How to read a HIQA inspection report

The Health Information and Quality Authority (HIQA) registers and inspects every nursing home in Ireland. Its inspectors work for the Chief Inspector of Social Services. They check each home against the care and welfare regulations for designated centres for older people (made under the Health Act 2007, in 2013) and the national standards for residential care.

Most inspections are unannounced. Inspectors talk to residents and visitors, talk to staff and managers, watch daily life, and review records. A home is registered for 3 years at a time, and HIQA can attach conditions to its registration. You'll see any conditions on each home's page here.

Every report is published on HIQA's Find a centre pages as a PDF, usually a couple of months after the inspection. Each home's page on this site links to its HIQA page.

1. Front page: the home, the provider, the type of inspection (for example unannounced), the date, and the centre ID (OSV number).
2. About the designated centre: the provider's own description of the home, and the number of residents on the day. This is the provider's wording, not HIQA's.
3. What residents told us and what inspectors observed: a plain-language account of daily life. If you read one section, read this one.
4. Capacity and capability: leadership and management, staffing, training, and the systems the provider uses to oversee care.
5. Quality and safety: the care and support residents get, their rights, safeguarding, the building, fire safety and infection control.
6. Appendix 1: a table of every regulation inspected and the judgment for each one.
7. Compliance plan: for each regulation that wasn't fully met, what the provider says it will do and by when. These are the provider's commitments. HIQA checks them at later inspections.

Each regulation inspected gets one of three judgments:

A not compliant finding is rated red when it poses a significant risk to residents' safety, health or welfare, or when the problem is continuing. For a red finding, the inspector sets the date by which the provider must comply. For yellow and orange findings, the provider chooses its own date in the compliance plan.

Findings against these regulations tell you most about residents' day-to-day safety and care:

• Regulation 23, governance and management: whether the provider is in control of the home and fixes problems.
• Regulation 15, staffing: enough staff, with the right skills, on every shift.
• Regulation 8, protection: safeguarding residents from abuse.
• Regulation 9, residents' rights: choice, privacy, dignity and meaningful activity.
• Regulation 5, individual assessment and care plan: whether care is planned around each person.
• Regulation 28, fire precautions, and Regulation 27, infection control.
• Regulation 29, medicines and pharmaceutical services.

Read the detail

Each regulation in the table is discussed in the body of the report, with a short explanation of what inspectors found. Reading that for any not compliant finding tells you whether it was about a missing form or about residents' care.

A single report is a snapshot. Looking at the last two or three shows you the trend:

• Repeat findings on the same regulation, especially governance or staffing, suggest the provider isn't fixing problems.
• Several inspections close together can mean HIQA is following up on concerns.
• Improvement from not compliant to compliant shows the compliance plan worked.
• A change of provider or person in charge can explain a sudden change, for better or worse.

Our HomeScore sums up each home's recent judgments, weighting recent inspections more and penalising orange and red findings, so you can compare homes quickly. Use it to choose which reports to read, not as a replacement for reading them. When you've narrowed it down, the short-notice guide lists questions to ask the home about any findings.