Today, the Health Information and Quality Authority (HIQA) has published 20 inspection reports on thematic inspections of restrictive practices and infection control 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.

Today’s publication includes the first seven reports on HIQA’s new programme of thematic inspections of restrictive practices in designated centres for people with disabilities. Restrictive practices are the intentional restriction of a person's voluntary movement or behaviour. The inspection programme focuses on assessing physical and environmental restraints as well as other forms of restrictive practices, and aims to promote quality improvement across services.

Reports on seven centres operated by Autism Initiatives Ireland Company Limited By Guarantee, Gheel Autism Services CLG, Peter Bradley Foundation Company Limited by Guarantee, St John of God Community Services CLG, St Michael's House and Sunbeam House Services CLG have been published. All 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.

Examples of good practice included:

• In a centre operated by Gheel Autism Services CLG, residents were supported by visual supports and equipment to have autonomy and choice. For example, residents had access to visual timers to support them in making decisions and understanding the timing of events. A visual roster was also in place to show residents which staff members were on duty that day. A regular ‘voices and choices’ meeting was held with residents. Records showed that residents were supported to understand and discuss topics including their rights and the complaints procedure at these meetings.
• In a Sunbeam House CLG centre, residents were consulted with about the running of the centre and were supported to express their wishes and preferences. Residents chose how to spend their time and the activities they engaged in such as swimming, shopping, eating out, meeting friends and family, horse riding, massages, walks and sensory activities, as well as paid and voluntary work. 

The remaining 13 reports relate to inspections on infection prevention and control (IPC) which aim to promote continuous quality improvement in IPC practices in line with the National Standards for infection prevention and control in community services (2018), published by HIQA.

Overall, inspectors found a generally good level of compliance with the regulations and standards across nine of these centres inspected.

Good practice was observed by inspectors in centres operated by: Avista CLG; Brothers of Charity Services CLG; Camphill Communities of Ireland; Cheeverstown House CLG; Health Service Executive (HSE); Nua Healthcare Services Limited; St John of God Community Services CLG; and Stewards Care Limited.

However, four centres, operated by Avista CLG and Brothers of Charity Services Ireland CLG, were found to be non-compliant or substantially compliant with the IPC inspection programme, which meant that residents were not being adequately protected from the risk of infection. These providers were required to take actions to improve their infection prevention and control arrangements.

Examples of areas requiring improvement included:

• Improvements were required in staff access to infection, prevention and control-related training.
• Improvements were required in the effective completion of IPC audits.
• Improvements were required in the storage of cleaning equipment to prevent the risk of contamination.

Read all reports at www.hiqa.ie.