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Residential services for people with disabilities are a nationwide and found all over Ireland and abroad. The Health Information and Quality Authority understands the significance “of increasing the quality and safety of care and support for people with disabilities” (www.hiqa.ie) in residential care. HIQA is informed by the Health Act 2007; it was set up to provide the registration and inspections of “designated centres” (www.hiqa.ie) and ensures that standards and policies are complying with the Health Act 2007. They promise that each service will provide a safe, efficient and supportive care to people with disabilities.
This essay aims to critically review the residential services available for people with disabilities in Ireland and abroad. It will look at how these services are delivered, what these services promise to provide, if they are implementing what they have promised and the standards of the service. It will also explain what residential care is and what the residential services used to be like in the past and how people with disabilities were treated.
Residential care for people with disabilities is a service to provide a safe and caring environment for both adults and children who are unable to live at home. According to the Health Service Executive or the HSE residential care “aims to meet in a planned way the physical, educational, emotional, spiritual, health and social needs” of each person (http://www.hse.ie).
Unfortunately it was not always like this, in the past people with disabilities were often sent into residential institutions and treated with abuse. They were not cared for and because very institutionalised as they were often made do the same thing day in and day out, they had no rights and were not allowed make any decisions for themselves (http://www.community-living.info).
There are many different residential settings, as I said above back in the past many residential services were institutions or asylums based care, however as the country has developed most have been changed to homes that are based within the communities, this is where between 3-5 service users live within a home with staff members how care for them when needed. These are better suited as it allows a better quality of life for each service user and gives them a sense of community and of home and most importantly it allows the service user have independence in their own lives.
Residential services for people with disabilities are there to help support people with disabilities in Ireland. Residential services in Ireland are expected to provide people with disabilities with a good quality of life, safety, to uphold rights, to be anti-discrimination, provide support the person to live a life as an equal, enable community integration and to give a responsive service (www.hiqa.ie).
Quality of life is a key element when providing residential services, making sure that people with disabilities have their privacy and dignity are maintained and respected, that they feel their residential service is home, they are not excluded from been given opportunities or been part of the community and that they are supported by staff and that their needs are provided. Equally important is ensuring that each person with a disability in the service has a sense of safety, that they do not receive any mistreatment such as abuse, bullying or neglect. They also need to be reassured that they will not be subjected to favouritism or personalised criticism (www.hiqa.ie).
These areas are both very important and it vital they be included in residential service practice as ensuring that people who have a disability know they are equals and that they will not be treated with insult and that their dignity will be maintained will take away the feeling of being vulnerable to each service user.
Another point stated about is that residential services are to ensure that a person with a disability has all their rights maintained and that they will be treated as equals. They have promised that each person will have the same rights in making decisions and choices about the service they receive such as if they wish to leave the service and live independently the residential service promises to support the person’s right to this. Following this the residential services in Ireland promise to ensure that no person is exposed to discrimination and that the same service and rights is given to each service users and that if discrimination arises they support the person by advocacy (www.hiqa.ie).
Additionally, having these points included in residential care services is significant as we must remember some if the services users are away from home and need to be assured that they will not be harmed and will be supported in all of their decisions. To not have these included would mean that many service users would be open to maltreatment and discrimination which is not a fair way to live.
The Health Information and Quality Authority also informs us that residential services are they not only provide people with disabilities with a good quality of life and upheld rights but they also promote person-centeredness which is a concept that the service builds their particular service to an individual which centres around their characteristics (www.hiqa.ie). They also encourage each service user to be involved in the community and to have their own social network. Finally, they state that the residential services are to be managed in a way that each service user will have good experiences.
Guaranteeing that each service user has a voice if not their own but given to them to ensure they can have the same rights and opportunities as every other person in the country and within the service is also important to have contained within the residential services. Furthermore, not excluding people with disabilities from society is a positive standard which works as it will encourage changes in attitudes in communities.
This next section of the essay will focus on the standards that Irish residential service are to follow, these are also used when looking at the various centres to see if they are meeting these standards or not.
Furthermore, these expectations are part of the development of standards for residential services, they also impact the way a service is delivered. The Health Information and Quality Authority have set up some standards that each centre and service use to inform their practice. These standards consist of seven sections which are quality of life, staffing, protection, governance and management, the physical environment, rights and health and development.
Each section adds up to 19 standards; they are developed with the help of those that work in the sector as well as families and people with disability. Each section is important, as I have already discussed quality of life I will give an example of the Staffing standard. This standard explains how each service user needs members of staff that are qualified, have experience are competent to achieve the goals they wish too with the support from these staff members (www.hiqa.ie). Another vitally important standard is under the heading Protection, this discusses how both staff and service users are safeguarded from mistreatment this includes finances.
Following on from this we need to see if the residential services in Ireland do their job and if they provide the service they are suggesting they do. The one thing that makes these effective are that the HIQA establishes that inspections will be regularly to ensure they each service and its staff are applying these correctly. This makes certain that the safety and precise care are provided to each service user. However one subject that could be added is, it does not state how often and extensive these inspections will be.
After reading through these standards, they are very clear and easy to understand. They are appropriate guidelines for workers to use to ensure the best care for their clients. They seem to cover most areas of care and various situations that may arise such as discrimination. It explains who the Health Information and Quality Authority are and what Acts they were guided under. The aims of what the Health Information and Quality Authority were clearly stated and it also included what their responsibilities are.
The section set out under complies of whether the various services and centres in Ireland follow these standards and if they provide what they have said they do. It will focus on one service in Ireland called Brothers of Charity.
To get a better understanding of how they are implemented and if they work we can apply it to a services like the Brothers of Charity. Brother of Charity state in their mission statement that they “value the uniqueness, and respect the rights of each person in our community” (Brothers of Charity 2012). They are known for been one of the most respected organisations for working with adults and children with disabilities. This services aims are similar to that of the standards in the Health Information and Quality Authority. This is a positive thing as it shows they have the intention to comply with these standards and to follow the Health Act 2007.
Brothers of Charity manages each of their centres and provides each service user with appropriate care while maintaining each individuals dignity, they manage each client well and have the correct documentations and professionalism when working with both clients and other staff members. They create a safe, healthy, caring environment through-out the service centres.
Subsequently, this section will compare the Irish residential services to those in Europe. It will focus on the differences between them and the similarities. It will also discuss the various changes and the reasons behind them.
Comparing the Health Information and Quality Authority to other residential services outside of Ireland, other countries focus more on having people within residential care be more interactive in their daily living as well as being more involved within the community. The reason for this is because in the past many people with disabilities were not respected in residential services and were mistreated.
The final section will look at how the service to best practice in social care and also concentrates on how the service contributes to professionalism.
Having reviewed the residential service in Ireland I have learnt some key elements of social care. There are many practice methods that social care practitioners use when working within residential services for people with disabilities. There are various approaches that social care practitioner’s use however one in particular that work best for residential care are person-centred practice.
Person-centred practice is an approach that allows a service user to be involved in their own care i.e. “treatment and care provision by health providers that place the person at the centre of their own care and considers the needs of the person as carer” (Lane, R 2012) It works best with residential services as it has a positive outlook on people with disabilities, it also works with the service user to develop goals that both service users and key-worker share, it is an empowering practice as it gets the person with a disability involved with their agencies and the wider community.
Additionally, it involves the family as well which is important in residential service as many of the service users miss family members therefore having them involved helps with this. It also is set within the standards of the Health Information and Quality Authority which implies they also agree it is the best practice. We see through the standards how they include this mention several times to respect the service user’s ideas, choices and needs. Person-centred practice also is about getting the service user involved in the community; this is also expressed several times in the standards.
Furthermore, P.O.Ms which stands for Personal Outcome Measures, this offers “people an opportunity to define their own quality of life outcomes and exert choice and self-determination” (Lane, R 2012). This has a beneficial effect on the service user involved, similarly to person-centred practice is focuses on the person, however the difference is when the program is being reviewed it is the service users critique that is taken into account. Likewise it is all about supporting the client and ensuring the quality of life of the client is defined by them and only them (Lane, R 2012).
This is a suitable practice for a residential services it benefits both the service users and the service, this is because of the feedback given from the service users which ensure that the service delivers a better quality of service and that the service users receive a high quality of service (Lane, R 2012). It also informs staff how best to support each individual service user. Moreover, it forms a better relationship between service user and staff member as it involved the key member to learn and listen more attentively to the needs of the service user.
Finally, by placing policies within the residential services for recruitment to ensure that each staff member knows these standards and upholds a professional manner both with staff and with their client. Keeping a professional manner is vital as you will be working with a large number of people that may be vulnerable. When working with other professionals and team members professional behaviour needs to be maintain to assure that you are capable of working within a team, if a problem arise is it necessary to sustain a professional conduct as it is important so show you are able to deal with conflict. In addition, when working in residential care it will be require from time to time to advocate on behalf of your service users, obtaining and preserving a professional demeanour is key to make certain you are speaking correctly and clearly in getting the best solution for your service users.
In conclusion, the Health Information and Quality Authority are vital for people with disabilities. Without it many people would be made exposed to risks and other are open to been subjected to abuse. With frequent inspections it assures that these do not arise and that service users are receiving the best possible care that can be given.
International countries are very similar to Ireland, they aim to help people with disabilities obtain their rights and make sure they are being fulfilled. Overall Europe is striving to continue changing the way of life for people with disabilities for the better.
Finally, certifying professionalism and best practice are implemented aids residential services. They advise staff on how to best facility each service user.
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