Non-compliance with residential disability care regulations in Ireland: a retrospective analysis of frequency and causes

Background Non-compliance with care regulations is common but underlying causes are poorly understood. Methods We used inspection data to calculate the frequency of non-compliance in residential disability services (RDS) in Ireland and characterised the non-compliance using thematic analysis. Results The median level of non-compliance across all centres was 27% (interquartile range 13% to 46%). Of the 1263 centres inspected 13 (1%) were compliant and 100 (8%) were non-compliant with all regulations inspected. Eight themes were identified in a sub-sample of non-compliant inspections. The theme ‘insufficient resources’ appeared most frequently, second was ‘governance and management failings’. The theme ‘poor documentation quality’ had the broadest explanatory reach, linked to non-compliance in 72% of regulations. Conclusion Non-compliance with regulations is common in Irish RDS. Themes describing non-compliance provide insight to service providers and regulators to develop quality improvement initiatives. Interventions focusing on resources, documentation quality and governance are most likely to stimulate broad-based improvement across all regulations.