This report by HCI highlights the trends in inspection findings, those being ‘Compliant’ and ‘Not Compliant’ as detailed by the Health Information and Quality Authority (HIQA) in reports for residential care settings for older people. The inspections were against the
requirements as outlined in the following:
- Health Act 2007 (Care and Welfare of Residents in Designated Centres for Older People) Regulations 2013 (S.I.No. 415 of 2013).
- Health Act 2007 (Registration of Designated Centres for Older People) Regulation 2015 (S.I.No. 61 of 2015).
HCI completed a review of seventeen (17) randomly selected HIQA Inspection Reports. All inspections were completed during November 2018 to February 2019.
Summary of Findings
The review highlighted that Regulation 21: Records and Regulation 28: Fire Precautions had findings that carried a Not Complaint Red Risk. Issues identified under these Regulations included:
- Regulation 21: Records (75% Services Not Compliant of the 16 Services reviewed against this Regulation). Issues included:
- Records were not stored securely.
- Failure to ensure all staff had a vetting disclosure in accordance with the National Vetting Bureau (Children and Vulnerable Persons) Act 2012 and 2016.
- Regulation 28: Fire Precautions (75% Services Not Compliant of the 16 Services reviewed against this Regulation). Issues included:
- Strong smell of gas from the cooker/oven in the kitchen which required urgent action.
Other areas recognised as requiring improvement:
- Regulation 23: Governance and Management (94% Services Not Compliant of the 17 Services reviewed against this Regulation). Issues included:
- Management roles and responsibilities were not clearly defined.
- Inspectors were not satisfied that the governance arrangements were sufficiently robust to ensure the service provided is
safe, appropriate, consistent and effectively monitored.
- Regulation 9: Residents’ Rights (93% Services Not Compliant of the 15 Services reviewed against this Regulation). Issues included:
- A person-centred approach to care was not observed.
- Appropriate arrangements were not in place to ensure the rights of residents were respected in relation to privacy, dignity and their ability to exercise personal choice.
- The language used in some care plans was not appropriate.
- Regulation 17: Premises (87% Services Not Compliant of the 15 Services reviewed against this Regulation). Issues included:
- The layout and design of the residential home was not fit for purpose.
- General maintenance of the premises was required.
- Regulation 27: Infection Control (73% Services Not Compliant of the 11 Services reviewed against this Regulation). Issues included:
- Standard of cleaning within the residential home was not monitored appropriately.
- Hand hygiene practices were not in compliance with best practice guidelines.
- The lack of auditing practices could not ensure that infection prevention and control practices were in compliance with best practice and National Standards.
- Regulation 26: Risk Management (70% Services Not Compliant of the 10 Services reviewed against this Regulation) Issues included:
- Risk management policy and procedure did not contain the requirements of the Regulations.
- There were inadequate arrangements to identify, assess, mitigate, monitor and report all risks.
- The risk register was not updated and reviewed on a regular basis.
Areas of Good Practice
An area of good practice was identified in relation to Regulation 14: Persons In Charge (100% of the 7 services reviewed against this Regulation were deemed compliant).
The following Regulations were not inspected in the reports reviewed and were therefore not included in the analysis:
- Registration Regulation 4 – Application of Registration or Renewal of Registration.
- Registration Regulation 6 – Changes to Information Supplied for Registration Purposes.
- Regulation 25 – Temporary Absence or Discharge of Residents.