Publication of HIQA report on HSE Disability residential centres: August 2016

29th August 2016

The HSE welcomes the Health Information and Quality Authority (HIQA) inspection reports on a number of HSE facilities published today.  These reports detail  inspections undertaken  at 11 centres for people with intellectual disability between March and  June 2016. 


The HSE welcomes HIQA’s positive findings in a number of the centres including Forest View, Westmeath; Radharc  Nua, Wexford; Dun Firth Farm, Kildare; Cluain Farm, Meath; and The Coastguards, Louth.  Inspectors found evidence of:

  • a good quality of life for residents,
  • good standards of support and care for residents
  • a high level of compliance with regulatory requirements
  • residents being supported to exercise choice
  • significant improvements for residents in centres where the HSE has put in place new service providers (Muiriosa Foundation & Gheel Autism Services)


The HSE will ensure the learnings and good practice from these inspections are shared to further improve compliance in other areas.


“Our focus remains on compliance with HIQA’s residential standards for people with an intellectual disability and we are pleased to see the progress being made in this area. HIQA recently acknowledged, in their first annual overview of inspections on residential centres, a cultural change that is steadily resulting in improvements in the standard of care provided and an overall pattern of positive and improved outcomes for residents. We will continue to build on this and further improve compliance with HIQA standards” said Marion Meaney, HSE Head of Operations and Service Improvement, Disability Services.


The HSE also acknowledges that in four particular centres (outlined below) there were areas of significant non compliance in the reports published today. The HSE wishes to reassure residents and their families that a comprehensive programme of work is underway to address these issues as quickly as possible.  The HSE has an agreed action plan with HIQA for each centre to address the areas of non compliance identified in today’s report (see specific actions below).  Many of the issues  identified have been addressed and other actions are currently being implemented.


Our Lady’s centre, Kilkenny (Our Lady’s is on the campus of St Patrick’s Centre Services. The HSE was appointed registered provider of Our Lady’s Centre in June 2015)

  • St Patrick’s appointed a new Board of Management in April 2016 and this, combined with the strengthened reporting relationships between St Patrick’s and the HSE, will bring about the required changes to meet HIQA requirements for the overall complex
  • Staff training on safeguarding
  • Individual safeguarding plans for each resident
  • Medication management
  • Category ‘a’ fire safety works completed
  • Person appointed with responsibility for quality and standards (implementing policies, training and mentoring for staff to ensure that care is of an appropriate standard)
  • Regular governance meetings
  • Decongregation is underway to transition people to more appropriate community settings.


Millmount Centre, Westmeath –

  • Ongoing review of the governance structures and systems in place within the service to ensure compliance with governance and leadership and ensure a safe quality service to residents.
  • A Quality Assurance Group has been established within the service.
  • A new person in charge has been appointed to the designated Centre on a full time basis.
  • An overall costed plan has been developed to address identified recommendations regarding fire and structural deficits.
  • Efforts continue to identify alternative suitable accommodation for residents in consultation with residents and families.
  • All Policies, Procedures and Guidelines have been reviewed including the complaints policy for the centre. A complaints officer is now available to residents of the centre.
  • Training in deficits identified in the report has been undertaken by the service. Outstanding training required will be completed by 30th October 2016. 


Ard na Greine, Donegal  

  • A clearly defined management structure has been put in place and Ard Greine has been reorganised into four designated centres with a Nurse Manager identified to manage each centre,
  • all incidents of abuse are dealt with as per HSE policies and procedures and reported to the relevant bodies including HIQA,
  • a review of behaviour support plans has been completed to identify and reduce causes of behaviours of concern,
  • training has been delivered to staff in safeguarding awareness, managing behaviours of concern, fire safety, and risk management training.


St Raphael’s Centre, Youghal  (report published today relates to St. Raphael’s Centre which is one of four centres within St. Raphael’s Intellectual Disability Services This centre is due to be closed in March 2017) 


  • Staff have received training on medication management, fire safety, social role valorisation (this enables people with disabilities to achieve significantly improved life outcomes)
  • Regular safeguarding audits are undertaken 
  • A review of all residents’ mealtime guidelines was undertaken by the speech and language therapist and nursing staff and up-to-date guidelines are in place to support residents at mealtimes
  • A comprehensive review of all healthcare support plans is underway and will be completed by 30th September
  • An independent assessment of need has been completed for all residents
  • Four suitable houses for de-congregation have been identified, engagement with residents and families is commencing,  a project manager appointed, and training in a new social model of care has been provided for staff.  


In addition, improvements and developments in the wider disability sector to support residential centres to comply with HIQA residential standards include;


Funding: A significant investment programme in both capital and revenue funding is underway with a €100m capital fund agreed. The Minister for State for Disabilities announced in June this year that €20 million of this fund is being made available to the HSE in 2016 to move people from congregated settings. In line with best practice, the current HSE national policy for residential services for individuals with intellectual disabilities, ‘A Time to Move from Congregated Setting’, recommends that residential services are provided in family sized units with no greater than four residents.


Safeguarding:  The HSE’s national policy, Safeguarding Vulnerable Persons at Risk of Abuse – National Policy and Procedures continues to be implemented in all HSE and HSE funded services. The National Safeguarding Office has developed a number of training programmes to ensure consistency both in terms of quality of the delivery of the programmes and the content.


HSE compliance audit:  The HSE’s National Disability Office is currently undertaking a compliance audit of HSE Disability Centres. This Audit covers all areas of the policy including roles, responsibilities, internal work practices and compliance with procedures. Any breaches or non compliance will be addressed by the relevant managers with their staff via supervision and performance review.


Training: In a joint initiative, the HSE’s Social Care Division & Quality Improvement Division are providing intensive support to staff in HSE residential services through coaching, mentoring and guidance.  Training is being provided to senior staff on compliance with HIQA regulations and Person Centred Planning and further training will be rolled out across all the Community Healthcare Organisations (CHOs) in 2017.


Quality & Safety: During 2015, the Social Care Division established a National Social Care Quality and Safety Committee. The Quality and Safety Committee oversees quality and safety on behalf of the Social Care Division and ensures there are appropriate and effective governance systems in place.


The HSE remains committed to respecting the rights and dignity of each resident in its care and is working to ensure residents have the maximum choice and control possible in accordance with each individual’s wishes.  

Last updated on: 29 / 08 / 2016