, with Mr Colfer saying they found residents in these large centres are “more likely to experience a poorer quality of life”. This is especially relevant for children, the overview highlights.

“As children transition into adult services, they can experience a poorer level of service,” Hiqa found. “However, this is less likely if they stay in a smaller community-based or non-congregated setting.” 

They also found more of these large centres now require work done on the quality of the buildings and even safety aspects.

“Further work is required to ensure that the use and reliance on congregated or campus-based settings continues to be reduced,” he said.

There are 1,401 designated centres, offering 9,039 residential places. The overview shows, however, while there were 61 additional centres designated last year, this resulted in 27 fewer residential places than the year before.

Among the designated centres are 201 congregated settings where more than 10 people live in the same building.

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“Centres in congregated settings had higher levels of non-compliance than centres based in the community,” the overview found among the 1,220 inspections carried out last year.

“Inspections found that the majority of centres provided a good standard of care and support to people with disabilities,” the overview found. “However, the report also outlines concerns over poor findings in relation to governance and management in a number of settings.”

Mr Colfer said inspectors found services continued to adapt to Covid-19 pressures, with a new inspection programme established to drive improvements in infection prevention and control across services.

Hiqa’s findings are based on inspections, receiving and monitoring information, and speaking with residents and their families. Last year, in addition to inspections, Hiqa met with 80 residents as part of 22 online meetings.