1. The Introduction of Regulation to Adult and children’s social care Services in Ireland
Vicky Blomfield, Msc Health Service
Management and Head of Corporate Projects, Health Information and Quality Authority.

2. Overview Role of HIQA in monitoring and regulating services
Standards and Regulations
How we inspect

3. The Health Information and Quality Authority
Who we are
HIQA is an independent authority responsible for driving quality, safety and accountability in various services for children, older people and people with disabilities in Ireland.
‘Safer Better Care’
We are responsible for driving improvements in the quality and safety of health and social care on behalf of patients, residents and service users.

4. Our Goals Promote the Authority’s core outcomes of
Driving improvement in services
Informing the public
Informing policy and ultimately
Improving outcomes for children and adults in Ireland.

5. Our role in services for children and adults in Ireland
We do this in a number of ways:
Regulating designated centres for older people and children and adults with disabilities (1500 centres)
Monitoring children’s services
Monitoring of healthcare services
Health Technology assessments
Standards Development
Health Information

6. Key Principles
Children and adults’ safety and wellbeing must be a top priority
Promote a high quality and effective service.
Their application
Standards apply to the HSE services
Children and Family Services.
Private providers of services.

7. Legal basis for inspection, monitoring and regulation
The Health Act 2007 s. 8 1 (c)
Child protection and welfare services
The Health Act 2007 s. 50
Designated centres for children with a disability (to be enacted)
The Child Care Act 1991

8. What are standards? Set out key attributes of an effective services:
Put the needs of children and adults at the heart of that service.
Promote the principles of safety and good quality services.
A level of quality or attainment
Outcome-based

9. What are the Regulations?
They ‘fall out’ of primary legislation
They are ‘must do’ rules

10. Compliance with standards and regulations
Meeting the requirements of rules (regulations)
Assuring safety and quality of service
Providing a good quality service (standards)
HIQA makes a judgement informed by findings which in turn are informed by evidence

11. Compliance and Non compliance
Non compliance – Major
Non compliance – Moderate
Substantially compliant
Compliant
Inspectors identify where a non compliance relates to serious risk, a medium risk, no risk
Risk = probability x impact of harm

12. Can compliance drive improvement ?
Reporting on non compliances – does it work?
Reporting on positive practice – being fair and transparent
The mixed picture – confusing or realistic?

13. Leadership, Governance and Management
Foundation of a good service
Strong leadership and effective governance, determination, commitment to change and improve
Clear lines of accountability, roles and responsibilities
Robust service delivery systems
Robust information systems informing planning
High quality professional supervision
Effective QA system, audits, learning leading to change

14. Principles of HIQA inspections
Transparency
Accountability
Targeting
Consistency
Proportionality
Even handedness

15. The inspection framework
During fieldwork we gather information from a variety of sources
Interviews
Observation of practice
Case files and other documentation
Data metrics

16. Schools/other agencies Social Workers/others
Who do we meet?
Management
Schools/other agencies
Social Workers/others
Parents
Child
Customer
Relatives
Your staff
Community nurses
Other key professionals
Managers
Representatives of the provider

17. What do we read? Care plans Assessments Narrative notes Staff files
Supervision records
Policies, procedures and guidelines
Minutes of team and management meetings
Complaints log
Audits and quality assurance documents

18. What do we see? Inspectors sit with staff in their offices
Social Work Offices
Meetings
Duty system
Inspectors sit with staff in their offices
Observe how phone calls and visits are managed in the duty room
Join child protection case conferences
Join strategy meetings
Join team meetings
Arrange to interview customers
Other meetings that are relevant to the delivery of the service

19. Reports
Draft
Due Process
Factual Accuracy
Final
Publication

20. What does HIQA want to see?
Good leadership
Person-centred care
Effective services
Safe services
Skilled, experienced, trained and qualified workforce
Good use of resources
Good use of information.

21. Registration
If homecare services require registration then there is an extensive process to be completed.
Application form and inspection
Fitness of the provider is considered as well as the compliance with standards and regulations
Chief Inspector may Grant, Refuse, Attach (limiting) conditions.

22. Enforcement Findings of risk, on going non compliance
Attach, remove or vary conditions
Enforcement orders
Prosecutions
Cancelling registration (number of different ways of doing this)

23. Thank you and Any Questions?