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Jun 05, 2023

Question 1

Using the Quality Management System (QMS) Periodic Service Review (PSR) complete the following:

  • Write a professional report outlining how you propose to address the issues raised in the HIQA Report and why you chose the QMS Periodic Service Review.
  • Draw up an Action Plan for the four areas identified in the HIQA report detailing the process for implementing and monitoring continuous service improvement in Oak Tree Services.


Case Study – Oak Tree Services

 Oak Tree Services provide residential services to 7 adults with intellectual disabilities. All of the residents have significant support needs and each person also receives individualised day supports – three people attend a day service and the other 4 people have their day service provided from the house.  A recent unannounced HIQA inspection focused on 4 areas:

  • Health Care Needs

All residents received appropriate and timely health care as needed from the GP, mental health service and multi-disciplinary services – physiotherapist, occupational therapist and psychologist. Two of the residents had significant and on-going mental health issues which the service was striving to manage but at the time of the inspection these were still unresolved.

  • Medication management

The inspector found that staff managed residents’ medication effectively and recorded and reported any incidents of medication errors appropriately.

  • Governance and management

There had been a lot of turn-over of staff and staff absenteeism in the previous 18 months and the team leader had also changed twice in that period. Staff reported that some staff had been absent due to stress and burnout. The management structure was weak as result.  Continuity and consistency in the service provided to residents was also weak and impacted on their quality of life.

  • Restrictive Practices

The person in charge had submitted a report in relation to restrictive practices to HIQA at the end of each quarter of each calendar year as required. However, this did not outline all environmental restrictive practices observed in the designated centre on the day of inspection. There were nine locked doors observed around the building on the day of inspection that residents did not have access to or access to keys for. These had not been recognised by management as environmental restrictive practices.


Question 2

Discuss how “What gets measured gets done” can be achieved through the use of a Periodic Service Review.

Question 3

Discuss the challenges of balancing service users’ risk taking, their rights, autonomy and empowerment with issues of protection with limited resources, increasing public scrutiny and fear of professional litigation for support staff in disability services and for organisation in Ireland today.

Question 4

“Quality means doing it right when no one is looking or inspecting” Ford, 1930

Discuss the significance of this statement and how it relates to you service and your own role as a support worker in disability services.  Illustrate your answer using work-based examples.


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