The regulation of Ireland's disability sector has led to improvements in services, however major challenges remain when it comes to the safeguarding of vulnerable people, the Health Information and Quality Authority (HIQA) has said.

It has just published a new report, which provides an overview of the first five years of regulation in the disability sector. It looks at the five-year period from November 2013 to October 2018, during which time, inspectors carried out 3,829 inspections of designated centres for people with disabilities.

The report shows that in 2013, there were 920 centres for people with disabilities registered with HIQA, but by the end of October 2018, this had increased to 1,183 centres. These were providing 8,894 residential places for adults and children with disabilities.

Data from the five-year period shows improvements in levels of compliance year on year. Overall compliance with regulations increased from 59% in the first year to 76% by the fifth year. Compliance with health and safety, and risk management, increased from 28% in the first year to 56% in the fifth year.

Meanwhile, protection from the risk of abuse increased from 50% in year one to 70% in year five.

"When HIQA commenced the regulation of residential services for people with disabilities on November 1, 2013, it was the first time such services were subject to independent regulation.

"Our findings in the first few years were reflective of a sector that was not initially prepared for regulation, with some services providing good services, and poor practice and low levels of compliance evident in others," explained Mary Dunnion, HIQA's director of regulation and chief inspector of social services.

She said that over the last five years, regulation has "driven improvements in these services", as a result of monitoring, inspections and enforcement orders.

"In particular, our inspection findings show that residents' rights and dignity are better promoted, and their social care needs are now being met in most cases. Residents regularly tell us how these improvements have positively impacted their lives. For example, moving to houses nearer their families, going on holidays or to concerts, working in their local communities and having more control over what they do on a daily basis," Ms Dunnion noted.

However, despite these improvements, she pointed out that "significant challenges remain" in relation to the management and oversight of services, addressing infrastructural deficits and safeguarding vulnerable people.

"The governance arrangements in some centres have continually failed to ensure there is adequate oversight of the quality and safety of the service. There are also ongoing challenges for some providers in achieving a safe and high-quality living environment for residents," she noted.

She said that while regulation led to increased awareness about the rights of people with disabilities, issues relating to safeguarding "continue to be regularly raised by our inspectors".

"Better protections need to be put in place to safeguard residents from abuse and to extend the protections offered by regulation to other vulnerable people," Ms Dunnion said.

HIQA and the Mental Health Commission have developed National Standards for Adult Safeguarding, however these have not yet been approved by the Minister for Health.

HIQA also supports the introduction of specific legislation that would ensure a legal basis to safeguard people in residential care.

"Similarly, we believe that the model of regulation in Ireland needs to be reviewed and expanded to ensure that all people who receive a health or social care package, either in a service or in their home, receive consistently good quality support that is underpinned by regulations," Ms Dunnion added.