40 Questions HIQA Ask

The Health Information and Quality Authority (HIQA) set out 40 key questions to guide inspection of residential services1. They are a useful tool to support judgment and decision-making.

Service Centered on the Individual

HIQA Theme 1 - Individualised Support And Care

  • Are residents consulted about how the centre is planned and run?
  • Is the privacy and dignity of each resident respected?
  • Are residents enabled to make choices about how they live their lives in a way that reflects their individual preferences and diverse needs?
  • How are residents’ belongings and finances valued and protected?
  • Are there opportunities for residents to participate in activities that are meaningful and purposeful to them and that reflect their interests and capacities?
  • Are residents assisted and supported to communicate at all times?
  • Are families actively encouraged and involved in the lives of residents?
  • Are residents supported in making friends and integrating into the community?

A Quality Residential Service

HIQA Theme 2 - Effective Services

  • Are admissions determined based on clear criteria in accordance with the centre’s written Statement of Purpose?
  • Are there written agreements with residents (a personal plan) which deal with the support, care, and welfare of the resident in the designated centre and include details of the services to be provided for that resident?
  • Does the care and support provided to residents reflect the assessed needs and wishes of residents?
  • Are residents supported in transition between services?
  • Are children supported in preparing for adulthood?
  • Is the design and layout of the centre suitable for its stated purpose?
  • Is there suitable equipment, aids, and appliances in place to support and promote the full capabilities of residents?
  • Is the health and safety of residents, visitors, staff promoted and protected?

A Safe Residential Service

HIQA Theme 3 – Safe Services

  • Are there measures in place to safeguard and protect residents from abuse?
  • Is there evidence that any incidents of abuse were appropriately investigated and managed in line with the centre’s policy, national guidance and legislation?
  • Are residents provided with supports to promote a positive approach to behavior that challenges?
  • Is a record maintained of all incidents occurring in the designated centre, and where required notified to the Chief Inspector of the Authority?

Health and Personal Development

HIQA Theme 4 – Health and Development

  • Do residents have opportunities for new experiences, social participation, education, training and employment?
  • Are residents health care needs met?
  • Are residents provided with a nutritious and varied diet?
  • Are residents protected by safe medication management policies and practices?

Management of the Residential Service

HIQA Theme 5 – Leadership, Governance and Management

  • Is there is a written statement of purpose that accurately describes the service that is provided?
  • Is the statement of purpose clearly demonstrated in practice?
  • Are there effective management systems in place?
  • Is there a clearly defined management structure that identifies the lines of authority and accountability?
  • Is the centre managed by a suitably qualified, skilled and experienced person?
  • Are there suitable arrangements in place for the management of the designated centre in the absence of the person in charge?

How Resources Are Used

HIQA Theme 7 – Responsive Workforce

  • Is the centre resourced to ensure the effective delivery of care and support in accordance with the Statement of Purpose?
  • Are the numbers and skill mix of staff appropriate to the assessed needs of residents?
  • Does the education and training available to staff enable them to meet the needs of residents?
  • Are staff supervised appropriate to their role?
  • Is there a safe and robust recruitment process?
  • Do volunteers receive supervision and vetting appropriate to their role and level of involvement in the centre?

How Information Is Used

HIQA Theme 8 – Use of information

  • Are residents protected against the risks of unsafe or inappropriate care by the completeness and accuracy of records?
  • Are there written operational policies to inform practice?
  • Is the centre adequately insured against injury to residents?

1 Question You Should Ask

1. What is it like to live here?

More detailed information is provided in the HIQA Assessment Judgment Framework for Disability Services and the Guidance for Assessment 2018 2&3. The framework and guidance set out the lines of enquiry to be explored by inspectors to assess compliance with the regulations and or standards being monitored or assessed.

Useful Links:

The Health Information and Quality Authority (www.HIQA.ie )

1. HIQA Assessment Framework for Designated Centers for Persons (Children and Adults) with Disabilities, January 2015.
2. HIQA Assessment Judgment Framework for Disability Services February 2018
3. HIQA Guidance for the Assessment of Centers for Persons with disabilities February 2018

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