Unannounced Restrictive Practices Audit for Laurel Lodge Nursing Home

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“The guidance around restrictive practices had recently been updated and we took this opportunity to do a review of the restrictive practices in place in Laurel Lodge Nursing Home. We asked HCI to conduct an unannounced restrictive practices audit as we wanted to get an independent baseline assessment of where we stood in terms of complying with the revised guidance. We were impressed with HCI’s knowledge and understanding of the regulations and guidance on restrictive practices. Their support helped us to ensures continuous improvement in our care and gave us assurance that we are prepared for a HIQA inspection.”

Alan Hynes

Registered Provider, Laurel Lodge Nursing Home


Laurel Lodge Nursing Home (LLNH) is based in Co. Longford and provides long term and short-term care to 114 residents. In March 2019, HIQA published Guidance on promoting a care environment that is free from restrictive practices. Following this HIQA began conducting thematic inspections of restrictive practices in residential homes. This prompted LLNH to undertake an independent review of restrictive practices within the nursing home.

Consequently, LLNH requested HCI to conduct an unannounced restrictive practices audit at the nursing home to assess their compliance with relevant standards and identify any areas for improvement that needed to be addressed.


  • Determine LLNH’s compliance with the regulations, standards and guidance relating to restrictive practices.
  • Identify areas for improvement and the relevant Quality Improvement Plan (QIP) required to promote a care environment that is free from restrictive practices.
  • Provide a report outlining the findings from the audit.
  • Be prepared for a HIQA thematic inspection of restrictive practices.


In order to ensure a comprehensive restrictive practices audit was completed, HCI provided the following service:

Preparation of audit agenda and auditing materials.

Offsite document review.

One-day onsite audit covering each unit within the home, including document review, staff interviews and process observation.

Analysis of findings and development of Draft Report and QIP.

Client review of draft report and feedback provided to HCI.

Audit report finalised and presented to the client.


  • New guidance from HIQA including Guidance on promoting a care environment that is free from restrictive practices and the Guidance on a human rights based approach to health and social care meant practices needed to be reviewed to ensure that they were not deemed restrictive.
  • Audit by its nature was challenging as it required a lot of different areas to be assessed with respect to restrictive practices.


HCI presented LLNH with a detailed report on the findings of the audit which identified areas of good practice and areas for improvement against the relevant regulations and standards around restrictive practices. The report also proposed a QIP set out under the relevant Themes to address the areas for improvement.

LLNH subsequently had an unannounced restrictive practices audit from HIQA and received a judgement of compliant.


  • A comprehensive and independent review of processes.
  • A detailed report on the findings of the audit including areas of good practice and opportunities for improvement and a proposed QIP.
  • Risk areas are identified.
  • HCI has extensive knowledge of the regulations and standards in relation to restrictive practices. This is transferred to staff during the audit.
  • Reassurance to Registered Provider and PIC that the correct practices are in place.
  • Be prepared for a HIQA inspection.
  • The audit mimics HIQA unannounced inspection This helps educate staff to be inspection ready.


Serena Horkan

Senior Quality and Safety Specialist

Phone: +353 (0)1 629 2559

Email: info@hci.care

To learn more about how we can help, get in touch today.