Disability centres need to focus more on sustained quality improvement — HIQA

Renewing the registration of disability centres has indicated to HIQA that sustained quality improvement is not being achieved in some centres, according to the Authority.

The second cycle of registration of disability centres commenced on 1 November 2018.

“Renewal activity to date indicates that sustained improvement is not being demonstrated in some centres,” according to the minutes of a HIQA board meeting in January.

The meeting also heard that the number of services requiring registration continues to increase due to “decongregation of settings”, with 129 new centres being processed during 2018.

The challenge for disability services to move from a “compliance-based” agenda to one of “ongoing quality improvement” was discussed at a meeting between HIQA and the HSE in July of last year.

Minutes of the meeting on regulatory risk, seen by the Medical Independent through Freedom of Information legislation, showed that while there are a cohort of centres which are of concern, and which require significant input from HIQA, as well as the HSE, the majority of services are achieving “good levels of compliance”.

Changing the focus to a quality improvement agenda was identified as a priority during the meeting.

“Other areas of concern at present are the pace of transitioning people from congregated settings and ensuring that services adapt to the changing needs of residents, particularly in relation to the transition of young people to adult services and responding to age-related changing needs for other residents.”

At the time, HIQA was monitoring 124 centres closely because of concerns about the way in which they operated.

According to the minutes, 26 were of “significant risk” and seven of these related to the HSE.

“The main areas of concern in the current centres that require close monitoring are governance and management, safeguarding, risk management (including fire safety arrangements), social care/rights and workforce,” the minutes stated.

HIQA said it ensures that the HSE at Chief Officer level within Community Healthcare Organisations and at National Disability Lead level are kept informed about all centres of concern.

Deputy Chief Inspector of Social Services of HIQA Mr Finbarr Colfer informed the meeting that since commencement of registration for centres, there has been “an increased level of compliance and improvements in the safety of care and quality-of-life for residents. Regulation has provided a standard benchmark for the sector and a useful governance framework.”

An overview of disability services will be published during 2019, which will reflect HIQA’s five-year inspection activity.