Today, the Health Information and Quality Authority (HIQA) has published 11 inspection reports on thematic inspections of restrictive practices in designated centres for people with disabilities. HIQA inspects against the Health Act 2007 (Care and Support of Residents in Designated Centres for Persons (Children and Adults) with Disabilities) Regulations 2013 and the National Standards for Residential Services for Children and Adults with Disabilities, which apply to residential services for people with disabilities in Ireland. 

HIQA’s programme of thematic inspections of restrictive practices in designated centres for people with disabilities focuses on assessing physical and environmental restraints as well as other forms of restrictive practices, and aims to promote quality improvement across services. 

All 11 centres were found to be compliant, with good practice identified in ensuring residents’ rights were promoted, their privacy and dignity were respected and their care was person centred. The centres are operated by: Brothers of Charity Services Ireland CLG; Cheeverstown House CLG; Health Service Executive (HSE); KARE Promoting Inclusion for People with Intellectual Disabilities; Positive Futures: Achieving Dreams. Transforming Lives. CLG; Praxis Care; Redwood Neurobehavioural Services Unlimited Company; and St John of God Community Services CLG.

Examples of good practice included:

• In a centre in Dublin operated by St John of God Community Services CLG, restrictive practices were being used to manage an identified risk linked to residents’ safety. There was a robust assessment process to ensure that the least restrictive measures were being used for the shortest duration possible. Inspectors also saw that staff were engaging with residents to provide them with information about the restrictive practices used and where possible, to seek their consent.
• In a centre operated by Positive Futures: Achieving Dreams. Transforming Lives. CLG in Meath, policies were in place to guide staff in supporting residents, including guidance on consent and decision-making which referenced legislation concerning assisted decision-making. Residents were further made aware of their rights through the provider ensuring that these policies were made available to them in an easy-to-read version.
• In a centre operated by Praxis Care in Dublin, residents’ rights in relation to the use of restrictive practices were actively upheld. Staff treated residents with dignity and respect and ensured that their privacy was respected at all times. Furthermore, residents were supported to develop a greater awareness of why restrictive practices were used, through regular meetings with staff.
• At a centre operated by Redwood Neurobehavioural Services Unlimited Company in Meath, staff had received training about human rights and assisted decision-making. In-depth discussions about residents’ rights and supports with decision-making occurred during regular staff meetings.  These discussions reinforced discussions with residents in their own meetings, where information was provided on human rights and how to make choices.