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
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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)
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
o Engaged with staff and observed structures/practices
o Shared information about the Project
o Discussed/identified priority areas for improvement
o Shared tools and resources
o Completed service reports
o Flagged operational issues, where observed, to managers/CHOs
o 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
Governance and Quality structures
PCCC Quality Safety
Risk Committee
Audit sub
committee
PPPG sub committee
Intellectual Disability
services
QSRM
Local QRSM
Local QSRM
Local QSRM
Local QSRM
Local QSRM
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
Example of annual audit/review checklist
YEAR___________________
Jan
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
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Signature and date
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
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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