Risk Management and Governance continue to be the main areas of concern in IPAS Inspection Reports

Introduction

In August 2024, HIQA published seven new inspection reports for International Protection Accommodation Services (IPAS). These reports underscore significant ongoing issues particularly in relation to governance, risk management and safeguarding practices. The findings echo concerns raised in previous inspection reports. The recurring themes of inadequate reporting and oversight mechanisms, poor audit programmes, ineffective risk management frameworks, a lack of comprehensive policies and procedures and insufficient safeguarding measures, highlight systemic weaknesses that need immediate addressing.

This article provides a summary of the compliance issues, focusing on Governance, Risk Management and Safeguarding.  It is essential to review the findings of these inspection reports and identify the learnings for your service.

Summary of Compliance Issues Identified by HIQA in IPAS Centres

Governance

• The service provider needed to ensure that all of the required policies and procedures were in place to guide staff practice.
• There was no formal procedure to ensure the centre was appropriately managed when the centre manager was absent for prolonged periods of time.
• Management and oversight systems needed to be developed to ensure there was appropriate and effective governance of the service.
• The service provider needed to develop formal monitoring and reporting systems to support good oversight of all aspects of service provision including risks, incidents, complaints and safeguarding concerns. Records relating to the residents needed improvement to ensure there was evidence of the work completed.
• There was an absence of an ongoing auditing programme to assess, evaluate and improve the quality of care and experience of residents living in the centre.
• The service provider needed to consider methods to increase their consultation with residents and how their feedback was reflected in a quality improvement plan.
• While there were improved governance arrangements in place, the effectiveness of this structure was compromised by an absence of recorded communication systems between staff.
• There were no formal monitoring and reporting systems to ensure the service provider was aware of all risks, incidents and safeguarding concerns.
• There were also no job descriptions on staff files reviewed.
• The process for reviewing and learning from incidents that occurred in the centre required further development.
• Management and team meetings were taking place but there was no set agenda to ensure routine discussions and oversight of risks, safeguarding, incidents and complaints. There was no centralised system to record or monitor complaints.
• While the staff team engaged with residents on a day-to-day basis, records relating to consultation with residents was limited and it was not evident how the views and experiences of residents guided quality improvement plans for the service.
• There was an absence of a full suite of policies and procedures essential for the delivery of the service and to guide staff in delivering appropriate supports to residents.
• While there were governance arrangements in place which clearly identified the lines of authority for the various positions in the staff team, the effectiveness of this structure was compromised by undefined areas of accountability and underdeveloped reporting systems.
• Audits of the quality of the service had not been completed.

Risk Management

• There was no overarching risk management policy to guide the staff team in the identification, assessment and management of risk. While there was a risk register and a number of risk assessments completed, not all risks relating to residents had been recorded and assessed.
• While the service provider had carried out an analysis of risk and developed a risk register, it was found that it was not an entirely accurate reflection of risk in the centre.
• The risk register required review to ensure control measures in place were necessary and relevant to known risks.
• There was a need for the further development of the centre’s risk management framework to include a risk and incident management policy.
• Improvements were required to ensure that risks across the service were identified, assessed and managed. Risks relating to the welfare and safety of residents had not been considered within the risk register.
• Risks relating to adult or child safeguarding had also not been included on the risk register.
• There was a lack of ownership of the identified risks and some known risks were not on the register. The arrangements for reviewing the risk register had not fully been decided upon.
• The risk register in place was not adequate and it did not provide an overview of the key risks within the service. In addition, there was a number of risks which had not been assessed.

Safeguarding

• There was no system to log or track concerns and as a result, concerns had not been reviewed to identify if there were risks that needed to be assessed or if additional safeguarding arrangements were necessary.
• While there were control measures in place for any potential risk to residents’ safety, the adult safeguarding policy required review, and staff required training in this area.
• The service provider needed to implement appropriate systems to ensure that incidents, adverse events and welfare concerns for children and adults were centrally recorded and tracked over time to review learnings and further inform practice within the service.
• There was an absence of risk assessments or safeguarding plans in place for dealing with situations where the safety of residents may be compromised.
• There were no arrangements in place to learn from these incidents and events as part of continual quality improvement.
• It was not recorded if safeguarding plans were communicated to staff or implemented when scenarios arose which required a such plans to be developed.

Conclusion

The persistent issues identified in the HIQA inspection reports for IPAS centres demand immediate action, especially in the areas of governance, risk management, and safeguarding. Addressing these challenges is crucial to meeting the National Standards and ensuring the safety and well-being of residents.

HCI’s extensive expertise in quality, safety, and regulatory compliance positions us as a valuable partner in this endeavour. We offer tailored solutions, including the development of robust Quality and Safety Management Systems, quality of care audits, development of policies and procedures and education and training.

We also offer a comprehensive Risk Management Programme for IPAS centres. As part of our ongoing programme you will have access to a dedicated Quality and Safety Specialist who has expert knowledge and understanding of the risks and challenges faced by IPAS centres. We will support you to conduct comprehensive risk assessments, complete a detailed risk register with well-defined controls, and develop and implement a risk management policy and procedure and training programme to guide staff to effectively implement the risk management framework. By collaborating with HCI, you can strengthen your governance structures, mitigate risks, and improve overall care quality and resident safety.

For specialised support in achieving regulatory compliance, please contact us at info@hci.care or call 01 629 2559.