HIQA inspections identify problems with reporting of abuse allegations and use of medicines
A resident at a disability centre in Cork was not provided with adequate food and nutrition for over 18 hours in June, according to health inspectors.
The Health Information and Quality Authority (HIQA) also identified issues with the reporting of abuse allegations and administration of medicines at St Raphael’s Campus in Youghal.
The facility was one of a number of HSE-run disability centres where inspectors found evidence of “very poor” management and oversight.
Newly published reports based on visits to four services cited failures to safeguard residents and ensure daily routines were “based on their preferences rather than staffing arrangements”.
An unannounced inspection of the Youghal campus found that there were 15 recorded incidents over the course of three weeks in 2015 where one resident was noted as alleging that someone “had hit me”.
There was no evidence that these allegations were screened to establish if an abusive act did occur and if there were reasonable grounds for concern.
The centre was also criticised for the “potentially catastrophic and fatal impact” of delaying and incorrectly administering medicines for epileptic seizures.
Lapbelts were used to restrain four residents, and a review of one case found that staff failed to monitor for possible physical, psychological and emotional risks.
Inspectors also identified areas of significant non-compliance at St Patrick’s Centre in Kilkenny, which was transferred to the HSE in October 2015.
Despite committing to improving on concerns identified in a February 2016 visit, the centre was found to have failed to address a number of issues during an unannounced inspection three months later.
The facility was described as "poorly maintained and decorated" in areas, with the physical layout of bedrooms impacting on some residents’ privacy.
HIQA also raised concerns regarding fire safety, the reporting of peer-to-peer abuse and healthcare provision for residents at risk of experiencing epilepsy-related seizures.
Another unannounced inspection of an unnamed disability facility in Donegal identified significant risks to safety and welfare.
HIQA criticised the centre for failing to protect resident from peer abuse, saying aggressive behaviour was not managed in line with national guidelines.
In one case, two female residents were physically assaulted by a male resident while travelling in a car in January 2016.
No adequate action was taken to safeguard the women following the assault and a similar incident happened during a car journey the following week, HIQA said.
A number of staff members reported either not being listened to or feeling they were seen as “troublemakers” when they raised safeguarding concerns with the person in charge.
Chemical restraint was frequently used in the centre and administered on one resident 44 times over a two-month period.
Another resident fell 11 times between May to December 2015.
HIQA concluded that it was "deeply concerned by the categorical denial" of two managers that "there had been any allegations, incidents or suspicions of abuse".
Inspectors also said they did not have confidence in the fitness of the person in charge to manage the centre.
Management at a smaller facility for six adults in Westmeath were found not to have ensured the service provided was safe, consistent, appropriate to residents' needs and effectively monitored.
During the unannounced visit, inspectors also discovered that some staff had not received training in administering medication prescribed to some residents.
Five other providers were found to have provided a good standard of support and care to residents, as well as high level of compliance with the regulatory requirements.
Minister Finian McGrath said he read the reports "with great concern".
"It's vitally important that these unacceptable practices are being brought into the light and residential centres are being compelled to improve their standards or face losing their registration," he said.
"While there is much to be done, these reports are a sign that the system of regulation is working."
Mr McGrath added that people with disability were best placed in smaller, community-based centres.
The Department of Health is providing €20 million in capital funding to the HSE this year in order to move people out of large, congregated settings, he said.
The 11 reports on HSE-run services can be found at www.hiqa.ie.