‘Notable deterioration’ in standards of residential centres for people with disabilities in last year — Hiqa

There was a “notable deterioration” in the number of residential centres for people with disabilities meeting minimum standards of governance and management over the course of last year, the State healthcare watchdog has said.

The Health Information and Quality Authority (Hiqa) raised concerns slipping standards of oversight could have a knock-on effect for the quality of residential disability services, if it was not addressed.

In the first quarter of last year some 10 per cent of centres inspected were not meeting governance and management requirements, which had increased to 22 per cent by the last quarter of the year.

In an annual report on disability services, published on Monday, Hiqa described the trend as “worrying”. The regulator warned it could result in a “deterioration” in the safety of residential disability services if improvements were not made.

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The regulator said overall there was an 83 per cent compliance rate with measures to keep residents safe and investigate allegations of harm or abuse.

Hiqa referred three safeguarding concerns to the Health Service Executive (HSE) national safeguarding office. In one of these cases the regulator also referred the matter to An Garda Síochána and Tusla, the child and family agency, “due to the nature of the concerns identified”, the report said.

There are 1,401 registered residential disability centres housing more than 9,000 people. The regulator carried out 1,220 inspections last year, around a third of which were unannounced.

In 94 cases centres were inspected twice during the year to allow Hiqa monitor improvements, while two centres were inspected three times.

‘Poorer quality of life’

The regulator said residents living in large congregated facilities, rather than smaller community-based homes, were more likely to have a “poorer quality of life”. During the pandemic those in congregated centres often spent “a significant proportion of their time” in the facilities, with limited visits from family or trips out to the local community.

The report said some providers of disability care had “struggled” to recruit staff and put in place measures to maintain safe staffing levels, particularly during Covid-19 outbreaks.

The number of centres that were not meeting fire safety standards increased from 16 per cent in 2020 to more than a fifth of facilities last year. The report said this increase was concerning but noted in a number of cases fire safety improvement works had been delayed due to Covid-19 lockdowns.

The healthcare regulator issued 31 warning letters over poor standards to 11 different disability providers last year.

Some 71 centres have conditions requiring improvements attached to their registration allowing providers to run the facilities. In eight cases these homes were run by the HSE, the report said.

In two cases last year Hiqa cancelled the registration of centres, as providers “did not demonstrate capacity to address significant safeguarding and quality of life concerns,” the report said. One of these centres was run by Camphill Communities of Ireland and taken over by the HSE, while the other was run by Stepping Stones Residential Care Ltd and has since shut.

Finbarr Colfer, Hiqa deputy chief inspector of disability services, said poor governance of centres had a negative impact on the quality of life for residents living there. “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,” he said.