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HIQA Publishes Regulatory Assessment Framework of the Preparedness of Designated Centres for Older People for a COVID-19 Outbreak



The Health Information and Quality Authority (“HIQA”) is an independent statutory authority established to promote safety and quality in the provision of health and social care services.

On 21 April 2020, HIQA released the Regulatory Assessment Framework ("the Assessment") which aims to support both public and private nursing homes that are currently free from COVID-19. The purposes of the Assessment is to prepare for an outbreak of COVID-19 and put in place the necessary contingency plans.

The Assessment will assist in ensuring that the providers of the nursing homes are in compliance with their obligations under the Health Act 2007 (as amended) ("the Health Act") and associated regulations. The Assessment, evaluates the following:
  • The readiness of the provider of nursing homes and the nursing homes ability to manage an outbreak of Covid-19;
  • The knowledge of the provider in relation to the resources available to support both staff and residents in preparing for and managing an outbreak of Covid-19;
  • The steps taken by the provider to access specialist clinical advice regarding providing safe care for residents;
  • The current systems in place in the nursing homes to ensure that it is a safe place for residents.


As part of the Assessment, HIQA have developed a self-assessment tool which sets out the minimum standard required at nursing homes to successfully respond to an outbreak of Covid-19 under specific regulations within the Health Act 2007 (Care and Welfare of Residents in Designated Centres for Older People) Regulations 2013 (as amended).

The self-assessment will require the provider to critically review their nursing home to determine that:
  1. "The governance, leadership and management arrangements in place will ensure the quality and safety of the services in the event of an outbreak of COVID-19;
  1. The care and welfare of all residents is maintained and promoted at all times;
  1. The actions and measures in place to prepare for an outbreak are effective;
  1. Risk assessment is an ongoing element of the centres preparedness/contingency plans and their supporting arrangements ensure a timely and appropriate response to any identified deficits;
  1. The registered provider and staff are aware of the internal and external support and resources available in the event of an outbreak, and how to access same;
  1. The registered provider has the capacity and capability to sustain the provision of quality care to residents in the event of an outbreak."
 The self-assessment tool is divided into two sections:
  1. Capacity and capability:
    1. This relates to the overall delivery of the service and how the provider is prepared for an outbreak of Covid-19;
    2. This section asks the provider to assess their compliance with specific reference to Regulations 15 and 16 which relate to staffing and Regulation 23 which relates to governance and management of the nursing home.
  1. Quality and safety:
    1. This relates to ensuring that the care and welfare of residents is maintained during the current Covid-19 Health Emergency.
    2. This section will ask the provider to assess their compliance with specific reference to Regulation 9 which relates to residents rights and Regulation 26 and 27 which related to risk management and infection control.

The self-assessment tool follows a yes/no format that must be completed by providers of nursing homes. Providers must assess their readiness for a COVID-19 outbreak using the judgement descriptors, which will also be used by the on-site inspectors.

Judgement Descriptors:
Compliant Substantially Compliant: Not Compliant:
This means the provider and/ or the person in charge has taken the necessary steps to prepare for an outbreak of COVID-19. This means that the provider or person in charge has most of the elements of an effective contingency plan but some action is required. This means that the provider has not taken the necessary steps to prepare for an outbreak of COVID-19. In the absence of this preparation and contingency planning, residents are at risk. Urgent action is required by the provider.
Although there is no requirement for the provider to submit the completed self-assessment tool, these must be completed and available for review by the inspector on the day of the on-site assessment. The self-assessment tool will also be utilised by the inspector during the onsite assessment to verify the provider's compliance.

On-Site Assessment

As the on-site assessments are taking place during the current Covid-19 Health emergency, the inspectors will be taking all the necessary precautions in line with the current public advice to include:
  • Social distancing during the assessment;
  • Inspectors will not be present in areas occupied by residents;
  • Inspectors will be subject to symptom checks i.e checking their temperature in advance of entering the centre;
  • Inspectors will be required to declare to the providers in the nursing homes that they have no Covid-19 symptoms;
  • Compliance with good hand hygiene, good cough and sneeze etiquette; and
  • Inspectors will be required to use personal protective equipment (PPE).
Following the on-site assessment, where further action is required by the registered provider to ensure compliance with the specified regulations, the provider will be issued a compliance plan and the provider will be required to carry out the appropriate actions to strengthen the plans currently in place.


If a nursing home provider fails to comply with the compliance plan set out, further action may be taken in accordance with Sections 51 and 59 of the Health Act.
  • Section 51 provides the Chief Inspector of HIQA the discretion to cancel registration, vary a condition or conditions of registration or impose new conditions in the case of non-compliance.
  • Section 59 provides the Chief Inspector of HIQA the power to make an application to the District Court for an order for cancellation or variation of registration if they are of reasonable belief that there is a risk to the life, or a serious risk to the health or welfare of the residents.
A copy of the framework is available here.

Written by Colm Reddan, Sinéad Taaffe and Sara O'Sullivan 

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