Disparities in quality and safety of care in congregated settings

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Residents living in campus-based or congregated settings experienced disparities in the quality and safety of their care and in their ability to independently exercise their rights, HIQA reported in its overview of its inspection and regulation of designated centres for people with disabilities in 2020.

The report published in November was based on  over 750 inspections in disability services in 2020.

Inspections found that the majority of centres provided a good quality of care and support to residents and there was increased compliance in key areas, such as safeguarding and positive behavioural support, across centres since 2019. However, there continued to be significant variance in the level of non-compliance in congregated settings compared to community-based settings.

HIQA’s Deputy Chief Inspector of Social Services (Disability), Finbarr Colfer, said. “While we found that there were improvements in compliance in congregated settings, the level of non-compliance remains significantly higher at nearly double the level of non-compliance found in community-based settings. Many residents living in campus-based or congregated settings experienced inequalities in the quality and safety of their services, control over their own lives and their ability to independently exercise their rights and choices. Those who lived in smaller homes often had more control and choice around their day-to-day routines, including important aspects of everyday life that many take for granted such as engaging in their local community, going for exercise and participating in the preparation and cooking of their meals.

“The absence of emergency provisions to support the sector in opening up additional capacity at short notice remains a critical weakness in the current legislation and this became more apparent during the pandemic. In addition, during 2020, the focus of regulation was on verifying that providers had developed contingency plans to manage any infection outbreaks in each centre. Where outbreaks did occur in centres which were well managed, while there were significant challenges, these centres tended to have better infection control systems in place, better supplies of critical resources and timely access to additional staffing resources to support continuity of service and isolation arrangements. Overall, inspectors found that providers worked together and with the HSE to minimise the risk of infection for residents”.