High Support Services – Quality of Care
High support services provide specific health care to meet the needs individuals with severe and profound disability. The quality of care and the interaction between carer and the person requiring care can range from positive and meaningful to negative and institutional. An assessment tool such as the Quality of Interaction Schedule1, used by providers and regulators to assess a healthcare service can provide examples of good and poor care. It is used to evaluate the healthcare service as whole, not individual carers or single events.
A healthcare or medical model of service is not appropriate for services intended to support inclusion and active participation in mainstream community programmes and activities.
Negative or institutional care is not acceptable in any service.
Positive Care
Positive Connective Care | Examples | Verbal Examples |
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Evidence that staff know residents well and facilitate meaningful human connections throughout the day
Score: +2 |
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Greeting each individual by name
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Task Orientated Care | Examples | Verbal Examples |
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Kind physical care, but conversation is superficial (instructive) and not personally meaningful Score: +1 |
Excellent physical care but with limited conversation
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Keeping the conversation only to current activities; washing, dressing, toileting -task orientated conversation
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Neutral Care | Examples | Verbal Examples |
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Passive and not stimulating Score: 0 |
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Not informing the resident what you are going to do
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Negative Care
Positive Connective Care | Examples | Verbal Examples |
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Individual care but the emphasis is on safety and risk aversion Score: – 1 |
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Institutional Care | Examples | Verbal Examples |
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Regarding residents as a homogenous group who will fit into the established routine of the home. Score: – 2 |
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1. The Quality of interaction Schedule was first developed for use in long term mental health settings but has since undergone many refinements and has been adapted for general use in care homes and hospital settings. Dean, Proudfoot and Lindsay (1993). The Quality of Interaction Schedule (QUIS): development, reliability and use in the evaluation of two domus units. International Journal of Geriatric Psychiatry Vol PP819-826
www.hiqa.ie/sites/default/files/2017-02/QUIS_examples.pdf