Donegal Intellectual Disability services Vision Statement Donegal Intellectual Disability Services seek to enable each individual with an intellectual disability / autism to achieve his / her full potential and maximise their independence including living as independently as possible. A range of services are provided in partnership with people with disabilities, their families, carers, statutory, non-statutory and locally based community group homes. The services are needs-led, person-centered and underpinned by the principle of equity.

Overview of Services Provided: 2015 Residential Services (41 people per month) Community Group Home Services (140 people per month) Independent/Semi Independent Living (15 people per month) Day/Activity/Resource Centres (255 people per month) Respite Services – day and overnight, weekend, drop in, in-home and home to home services 220 people per month (adults & children) Autism Services (Number of children on caseload 485) Specialist Pre-Schools (15 children per month attending) Home Supports (approx 25 people per month) Direct Payments (approx 70 people per month)

Project Update – Phase 1A Preliminary Visits QIET Project Update – Phase 1A Preliminary Visits March 2015-June 2015 – Preliminary Service Visits HSE residential services for adults with ID: 148 units, 1,054 HIQA beds Engaged with staff and observed structures/practices Shared information about the Project Discussed/identified priority areas for improvement Shared tools and resources Completed service reports Flagged operational issues, where observed, to managers/CHOs Validated data

What is quality in Intellectual Disability services Clinical effectiveness: quality care is care which is delivered according to the best evidence as to what is clinically effective in improving an individual’s health and social outcomes Service user safety: quality care is care which is delivered so as to avoid all avoidable harm and risks to the individual’s safety Service user experience: quality care is care which looks to give the individual as positive an experience of receiving and care as possible, including being treated according to what that individual wants (personal goals)or needs (goals of care) and with compassion, dignity and respect

Components of quality Clinical effectiveness Service user experience Service user safety Service user experience

Governance and Quality structures PCCC Quality Safety Risk Committee Audit sub committee Intellectual Disability services QSRM Local QRSM Local QSRM PPPG sub committee

Processes for Clinical effectiveness Audit/Nursing metrics Medication management Personal plans Provision of Information for service users PCPs Person centred Care planning Documentation Reviewed and Updated to promote service user and family involvement PDSA cycle used to introduce and study changes

Service user safety Risk management and managed risk to promote ordinary living Medication errors policy incorporating:- root cause analysis to determine systemic causes Reflective cycle to identify individual responsibilities and gaps in own competence Development planning to gain competencies identified On going co-operation and consultation with community pharmacists regarding medication management: 3 monthly reviews of medication by pharmacist for individuals

YEAR___________________ Example of annual audit/review checklist YEAR___________________ Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Signature and date Risk Register reviews Care planning Audits Site Profile (annually) Safety statement Hazard controls Maintenance of equipment record Training for staff review Evidence of Registration of nurses (annually) Evidence based practice Fire Register checks Statement of purpose and function (annually) Annual reviews Nursing Metrics (Monthly) Incidence analysis Hygiene audits (2 monthly) Infection control Fire drills (one at night) Vehicle check (6 weekly) Staff supervision/appraisals

Safeguarding and protection National Policy Establishment of National Safeguarding Office Training of designated officers Training of frontline staff Establishment of Safeguarding and protection teams

Multi element behaviour support model Positive Behaviour Support Emphasises Human Rights based approach to supporting people with behaviours of concern Promotes:- Holistic assessment/person centred Functional assessment/analysis Nonaversive interventions Person centredness Promotion of choice and autonomy Skills teaching for coping and for increased self confidence Environmental adaptation

Service user experience Person centred planning Annual Review meetings Satisfaction surveys (respite Care Congregated settings Report and implementation committee New Directions report Introduction of ASDAN modules of learning foe sevice users

Quality outcomes Enhance Service User quality of life Compliance with national standards/regulations Staff involvement in initiatives Nursing metrics, Review of documentation Review and development of Regulatory policies Mebs Dual Diagnosis Part of QIET Working with NMPDU – to provide a quality improvement facilitator