Ms Carol Grogan:

On registered designated centres, not all residential centres would meet the definition of a designated centre. It depends on the level of care and support required, the type of service, how much control the person has over their own living environment and whether they have their own lease. We have updated our guidance on the definition of a designated centre. We have included scenarios to help providers to ensure that when they are looking at either setting up the service or where certain circumstances change - somebody may have been independently living with support - that the level of support is so great that it becomes a designated centre. We updated that and we issued it to all providers. It is also available on our website. We sometimes hear by word of mouth, we sometimes get details of concerns sent to us or people call to ask us if we are aware of the existence of a service. We will take that, risk assess it and then we would have to be invited into the service because the Act does not allow us to go into unregistered designated centres. We only have rights to enter designated centres. We contact the provider and request them to invite us in so that we can do an assessment. We have criteria by which we would assess a service. It is the provider's responsibility to ensure that they adhere to the terms of the Act and the guidance we have issued and assess their services to make sure that if circumstances change, they make an application to us.

An area of concern for us is that we do not have any legislation for emergency provision. Similar to what our colleagues were talking about when somebody is in crisis, the capacity within the designated centres is very limited. If a person's family breaks down or if they need placement and care and support, sometimes that requires the provider to contact us and ask for permission to open a centre. They submit an application and we assess if the person is in genuine crisis by engaging in discussion with the provider. We do not have emergency registration and we are working with the Department to progress that because it is definitely a gap within the legislation.

On announced and unannounced inspections, some 70% of inspections last year were unannounced. We try to announce one in a three-year cycle. The reason for this is to give families advance notice of when we are going to go if they wish to make arrangements to come and meet us. The sole purpose of an announced inspection is to give residents and their families an opportunity to meet us. During Covid, we did not do those announced visits because of visiting restrictions. "e are looking at how we can re-establish that practice in order to give people notice that we are coming.

As stated earlier and is outlined in our overview report, meeting people and getting details of their lived experience is extremely important to our methodology in the context of how we inspect. Some people have communication difficulties, so we will observe practices and how they live in the centres. We only talk to children who want to speak with us because we are very aware that we do not want to put children at risk. We will tell them how they can get in contact with us or their families after the inspection, and sometimes people do. If people cannot talk to us, we observe. Over the past year, we have put a greater emphasis on the section of the report relating to what residents told us and what we observed on the day of the inspection. This enables us to describe what it is like to live in a centre from the experiences of people living there, how they are integrated into the community and how they are supported to do what they want to do, to play, to access education and, as they transition into adulthood, how that is supported by the provider.

Regarding protected disclosures, we have two roles in HIQA. We have the internal role with our own staff. We are also authorised to receive protected disclosures under the Protected Disclosures (Amendment) Act 2022. That puts quite a lot of emphasis on taking the protected disclosure, the confidentiality around it, the protection for the person and the opportunity for them to meet us. We have staff authorised to meet people who wish to make protected a disclosure in person. The amendments to the Act require that we would either give the person back notes or a recording of the meeting. That is set up and we have we are in receipt protected disclosures. We then take that information to inform our inspection. The content of the concern they are bringing would be passed to our inspectors and they would risk rate it, assess it and determine the best course of action to take. I hope I have not missed anything in my response.