6. HIQA 6.1 The inspection process Every person interviewed recognised and welcomed the need for regulation and inspection in the disability sector. The need for inspections to cater to people with a huge spectrum of abilities and needs in different settings was recognised as a challenge in the disability sector. A number of issues arose with service providers with regards to: The perceived lack of consistency both in of the inspectors approach to particular issues and interpretation of Regulations Apparent variance across different HIQA regions HIQA inspectors covering both Nursing Homes and Disability Residential services Advice 12. HIQA should reconfigure the inspector team structure to have one group inspecting older person's services and a different team of inspectors for disability services. 6.2 Verification processes used by HIQA The National Disability Authority acknowledges the importance of having a robust verification process within a Regulatory Framework and the importance of up to date documentation in this process. HIQA have acknowledged same, as well as, other elements that are used to inform a judgement, such as, observation by inspectors in the course of inspections; notification of incidents; reports etc Some service providers, however, did highlight the perception that the HIQA inspection is primarily “a paperwork” exercise. Other stakeholders stressed the need for more engagement by HIQA with third parties who are involved with the
Examination of Primary Legislation definitions registration of centres care of residents if registration is cancelled implications of Assisted Decision Making (Capacity) Act 2015 Department of Health 1-3 Review of regulations Conduct a comprehensive review of the current regulations Department of Health 7 and Appendix 1 (31-49) Ensuring Residents’ Rights are upheld awareness of HIQA and inspection process residents are communicated with appropriately giving consent right to advocacy HIQA and HSE have lead roles in relevant areas 8-11 Reviewing HIQA inspection process Dedicated inspection teams for disability services 3rd party verification processes Ongoing training for inspectors HIQA 12 13 14,15 Service provider audits Service providers 16
Guidance on Action planning Developing national protocols and shared learning mechanisms HSE 17 18 Promoting good practice Transforming Lives- tasking a group to identify good practice Developing a national competency framework Reviewing the medical needs of residents and identifying good practice in this area Department of Health 19 20 21
Promoting good practice Implement advice to HSE-run services of Quality Improvement Team Establishing a Sustainable mechanism for shared learning Developing an appropriate training and education programme for Persons in Charge Establishing an online portal for good practice Annual report of HIQA findings and highlighting good practice Thematic inspections with key focus (initially( on: Quality of life outcomes Person centred planning HSE HSE. Service Providers have lead roles in relevant areas HSE HIQA HIQA 4 22 23 24 25 26
Leadership, culture and practice Clear communication systems for management, staff and residents Proactive and meaningful engagement with residents Implementation mechanisms to ensure learning is transferred into local practice Addressing organisational structure that impacts on leadership and quality of life of residents Service providers and HSE have lead roles in relevant areas 27 28 29 30 In the establishing a Commissioning Process Having an agreed Commissioning framework in Commissioning process should include: Assessment of need Service Outcomes Monitoring and evaluation HSE 5-6