Ms. Furness charted the development of UK legislation on care home inspection, from a system with no nationally agreed standards which was open to abusive practices to one where there are national minimum standards for care homes and evidence of each standard being met is looked for in inspections. She stressed the importance of respecting and involving the people who use care home services in the process of regulation and inspection.

The seminar also revealed the results of a survey of the managers of care homes to gather their opinions on the usefulness of inspection, its influence on core practices and ways inspection could be improved. 37% of care home managers believe that getting feedback from an external agency is the most useful aspect of inspection. Another 37% value inspections as a source of support and guidance. However, care home inspections are no longer seen as a source of advice or support.

Ms. Furness believes that inspection should have more of an influence on care practices, particularly if a home is not meeting the minimum standards under legislation. With the numerous media stories in Ireland and the UK of care home abuse, there is a feeling that all managers of care homes are being vilified. As part of the discussion, it was proposed that there should be more rewarding and highlighting of good practice which could promote the success stories in care home management.

During a lively discussion led by academics, care home managers, HIQA employees and others, the point was made that an increasing emphasis on safety and regulations in care home management can in fact impinge on the quality of life of care home residents. The HIQA standards for care homes are attempting to achieve a balance between risk and quality of life. HIQA also places an emphasis on the fitness of the residential care provider. Finally, it was felt that people should be encouraged to have high expectations of the standard of care that they will receive from care homes.