Inclusion Ireland Annual Conference 28 March 2009 “Living Life to the Full” So where do Standards come in? Niall Byrne Deputy Director Office of the Chief Inspector of Social Services

This morning’s 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 people’s 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!

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

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”

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

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

How regulation will work in older people’s residential services as from 1 July 2009

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

The Tools of Regulation StandardsLegislation CriteriaRegulations Standards, legislation and regulations are designed to be congruent The Regulatory Framework consists of Registration, Inspection and Enforcement

Standards are about…  Driving improvement  Keeping people safe  Supporting quality of service

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 – “What’s this centre like as a place to live?”

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

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

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

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 – “What’s 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

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

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

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

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!

Thank You