The Health Information and Quality Authority (HIQA) is recommending that it is time to review the current way of regulating social care services in Ireland to keep pace with the rapidly changing nature of those services. Research carried out by HIQA looked at the various models of care available to older people and people with disabilities in Ireland. The research also reviewed how these services are regulated in a number of other countries and has today published its reviews.
New model proposed
Mary Dunnion, Chief Inspector of Social Services and Director of Regulation with HIQA commented: “A key finding from other countries is that in some cases there is a fundamentally different approach to regulation of services compared to Ireland. Where we register and regulate buildings and centres, other countries have moved to a model of regulating services, and have a set of regulations that are specifically tailored to those services.
“This allows for greater innovation and flexibility in how providers deliver their services. In addition, providers simply register once and are then monitored for compliance on an ongoing basis thereafter. HIQA believes this model has potential in Ireland, particularly in light of the challenges we face in terms of our ageing population and the need to provide alternatives to long-term residential care.”
“All people who are receiving care are potentially vulnerable. However, our regulatory framework currently only provides for regulation of residential care. Therefore, people in non-residential care are not afforded the protections of regulation.”
Reform in this area
HIQA believes it is an opportune time to reflect on how we, as a State, provide services to people into the future, and how these services should be regulated.
Mary Dunnion continued: “It is likely that we will all have a need to access some kind of social service during our lives. As such, we should all take an interest in the quality of these services. We hope that this research will contribute to the debate around how we should plan, fund and deliver our social care services to meet the needs of the population. ”
Informing the debate
The only additional social care model where regulation is currently being mooted in Ireland is in home care. HIQA has brought its proposals on broadening the scope of regulation — and addressing the over-reliance on long-term residential care for older people — to the attention of the Joint Oireachtas Committee on Health and to the Minister for Health Simon Harris TD.
Mary Dunnion concluded: “We plan to work with the Department of Health and other relevant interested and informed parties in order to bring about reform in this area. We hope that the findings and recommendations published today arising out of this research will inform the public debate on the best way to regulate services for vulnerable people into the future.”
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Notes for the editor
Key points from the HIQA research papers
- HIQA has regulated older people’s residential services since 2009 and residential services for people with disabilities since 2013.
- A key component of the legislative framework is the ‘designated centre’ which must register with HIQA and comply with legislation and regulations.
- A designated centre is defined as an institution where residential services are provided to certain groups of people.
- HIQA’s own guidance says a designated centre is a service which provides both care and accommodation.
- Both research papers looked at Northern Ireland, Scotland, Wales, England, Australia, New Zealand and British Columbia in Canada.
- HIQA found the definition of a designated centre does not capture all of the current and emerging models of care in Ireland.
- There is a consensus that a provider should be registered with the regulator rather than an individual centre or service.
- HIQA believes the current registration cycle is overly burdensome, both for the service provider and the regulator.
- In any future scenario, the question of the fitness of the provider is a key consideration when assessing the quality of a service.