Health and social care provision improving, but ineffective governance and safeguarding continue to put residents at risk

Health and social care provision improving, but ineffective governance and safeguarding continue to put residents at risk

Health and social care provision improving, but ineffective governance and safeguarding continue to put residents at risk

Date of publication:

Wednesday, 06 June, 2018

HIQA has today published a review of its regulation of health and social care services, identifying areas of good practice and improvement, as well as the key challenges in providing care to some of Ireland’s most at-risk population.

The overview of HIQA’s health and social care services in 2017 includes findings from nursing homes, residential services for people with disabilities, children’s and healthcare services. While each sector HIQA regulates is subject to varying models of monitoring and regulation, inspections found that, overall, compliance with the regulations and national standards has increased.

HIQA’s Director of Regulation and Chief Inspector of Social Services, Mary Dunnion, said: “A review of our inspections in 2017 shows that the number of centres compliant with the regulations has increased. Furthermore, our thematic programme which focuses on quality improvement has found that many providers are striving beyond basic compliance and are looking to the relevant national standards to improve the quality of life and care for people using health and social care services.”

“We spoke with thousands of people using health and social care services during 2017. Most people who speak with inspectors express satisfaction with the service being provided to them.”

In 2017, HIQA inspections found that governance and management of health and social care services continues to play a key role in the safety of care and quality of life of residents. Today’s report highlights:

The importance of effective governance and clear accountability at a provider level to deliver and sustain safe, quality care.

The positive impact of thematic programmes on quality of life and safety of care for people using services.

That some services must take safeguarding more seriously, particularly in regards to ensuring An Garda Síochána (police) vetting is in place for all relevant staff and volunteers.

National health and social care policy needs to be developed and implemented to support improvement in care, for example safeguarding legislation.

The need for a system of regulation and monitoring which promotes innovation in health and social care models, to ensure quality and safety of services into the future.

Mary Dunnion continued: “Over the past nine years, regulation has shown that in order for any provider to deliver and sustain a good service there must be effective governance and management. The provider must have robust governance arrangements in place in order to ensure that a safe, quality service is being run. Service providers also need to assure themselves of the safety and quality of their service through audit, rather than relying on HIQA inspectors to find non-compliance.

“HIQA also encountered services where safeguarding was not sufficiently strong and comprehensive. Too many providers of social care services are failing in their duty to safeguard people in care and ensure that individual rights are upheld. Adults and children in care are particularly at risk. As a result of these continued failings, HIQA is working across the different sectors to influence national policy and legislation in respect of adult safeguarding, including the development of safeguarding standards in conjunction with the Mental Health Commission.”

The report found that the level of compliance differs per area of regulation, which is reflective of the length of time a sector has been regulated.

  • Nursing homes have been regulated by HIQA since 2009, and nursing home providers now have a good deal of experience in implementing the regulations. This sector saw an increase from 15% in 2016 to 27% of all designated centres inspected in 2017 found to be fully compliant with the regulations.
  • Residential disability services have been subject to HIQA regulation since 2013. While in general, there is evidence of good quality services and a good level of compliance in many centres, some providers in this sector are still focused on achieving basic compliance with the regulations, with a number of centres continuing to have significant difficulties in meeting the basic requirements to be registered in advance of the 31 October 2018 deadline.
  • During 2017, HIQA continued to monitor compliance with the national standards in both children’s and healthcare services through its various programmes.


For further information please contact:

Suzanne O’Brien, Communications and Complaints Manager

01 814 7488/ 087 624 1216

Notes to Editor:

In 2017, HIQA carried out:

  • 600 inspections in nursing homes
  • 839 inspections in centres for people with disabilities
  • 43 inspections in children’s residential services, special care units, protection and welfare, detention campus and foster care
  • 57 inspections in public acute hospital in the areas of prevention and control of healthcare-associated infection, medication safety and nutrition and hydration.
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