Guidance on developing a Quality and Safety Management System for International Protection Accommodation Services
Introduction
International Protection Accommodation Services (IPAS) provide accommodation to people seeking asylum or international protection in Ireland. As these centres cater to vulnerable populations, it is crucial to establish a robust Quality and Safety Management System that prioritises residents’ health, safety, and dignity.
The National Standards for accommodation offered to people in the protection process, published by the Department of Justice and Equality, provide a framework for the continual development of person-centred, high-quality, safe and effective services and supports for residents living in accommodation centres. These standards should be utilised by International Protection Accommodation Services as a guide to building the QSMS.
It is also important to note that regulation of the sector is swiftly approaching. In HIQA’s recently published HIQA Annual Report 2022, they commented that they have begun preparations to establish a regulatory function for the monitoring and inspection of IPAS.
Given the upcoming regulation of the sector, we feel now is a good time for IPAS to review the processes and structures currently in place within their services and look towards implementing a QSMS to support regulation compliance. In this blog, we will explore the four key steps to successfully implement a Quality and Safety Management System in an IPAS.
Step 1: Planning for the QSMS
Begin the implementation process by defining a clear vision for quality improvement within the service. This involves looking at the governance system, the aims and objectives of the QSMS, the structures in place and the communication pathways.
The National Standards for accommodation offered to people in the protection process provide a framework for the QSMS. The standards are set out under ten themes and describe how a service provider should provide high-quality and dignified services to residents, which are human rights and equality based. Each standard contains a binding statement and supporting indicators which indicate how a service provider may be judged to have met the standard.
Perform a comprehensive Gap Analysis of your organisation’s current quality practices, processes, and systems against the relevant regulations and/or standards including the National Standards for accommodation offered to people in the protection process.
The gap analysis will identify areas of strength and areas that require improvement. When conducting a gap analysis, utilise a triangulation approach consisting of a documentation review, staff interviews and process observation. Engage relevant stakeholders, including managers, staff, and residents, to gain a holistic perspective.
From the gap analysis being completed, you can identify the quality improvement plans (QIPs) that need to be put in place, along with a timeframe and responsibility. Initiate a project team to start looking at evidence-based practice to provide assurances to the governance team and residents.
Step 2: Implementation of the QSMS
When implementing the QSMS framework it is important for the IPAS to take the approach of developing structures, processes, and outcomes.
- Structures: It is crucial to have clear governance arrangements and structures in place for the service and these should be explained clearly to residents and staff. The structures set out who has authority and accountability, and for which area. There should be clear Terms of Reference for the Management Team, standardised agenda and minutes that are used to ensure that the key areas are discussed at each meeting, and job descriptions for all staff to ensure it is clear who is responsible for what.
- Processes: Policies and Procedures are essential to the delivery of safe, standardise care. Policies and procedures should be developed for critical areas across the service such as care and service delivery, risk management, incident management, compliant management, internal quality auditing, safeguarding and protection, management of conflict, data protection, amongst many others. When developing policies and procedures it is important to adhere to regulations, standards and best practice guidance to ensure there are evidence-based policies and procedures in place. Effective implementation of the policies and procedures requires the active involvement of staff members. Educate and engage staff at all levels about the agreed policies and procedures and their individual roles and responsibilities.
- Outcome: Review the relevant regulations and National Standards for guidance on what outcomes your service must have in place to meet regulatory compliance. This will help you understand at a minimum, what is required to achieve the delivery of a safe, effective service.
Step 3: Continuous Review of the QSMS:
Once the QSMS has been implemented, the service must establish a robust system for monitoring and oversight of the QSMS. Regular audits must be conducted to assess, evaluate and improve the services in a systematic way, and to ensure the best outcomes for children and adults living in the centre. Audits should be completed on a regular basis, by trained, competent staff. Once an audit is completed, the service must look at the findings and identify what action plans need to be implemented to correct any non-conformances and drive quality improvement.
Another important mechanism for monitoring the effectiveness of the QSMS, is through Key Performance Indicators (KPIs). A KPI is a specific and measurable element of service that can be used to assess quality and safety of care (HIQA, 2012). The Governance Team must identify and agree what the appropriate KPI’s should be for the IPAS and put in place a structure for the monitoring and reporting of the data to the Governance Team on a monthly basis. Any gaps or changes in the data needs to be interrogated to identify the causes.
Leverage digital health transformation solutions such as HCI’s QualSIPTM to support the collection and analysis of real time key governance, quality and safety data from the Quality Management Information System.
Gathering and reviewing feedback such as resident feedback, complaints and incidents can also provide valuable data for areas for improvement. As outlined in the National Standards for accommodation offered to people in the protection process, there must be a clear culture of involvement and consultation with residents on an individual and group basis. The management and staff must ask about the needs and views of children and adults living in the centre and respond to feedback.
Step 4: Continuous Improvement within the QSMS
Standard 1.4 of the National Standards, stipulates that the service provider must monitor and review the quality of care and experience of children and adults living in the centre and this is improved on an ongoing basis. It is important to remember that developing a QSMS is not a one-time project; it requires a commitment to continuous improvement.
Establish oversight mechanisms for ongoing evaluation and review of the QSMS effectiveness. Review data from the QSMS on a regular basis from audits, risks registers, incidents, complaints, resident feedback, training compliance, KPIs and external inspection reports to identify areas for improvement. Implement the appropriate QIPs, with a timeframe and responsible person. Follow up on these to ensure that they are implemented and closed off in a timely manner.
Conclusion
Implementing a well-designed Quality and Safety Management System not only ensures compliance with regulations and standards, but also enhances the overall quality of care provided to residents. With regulation of the sector just around the corner, now is the time for service providers to review their current structures, process and outcome measurements to determine if they are in line with best practice. By following these four key stages, International Protection Accommodation Services can establish a framework that promotes continuous improvement and prioritises the health, safety, and dignity of residents.
At HCI we help providers of health and social care make intelligence driven decisions to attain, manage and improve quality, safety and regulatory compliance. We have almost two decades of experience helping health and social care providers to implement robust Quality and Safety Management Systems. We support and guide you through the entire process and can provide ongoing, independent quality assurance of the QSMS through our independent Quality of Care Audit Programme.
If you would like further information on our QSMS support, contact HCI at +353 (0)1 629 2559 or email info@hci.care.