Effective from the 1st of January 2018, Health Information and Quality Authority (HIQA) implemented the use of the Enhanced Authority Monitoring Approach (AMA) to the regulation of designated centres. This approach implemented changes to the inspection report format, which now reflects:
- Views of the people who use the service (as provided through resident questionnaires and Inspectors communications on-site with residents).
- Capacity and capability of the Registered Provider to deliver a safe quality service (addresses governance, leadership and management arrangements in the centre and how effective they are in assuring that a good quality and safe service is being provided).
- Quality and safety of the service (addresses the care and support people receive and whether it was of a good quality and ensured people were safe).
Another enhancement includes the risk-rating of not compliant regulations within the designated centres. The inspection report format is regulation driven rather than the previous template which presented the findings under outcomes.
HCI completed a review of the HIQA inspection reports released between February to April 2018 to highlight the trends in findings within designated centres for older people. A total of forty-three (43) inspection reports were released by HIQA for the period February to April 2018. Out of the of forty-three (43) inspection reports published, twenty-eight (28) (65%) followed the AMA layout, with the remaining fifteen (15) inspection reports having the findings detailed under the outcomes as set out in the National Standards. Out of the twenty-eight (28) inspection reports published using the AMA format, HCI reviewed a total of fifteen (15) (54%) of the inspection reports and their associated findings.
As part of the review, HCI identified trends where improvement was deemed required by HIQA to ensure compliance of designated centres for older people with the regulations. Trends in areas deemed Not Compliant included, but were not limited to:
- Regulation 23: Governance and Management (73% Not Compliant) – Systems in place to monitor quality and safety of care were not robust; Governance arrangements did not provide sufficient assurances that key indicators of quality and safety of the service and the quality of life of residents was comprehensively reviewed.
- Regulation 21: Records (87% Not Compliant) – Residents’ personal information was not maintained in a safe manner; Records for each member of staff were not kept in the designated centre and available for inspection.
- Regulation 31: Notification of Incidents (80% Not Compliant) – Registered Provider failed to recognise allegations of abuse and did not inform HIQA accordingly.
- Regulation 12: Personal Possessions (100% Not Compliant) – Some residents did not have adequate space for personal possessions in their bedroom; Some items of clothing inspected did not have any label to prevent loss when sent for cleaning or to the laundry.
- Regulation 17: Premises (100% Not Compliant) – The design and layout of the premises was not suitable for its stated purpose as it did not conform to the Schedule of the Regulation; General maintenance of the building was required.
Good practice was identified in relation to Persons in Charge, Directory of Residents, Visits, End of Life Care, Food and Nutrition and Temporary Absence or Discharge of Residents.
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