Donegal Intellectual Disability servicesVision 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 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/practiceso Shared information about the Projecto Discussed/identified priority areas for improvemento Shared tools and resourceso Completed service reportso Flagged operational issues, where observed, to

managers/CHOso 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 effectivene

ss

Service user

safety

Service user

experience

Governance and Quality structures

PCCC Quality Safety Risk Committee

Audit sub committee

Intellectual Disability services

QSRM

Local QRSM Local QSRM Local QSRM Local QSRM Local QSRM

PPPG sub committee

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

YEAR___________________

Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Signature and date

Risk Register reviewsCare planning AuditsSite Profile (annually)Safety statementHazard controlsMaintenance of equipment recordTraining for staff reviewEvidence of Registration of nurses (annually)Evidence based practiceFire Register checksStatement of purpose and function (annually)Annual reviewsNursing Metrics (Monthly)Incidence analysisHygiene audits (2 monthly)Infection controlFire drills (one at night)Vehicle check (6 weekly)Staff supervision/appraisals

Example of annual audit/review checklist

Safeguarding and protection

National PolicyEstablishment of National Safeguarding

OfficeTraining of designated officersTraining of frontline staffEstablishment 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 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 planningAnnual Review meetingsSatisfaction surveys (respite CareCongregated 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/regulationsStaff 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