Before you visit a nursing home, read its HIQA reports. HIQA — the Health Information and Quality Authority — is Ireland's independent health regulator. It inspects every registered nursing home without warning and publishes the full report online. Reading them takes 20 minutes per home and it's the single best free signal of care quality in Ireland. Here's how to get the most out of them.
What HIQA actually does
Every "designated centre for older people" — the formal term for a nursing home — must be registered with HIQA. Registration is conditional on passing inspection, and is renewed every three years. Between registrations, HIQA carries out unannounced inspections (usually several per three-year cycle) to make sure standards are maintained.
Inspectors talk to residents, observe care in progress, check records, and speak with staff and the person in charge. The inspection report is then written up and published within a few months. Every report is publicly searchable.
How to find a home's reports
- Go to hiqa.ie/reports-and-publications/inspection-reports.
- Filter by "Services for older people".
- Search the home's name, or the name of the company that operates it (often different — e.g. many Bartra or Mowlam homes share a parent entity).
You'll see every report ever published for that centre, newest first. Download at least the most recent two or three. Always read the most recent one in full; use the older ones to spot trends.
The three compliance judgments
HIQA uses a three-tier judgment system against each regulation they assess. Reports label these visually — they're easy to scan.
- Compliant (green): The home meets the regulation. No action needed.
- Substantially compliant / Not compliant — moderate (orange): Partial or minor breach. The home must submit a corrective action plan.
- Not compliant — major or serious (red): A substantive breach that puts residents at risk. HIQA expects immediate action and will return to verify.
A red judgment is rare and serious. More than one red in the same report, or reds that persist across multiple inspections, is a significant signal.
Which regulations matter most
HIQA assesses against around 30 regulations. They're not all equally important for the day-to-day resident experience. The ones most worth focusing on:
Resident-impact regulations (read these first)
- Regulation 5 — Individual assessment and care plan: Does each resident have an up-to-date care plan, reviewed regularly, that reflects their actual needs and preferences?
- Regulation 8 — Protection: Safeguarding from abuse. A red here is the most serious finding in the report.
- Regulation 9 — Residents' rights: Dignity, privacy, choice, and involvement in decisions.
- Regulation 13 — End-of-life care: Palliative care standards, family access, pain management.
- Regulation 15 — Staffing: Staff numbers, skill mix, training, and whether staffing was actually adequate on inspection day.
- Regulation 27 — Infection control: More closely watched since 2020.
Governance and structural regulations
- Regulation 23 — Governance and management: Is the home being run competently? A red here often cascades into multiple care-level failures.
- Regulation 16 — Training and staff development: Are staff trained in dementia care, fire safety, safeguarding?
- Regulation 17 — Premises: Is the physical building fit for purpose?
Regulatory-housekeeping regulations
- Regulation 3 — Statement of Purpose
- Regulation 19 — Directory of residents
- Regulation 21 — Records
These matter, but an amber judgment on them is much less alarming than an amber on a care regulation. A home with a messy statement of purpose isn't the same as a home with amber protection findings.
Reading the "narrative" section
Each report has a few pages of narrative before the regulation-by-regulation judgments. This is often the most valuable part — it describes:
- What inspectors observed on the day (care being provided, residents' apparent wellbeing, atmosphere)
- What residents and families told inspectors when interviewed
- How staff interacted with residents
- Any concerns the inspector had that don't fall into a single regulation
Quotes from residents are gold. "Residents spoke highly of the food and activity programme" reads very differently to "Some residents expressed frustration at waiting for assistance to use the bathroom." Read these sections carefully.
Red flags to watch for
- Any red judgment (major non-compliance) — read the detail closely, and check whether the next inspection confirms it was fixed.
- Repeat findings — the same regulation amber or red across two or more consecutive inspections. It means the home isn't learning.
- Staffing regulations trending worse — staffing pressure is the single most common cause of poor care; regressions here are worth taking seriously.
- Safeguarding (Regulation 8) findings of any colour. Protection concerns are the most serious category by definition.
- Compliance Plan not accepted — occasionally HIQA rejects a home's corrective action plan. If you see that, read the follow-up inspection closely.
What HIQA reports don't tell you
Inspection reports are a snapshot and have limits. They won't tell you:
- What the home "feels" like — warmth of staff, quality of activities, whether residents look engaged
- How the food actually tastes
- What the typical waiting time for the bell is at 3am
- How the home handles the in-between days — birthdays, small outings, family events
For that, you have to visit. Treat the report as a reason to either short-list a home or rule it out — not as the final word.
Combine the report with a visit
Before visiting, write down the one or two regulations where the home got its worst judgment. Then, on your visit:
- Ask the Person in Charge what they did to address those findings
- Look for evidence of the change (for example, if staffing was the issue, ask about current rota and night cover)
- Notice whether they engage honestly with the question or get defensive
A well-run home will know exactly what its last report said, what action they took, and what the follow-up inspection confirmed. If the Person in Charge fumbles the answer, that's a much bigger red flag than the original finding.
What about public nursing homes?
Public (HSE-run) nursing homes are also inspected by HIQA and their reports are published the same way. Apply the same checks. Inspection standards are the same regardless of ownership — HIQA is the regulator for all of them.
Filing a complaint
If something you see in a report concerns you — or if something happens during a family member's care — you can submit a concern to HIQA via their concerns form. HIQA investigates concerns that indicate potential risk to residents. They're not a complaints service for individual disputes — for that, raise with the home first, then the HSE or Office of the Ombudsman.
What to do next
- Make a shortlist of 3–5 homes from our directory
- Look each one up on hiqa.ie and download the most recent report for each
- Score them on the care regulations listed above before you even pick up the phone
- Use the visit to verify what the report told you
Sources: HIQA — Inspection reports, HIQA — Inspection framework. General information, not legal or regulatory advice.