The Regulation and Quality Improvement Authority (RQIA)

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The Regulation and Quality Improvement Authority (RQIA)

What is the RQIA and what does the RQIA stand for?

RQIA stands for Regulation and Quality Improvement Authority, an independent body that regulates, registers, and inspects the availability and quality of Northern Ireland’s health and social care (HSC) services.

The purpose of the RQIA is to assure the quality of care, challenge poor practice, and safeguard the rights of service users. The RQIA aims to uphold public confidence in health and social care through independent, proportionate and responsible regulation.

The RQIA has three key responsibilities:

To register and inspect independent and statutory health and social care services.
To assure the quality of services provided by health and social care.
To assess services provided to people with mental ill health and learning disabilities.

The RQIA measures its effectiveness through four stakeholder outcomes:

Is care safe?
Is care effective?
Is care compassionate?
Is the service well-led?

This article will provide a comprehensive overview of the RQIA’s role in regulating health and social care in Northern Ireland, particularly in relation to home care, care homes and nursing homes. The final section will examine how software solutions can help with regulatory compliance.

Health, Support and Social Care

Posted 01/08/2024

RQIA legislation

The RQIA was established through legislation, namely the Health and Personal Social Services (Quality, Improvement and Regulation) (Northern Ireland) Order 2003. Under the Order, the RQIA is responsible for overseeing the provision of services in health and social care on behalf of the Department of Health (DoH).

RQIA regulations

There are several regulations that govern the RQIA’s work in health and social care organisations including residential care homes, residential family centres, domiciliary care agencies, nursing homes, nursing agencies, independent hospitals, independent clinics, children’s homes and day care settings.

These regulations include:

RQIA standards

The RQIA standards act as guidelines for the RQIA’s work. RQIA standards are underpinned by a core set of values:

Dignity and respect: Acknowledge the uniqueness and value of each service user.
Independence: Service users exercise control over their lives whilst being protected from risk.
Rights: Service users rights are safeguarded and promoted.
Equality and diversity: Service users are treated equally and valued for their background and culture.
Choice: Service users can choose from a range of options.
Consent: Service users have a legal right to determining the care and support they receive.
Confidentiality: Information about service users is managed appropriately.
Safety: Service users are free from exploitation, neglect and abuse.

The RQIA domiciliary care standards and residential care standards are fundamental to the provision of health and social care in Northern Ireland.

RQIA minimum standards - domiciliary care

RQIA minimum standards for domiciliary care are for providers of services that support a person in their own home. The standards specify the minimum arrangements and procedures that need to be implemented for a quality service.

The RQIA standards apply to the following service providers:

Domiciliary care agencies
Supported accommodation services that provide personal care
Intentional communities which offer personal care

The standards do not apply to employment agencies whose only function is to pair care workers with service users.

The RQIA standards for domiciliary care focus on two main areas:

1. Quality care

Care should be collaborative, multi-disciplinary and service user-centred:

Agencies should have a proactive engagement and listening partnership with each service user.
Agencies should have open and transparent arrangements for all their services and provide all relevant information in suitable formats.
Agencies are responsible for assessing the abilities of their care workers to provide suitable care for their service users.
Agencies should have joint working arrangements with community care teams.
Agencies’ practices and interventions should promote the health and well-being of service users.
Agencies should issue guidance to assist their managers and staff to keep up to date with current best practice.

2. Management of the domiciliary care agency

Agencies should deliver services effectively and efficiently.
Agencies should maintain close working relationships with all involved.
Management systems and processes need to be capable of dealing with diverse and complex issues.
Managers should provide leadership, support and development for their team.
Staff development should be encouraged and learning shared.

RQIA minimum standards - residential care

RQIA minimum standards for residential care are for all sizes of care homes.

The RQIA standards for residential care focus on two main areas:

1. Quality care

Care should be open and responsive, allowing residents to be involved in planning, delivery and review of their care:

Homes should have a proactive engagement and listening partnership with each resident.
Homes should maintain links with the local community, to help residents build a positive sense of worth.
Homes should have open and transparent arrangements for all their services and provide all relevant information in suitable formats.
Homes should give residents the right to full involvement in the care planning process.
Home practices and interventions should promote the health and wellbeing of residents.
Homes should issue guidance to assist their managers and staff, in order to keep up to date with current best practice.

2. Management of the home

Homes should have a participatory culture and retain evidence that residents’ views and comments have been taken, sought and considered.
Management systems and processes need to be capable of dealing with diverse and complex issues.
Managers should provide leadership, support, and development for their team.
Staff development should be encouraged and learning shared.
The manager or nominated registered person is responsible for ensuring that the standards are met.

Care worker with elderly person following RQIA regulations

RQIA care homes

The RQIA’s guidance for adult residential care homes advises providers on how to pass RQIA’s inspections. The RQIA is required to inspect every adult residential care home at least twice a year.

RQIA’s inspectors inspect and report on the following four domains:

Is care safe?
Is care effective?
Is care compassionate?
Is the service well led?

Is care safe?