Hiqa warns of deterioration in disability centres since covid

Hiqa now prioritises applications from centres looking to transition residents from large centres to community settings, Finbarr Colfer, Hiqa Deputy Chief Inspector of Social Services (Disability), said. File photo: Sam Boal / © RollingNews.ie

The Health Information and Quality Authority (Hiqa) has warned of deterioration across disability centres in complying with standards linked to the ongoing impact of the covid-19 pandemic.

One resident in a large congregated centre told inspectors they felt “scared” because of the noise levels while others spoke of spending time alone every day.

The health watchdog also identified a slow pace in the transition from large centres to community settings, finding only 140 people moved between 2021 and the end of 2022.

They noted "an increase in non-compliance across services for people with disabilities in 2022". 

An overview following 1,329 inspections last year found while most centres provided good care and support, there are growing concerns over “poor findings” around governance and management in some centres. Inspectors found this impacted “directly on the quality of care and support that residents received, and their lived experiences.” 

The report includes this comment by an inspector: “One resident repeatedly spoke to the inspectors and a staff member about how noisy and busy their living environment was. When asked if they were happy living in the centre they stated 'it will do for the moment'. When asked if they felt safe, they said that sometimes when it was very loud, they felt scared."

Again in relation to a large residential unit, inspectors at one site wrote: “Residents were living in a highly restrictive environment where they engaged in safety-related behaviours such as staying in their bedrooms during the day, only eating in communal areas when they were alone, and planning daily routines to prevent crossover with other residents.” 

Finbarr Colfer, Hiqa Deputy Chief Inspector of Social Services (Disability), said the reports show that good governance leads to better living standards for residents.

Hiqa's headquarters in Dublin. The health watchdog also identified a slow pace in the transition from large centres to community settings, finding only 140 people moved between 2021 and the end of 2022. File photo: Sam Boal / © RollingNews.ie

“As public health restrictions eased during the second part of the year, crucially this allowed for improved management of centres by providers and for residents to re-engage in social and community activities,” he said.

“We continued to closely engage with providers around governance and management and oversight of their centres throughout the year, which resulted in some improvement in compliance with governance towards the end of 2022.” 

The overview also notes “significant variance” between the quality of life for people living in large congregated residential settings compared to people living in smaller homes in the community.

Mr Colfer warned: 

This means that people with disabilities living in congregated settings are at higher risk of receiving a poorer quality support that does not uphold their rights.

Hiqa now prioritises applications from centres looking to transition residents from large centres to community settings, he said. They found 201 congregated settings last year, the same as during 2021 with only a small number of people helped to change accommodation to the community.

“We also continue to focus on ensuring a human rights-based approach to regulation for all residents, using our legislative powers to support and promote the human rights of people with disabilities,” he said.

The report shows only 60.2% of congregated settings were fully compliant with standards when they were inspected. Overall 18.2% were not compliant and a further 21% were substantially compliant.

In contrast with this the inspectors found 73.5% of community settings were found to be compliant, with 8.2% found to be non-compliant.

The full overview report can be read on hiqa.ie.