Summary of HIQA Inspection Findings in Designated Centres for Older People completed during August to October 2018

Introduction

This report by HCI highlights the trends in inspection findings, those being ‘Compliant’ and ‘Not Compliant’ as detailed by the Health Information and Quality Authority (HIQA) in reports for residential care settings for older people. The inspections were against the requirements as outlined in the following:

• Health Act 2007 (Care and Welfare of Residents in Designated Centres for Older People) Regulations 2013 (S.I.No. 415 of 2013).
• Health Act 2007 (Registration of Designated Centres for Older People) Regulation 2015 (S.I.No. 61 of 2015).

Summary of Findings

HCI completed a review of fifteen (15) randomly selected HIQA Inspection Reports. All inspections were completed during August 2018 to October 2018. The review highlighted that Regulation 17 Premises had findings that carried a Not Complaint Red Risk. Issues identified under these Regulations included:

• Regulation 17: Premises (57% Services Not Compliant of the 14 Services reviewed against this Regulation) – Issues included: Major improvements to the design and layout of the residential home to ensure it was suitable for its intended purpose and could meet residents’ individual and collective needs in a comfortable and homely way.

Other areas recognised as requiring improvement included:

• Regulation 12: Personal Possessions (67% Services Not Compliant of the 3 Services reviewed against this Regulation) – There was a lack of space in the multi-occupancy bedrooms for residents to adequately store their clothes or personal possessions.
• Regulation 21: Records (58% Services Not Compliant of the 12 Services reviewed against this Regulation) – Samples of staff files viewed by the Inspector did not contain all the information required by Schedule 2 of the Regulations.
• Regulation 9: Residents’ Rights (50% Services Not Compliant of the 12 Services reviewed against this Regulation) – Issues included: Undignified practices were observed which did not support a person-centred approach to care. Appropriate arrangements were not in place to ensure the rights of residents were respected in relation to privacy, dignity and their ability to exercise personal choice.
• Regulation 28: Fire Precautions (50% Services Not Compliant of the 12 Services reviewed against this Regulation) – Appropriate evacuation procedures were not in place for all residents. Fire drills carried out did not include any night-time scenarios when staff numbers were reduced.
• Regulation 23: Governance and Management (47% Services Not Compliant of the 15 Services reviewed against this Regulation) – Management roles and responsibilities were not clearly defined. Inspectors were not satisfied that the governance arrangements were sufficiently robust to ensure the service provided is safe, appropriate, consistent and effectively monitored.

Areas of Good Practice

An area of good practice was identified in relation to Regulation 20: Information for Residents (100% Services Compliant of the 5 Services reviewed against this Regulation) and Regulation 32: Notification of Absence (100% Services Compliant of the 5 Services reviewed against this Regulation).

The following Regulations were not inspected in the reports reviewed and were therefore not included in the analysis:

• Registration Regulation 7 – Application by Registered Providers for the Variation or Renewal of Conditions of Registration.
• Regulation 10 – Communication Difficulties.
• Regulation 25 – Temporary Absence or Discharge of Residents.

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