Inclusion Ireland Annual Conference

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Living Life to the Full So where do Standards
come in?Niall ByrneDeputy DirectorOffice of
the Chief Inspector of Social Services
Inclusion Ireland Annual Conference 28 March 2009
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This mornings presentation

• Apologies on behalf of Dr. Marion Witton, Chief
  Inspector of Social Services
• Background to HIQA and the Office of Chief
  Inspector of Social Services
• How regulation will work in older peoples
  residential services as from 1 July 2009
• How this will link to regulation of residential
  services for people with disabilities where we
  are now
• Linking to your theme - Living life to the full!

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• Background to HIQA the Office of Chief
  Inspector of Social Services

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Health Information and Quality Authority

• Established in May 2007 as part of the
  Government's Health Reform programme
• An independent Authority - reports directly to
  the Minister for Health Children
• Promote safety and quality in the provision of
  health personal social services for the benefit
  of the health 7 welfare of the public (Section 7,
  Health Act, 2007)
• Has a remit across public, voluntary and private
  services
• Clear focus on Putting People First

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How HIQA is organised

• Four Operating Divisions within the Authority
• Healthcare Quality and Patient Safety
• Health Technology Assessment
• Health Information
• Office of the Chief Inspector of Social Services
• Two Support Divisions
• Corporate Services
• Communications Stakeholder Engagement

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The Office of Chief Inspector of Social Services

• A new statutory position established by Health
  Act 2007
• Functions of Chief Inspector are
• To Register and Inspect all designated
  (residential) centres for children, older
  people, people with disabilities
• Inspect Special Care Units
• Inspect Detention Schools
• Has a range of regulatory and enforcement powers

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• How regulation will work in older peoples
  residential services as from 1 July 2009

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Regulation under the Health Act 2007

• All residential care (HSE, Private and Voluntary)
  must be registered with Chief Inspector in order
  to operate
• Registration must be renewed every three years
• Inspections will be announced and unannounced, in
  and out-of-hours
• Everyone involved in running a service must be
  fit person
• Designated centres must be in compliance with the
  Regulations and the Standards
• System will be largely self-financing through fees

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The Tools of Regulation

• Standards Legislation
• Criteria Regulations

• Standards, legislation and regulations are
  designed to be congruent
• The Regulatory Framework consists of
  Registration, Inspection and Enforcement

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Standards are about

• Driving improvement
• Keeping people safe
• Supporting quality of service

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National Quality Standards for Residential Care
Settings for Older People

• 32 Standards across 6 Domains
• Standards Statements These are principles not
  rules
• Outcome-based and focus on the experience of the
  resident as well as on objective data.
• Standards have been approved by Minister for
  Health Children
• Key outcome question Whats this centre like
  as a place to live?

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Criteria

• Standard statements are supported by indicative
  criteria
• Criteria are examples of how Services may achieve
  the Standard
• They are not the only way of meeting the
  standards
• They should not be considered as prescriptive

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What will inspectors do ?

• Assess information prior to the inspection
• Meet with residents, family members, owner, mgt
  and staff
• Review policies and procedures, rosters, records,
  brochures, staffing issues, incident reports
• Inspect quality of life issues activities,
  privacy and dignity, care practices, choices,
  routines, meals
• Review the physical environment
• Assess the evidence objectively
• Reach fair and reasonable conclusions
• Report publicly on their findings
• Act decisively on issues of safety

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• How this will link to regulation of residential
  services for people with disabilities and where
  we are now

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Regulation of residential services for people
with disabilities

• Same regulatory framework will be used as for
  older peoples services
• Same principles will apply in assessing services
  Whats this like as a place to live?
• Inspectors will talk to people, observe, review
  documents and make balanced assessments
• All reports will be published on HIQA website

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Where we are now

• Draft National Quality Standards have been
  drawn-up by HIQA in partnership with stakeholders
• These will be published shortly by HIQA and are
  subject to the approval of the Minister
• A Regulatory Impact Assessment must be conducted
  by the Dept. of Health Children
• Regulations under the Health Act, 2007 must also
  be made by the Minister
• A decision is awaited as to when the Minister
  will formally commence the regulation of
  designated centres for people with disabilities

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• Living life to the full !
• So where do Standards come in?

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Key points to remember

• Registration, Inspection and Standards are tools
  within a wider process of regulation
• The system allows a service to demonstrate its
  quality of care to the regulator
• Providers, managers and staff are those who
  deliver services and are responsible for the
  quality of care
• Registration and inspection assure public
  confidence that services are in keeping with
  Standards
• Regulation assures quality, eliminates poor
  providers and recognises and encourages good
  providers

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Live your life to the full!

• Page 13 of the Draft National Quality Standards
  says
• Quality of Life
• The purpose of residential services for people
  with disabilities should be to provide them with
  the supports they require in order to lead a
  fulfilling life

• This is the challenge to Service Providers,
  Funders and Regulators Are we supporting people
  or are we getting in the way of people having a
  fulfilling life?
• Our Standards focus on the things that matter -
  choice, quality, opportunity living your life
  to the full!

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• Thank You