Most Cork disability centres not fully compliant with regulations - Hiqa

An analysis of reports by the Health Information and Quality Authority (Hiqa) into centres for adults with disabilities in Cork has found that just two centres were found fully compliant with regulations in 2024, as providers say staff shortages are causing problems in the sector.

Hiqa regularly inspects centres through both announced and unannounced inspections, and assesses their compliance under a number of different areas including residents’ rights, premises and governance and management, marking them compliant, substantially compliant, or not compliant under each area.

Overall, Cork centres for people with disabilities were 59% compliant, 26% substantially compliant and 15% not compliant in 2024.

Social Democrats TD for Cork East Liam Quaide told The Echo: “These inspection compliance ratings are very concerning.

“There are major issues with recruitment and retention of staff in the disability sector at present, which are likely impacting on the compliance of some services.”

Staffing was a common reason for non-compliance across the Hiqa reports examined by The Echo.

Unions representing Section 39 workers, who provide care to elderly or disabled people in non-public settings, are currently balloting their members on industrial action over failure by the government to bring their pay and terms in line with HSE workers in the same job.

Earlier this week, Sharon Cregan, a Cork SIPTU health organiser, told The Echo that these issues are making it impossible for services to recruit and retain staff across many organisations.

The HSE has also experienced persistent staffing difficulties due to the recruitment embargo that was in place up until last summer.

The Echo looked at all 71 Hiqa reports into Cork centres published in 2024. Just five of them were HSE-operated facilities — nationally, the HSE runs just over 10% of all residential disability centres in Ireland, with the remainder operated by charitable or non-profit organisations.

Cope Foundation operated the largest number of the assessed centres at 25, followed by the Brothers of Charity at 18.

Other smaller groups include Nua Healthcare who operated five assessed centres, Co-Action and Enable who operated three each, Praxis, L’arche, Resilience Healthcare, St Joseph’s Foundation, and Abode Doorway to Life, who each operate two, and The Rehab Group which operates one.

Hiqa inspection reports set out the findings as observed on the day of the inspection visit, but not all regulations are examined at each inspection and different regulations can be examined in different centres.

Compliance rates

Cope Foundation centres had an overall compliance rate of 52%, with 30% substantial compliance and 18% non-compliance.

The Brothers of Charity centres were marked compliant in 57% of areas examined, substantially compliant in 27% and not compliant in 16%.

60% of Cope Foundation centres had at least one non-compliance, while Brothers of Charity saw at least one non-compliance in 94% of centres.

HSE centres were 36% compliant, 34% substantially compliant and 30% not compliant, while the highest overall rate of non-compliance was seen in Co-Action, which had 42% compliance, 22% substantial compliance and 36% non-compliance.

Centres range in size from just two residents to 26 residents, with all the larger centres being run by the HSE or Cope.

Enable, which saw regulations assessed across two small and one larger centre, had 77% compliance, 14% substantial compliance and 9% non compliance with the larger centre having the highest level of non-compliance.

The majority of the smaller providers saw high levels of overall compliance — Resilience Healthcare was 87% compliant, and 13% substantially compliant and Nua Healthcare was 97% compliant, 3% substantially compliant — both had no non-compliances.

Similarly, Praxis was 80% compliant, 16% substantially compliant and just 4% not compliant, while St Joseph’s Foundation was 65% compliant, 23% substantially, and 12% not compliant, and Abode Doorway to Life was also 65% compliant and had 29% substantial compliances and 6%Just two Cork centres were found to be fully compliant by Hiqa in 2024; Lavanagh House, operated by Enable, and Valley View, operated by Nua Healthcare.

Cork City North 15 and East County Cork centres, both operated by Cope Foundation, were both found 100% not compliant, as was HSE-operated Kilcoran East Cork, but all three of these were specific risk inspections which looked into only specific areas which had caused problems in the past rather than the full centre.

'Matters being addressed'

A spokesperson for the Cope Foundation, now called Horizons, told The Echo: “Horizons (formerly Cope Foundation) supports more than 2,800 children and adults with an intellectual disability and/or autism to live a life of their choosing and has over 70 locations throughout Cork city and county.

“The organisation acknowledges the findings of the Hiqa reports in 2024 and the matters identified are being addressed.

“Horizons is working, within the resources available to it, and in conjunction with Hiqa and the HSE, to continue its efforts to improve compliance. At all times, we strive to provide the best possible care we can to our residents.

“The recruitment of staff is an issue affecting organisations right around the country, and Horizons is working within the limits of our funding when it comes to staffing. We held recruitment open days in 2024 with more planned for 2025.”

A spokesperson for the Brothers of Charity said that it “endeavours to deliver the highest possible quality of services at all times”.

They explained: “Where a Hiqa report highlights an issue, a comprehensive action plan to address the issue raised in the report is submitted to Hiqa. The services are committed to ensuring all actions are addressed in line with the timeframes outlined in the plan.”

A Co-Action spokesperson said: “CoAction West Cork CLG values the role of the Health Information and Quality Authority (Hiqa) in the regulation of residential services for people with disabilities.

“In 2024, environmental factors of one of our designated centres significantly impacted on our overall compliance levels.

“As per the compliance plan submitted to the Authority, actions were taken which has addressed these factors and resulted in positive outcomes for the people we support.

“The impact of these actions is evident in the increase in compliance in our Bantry Residential Centre in August 2024.

“CoAction West Cork CLG strives for continuous improvement and compliance with regulations to ensure positive outcomes for the people we support.”

A HSE Cork Kerry Community Healthcare (CKCH) spokesperson told The Echo: “Residential disability services across Cork and Kerry are mainly provided by organisations funded by the HSE under Section 38 and Section 39 of the Health Act” with the exception of St Raphael’s services in East Cork, which they operate themselves.

“We work to ensure that all residential services delivered by us — or on our behalf — are compliant with the required regulations and standards and deliver safe, secure homes for residents.”

They added that they “have made significant ongoing progress to improve the services delivered at St Raphael’s”, including a programme of de-congregation, moving residents into new homes in the community, and that they “recognise the importance of Hiqa regulation”.

“There are robust management and governance structures in place at St Raphael’s and the management team undertake regular audits.

“In respect of the Section 38 and 39 organisations delivering disability services and funded by CKCH, there are robust mechanisms in place so that we can ensure the service is being delivered consistent with the required regulations and standards.”

They added that they have worked to address issues in Kilcoran and East Cork, and a recent inspection in January 2025, which has not yet been published by Hiqa, showed improvement in all areas.