Summary of HIQA Inspection Findings in Designated Centres for Older People completed during May to July 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 May 2018 to July 2018.

The review highlighted that Regulation 17 Premises and Regulation 21 Records had findings that carried a Not Complaint Red Risk. Issues identified under these Regulations included:

• Regulation 21: Records (73% Services Not Compliant of the 11 Services reviewed against this Regulation) – Issues included: Confidential information was maintained at the end of some resident’s beds; Staff files did not meet the requirements of the Regulations as gaps including Garda Vetting forms, lack of references and gaps in employment were identified.
• Regulation 17: Premises (80% Services Not Compliant of the 10 Services reviewed against this Regulation) – Issues included: Improvements to the design and layout of the sitting room and dining room remained outstanding; General maintenance of the building was required.

Other areas recognised as requiring improvement included:

• Regulation 23: Governance and Management (100% Services Not Compliant of the 15 Services reviewed against this Regulation) – Issues included: Management systems in place did not ensure the service provided was safe, appropriate, consistent and effectively monitored. Audits completed by management did not include a meaningful review of the quality and safety of care or any quality improvement plans. Management structures were not clearly defined; No annual review was completed regarding the quality and safety of care delivered in the residential home.
• Regulation 28: Fire Precautions (70% Services Not Compliant of the 10 Services reviewed against this Regulation) – There were issues with the installation of a new fire alarm system. There were no assurance the appropriate evacuation procedures were in place for all residents. No sufficient evidence was available to confirm all staff had attended fire training.
• Regulation 4: Written Policies and Procedures (67% Services Not Compliant of the 6 Services reviewed against this Regulation) – Issues included: Policies, procedures and guidelines were not maintained in accordance to Schedule 5 of the Regulations; No reference to current legislation, National Standards or research based best practice; Policies and procedures were not dated and not signed by staff to indicate they understood them.
• Regulation 26: Risk Management (60% Services Not Complaint of the 10 Services reviewed against this Regulation) – Issues included: Hazard identification and assessment of risks in the residential home were not complete; There was concern regarding the number of residents accommodated in one compartment.

Areas of Good Practice

A area of good practice was identified in relation to Regulation 14 Person in Charge (100% Services Compliant of the 9 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 6 – Changes to information Supplied for Registration Purposes.
• Registration Regulation 7 – Application by Registered Providers for the Variation or Renewal of Conditions of Registration.
• Registration Regulation 9 – Notice to be given by a Registered Provider of a Designated Centre of  Intention to cease to carry on its business and close the Designated Centre.

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