The health and social services watchdog has found sustained improvement in the conditions at one of the republic's largest residential campuses for people with disabilities.
In 2017 and early 2018, HIQA had found that some 170 adults and children depending on Stewarts Care's residential services in west Dublin had "a poor quality of life".
HIQA had also criticised the facility for failing to safeguard the residents adequately and to provide them with the quality of service they were entitled to.
Up until this time last year, HIQA judged that Stewarts Care had not demonstrated an ability to effectively address the breaches of regulations that were being highlighted in successive inspection reports and that this was also detrimental to residents.
In this morning's overview report of its subsequent escalated regulation of the service's eight sub-centres, the watchdog says that further inspections last year found advances in both the safety and quality of life for many residents.
It also notes that residents' physical environment had improved. However, it adds that the gains were not consistent in all centres and that further progress was required.
In an accompanying statement the watchdog adds that subsequent inspections completed this year found "sustained improvements" but that further progress is required to address outstanding breaches of statutory regulations.
It says that it will publish reports on this year's inspections "in the coming weeks". These inspections focussed on Stewarts Care's reconfiguration plan for the six on-campus centres and two satellite facilities.
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In a statement today from Stewarts Care, it said "the conditions described in those reports were not acceptable and the governance and management systems which pertained at the outset of this period (pre-2017) were not capable of addressing the shortcomings.
It said the "necessary improvements reflect a systematic and concerted effort by the Board, management and staff at Stewarts to thoroughly overhaul all aspects of care at Palmerstown.
"That has included significant changes in structure and human resources in each of front-line care, in management and in governance with several senior appointments made to oversee and drive the change programme.
"It has also required close collaboration with its key stakeholders in the HSE CH07 (community healthcare areas Dublin South, Kildare. West Wicklow), Disability Operations and the Office of the Director of Community Services as well as with key suppliers and partners and of course residents and their families.
"There has also been investment in new physical settings and infrastructure reconfigured buildings, individual rooms and specialist equipment that will break-up the congregated residential setting in which residential services had historically been provided on the Palmerstown campus.
The Board of Stewarts also confirmed that it has applied to HIQA for the registration of its newly reconfigured Designated Centres.
Fund for staff 'might be useful'
One of the advocacy organisations that works with residents of Stewarts Care said it might be useful to provide a fund to assist staff who cannot adapt to necessary changes in the service to "move on".
Sage Advocacy told RTÉ News this would allow staff with fresh ideas and enthusiasm to move forward.
In a statement, spokesman Mervyn Taylor said that the scale of the challenges faced by residents, staff, management and the board at Stewarts Care residential services was clearly spelt out by HIQA in April 2018.
He described as "genuinely encouraging" the response by Stewarts and the level of progress made since then.
However, he said major changes in attitudes and approaches are required among those supporting and working with people with intellectual disabilities and that these may not always be possible for some of the staff.
"In such circumstances it might be useful to provide a fund to assist people to move on and allow those with fresh ideas and enthusiasm to move forward. Institutions can institutionalise not just the residents but also the staff," Mr Taylor observed.
He said Sage Advocacy would assist in what he termed "the necessary culture change" but said the best way forward would be to develop "Advocacy Champions" within Stewarts who would be supported by Sage.
He said this would be preferable to staff making many referrals about day-to-day issues which, in his view, they should be addressing themselves.
Meanwhile, the National Advocacy Service for People with Disabilities (NAS) said it experienced an increase in referrals from the Stewarts Care services last year.
It said the referrals were made by residents themselves, their families and by Stewarts staff.
