HSE implements 52 of 59 HIQA recommendations at Mayo care centre

The HSE says it is implementing the recommendations of a HIQA report that highlighted poor levels of care at a County Mayo centre for people with intellectual disabilities.

A report on standards at the Aras Attracta centre in Swinford made 59 recommendations, following two unannounced inspections.

HIQA inspectors found that some residents at the centre were underweight, and some of the service users went for 15 hours without food.

The HSE has moved to reassure families of the residents.

It says 52 of the 59 recommendations have been implemented while work is underway on the remaining seven.

The HSE list of actions already undertaken at the HSE Designated Centre for people with disabilities are:

1. A full range of additional training courses was added to the ongoing staff training programme; these additional sessions were put in place starting in March and continuing into June. The training covered:

* Dysphagia Training (swallowing)

* Modified fluids training

* MUST training –(nutritional assessment tool )

* Dignity at Work training

* Safeguarding of Vulnerable Adults

* Values Training (dignity and respect)

* Information sessions following HIQA inspections

* Training in Crisis Prevention Intervention Management of Actual or Potential Aggression

* Fire Training

* Manual Handling Training

* Scope of Nursing Practice training

* Best Practice in Recording Clinical Care for Nurses

* Information Sessions for Persons Participating in Management of Service

* Examining Nurses and Support Staffs Attitude and Behaviours toward client nutrition and Hydration

* Care Planning for Nurses

2. Risk assessments have been reviewed and are now reviewed on a monthly basis and discussed at the Management Team Meeting. Audits of identified area of service have commenced.

3. Twenty One project teams have been set up to include all members and grades of direct care staff. Each group has been assigned a HIQA standard and have examined the regulation governing this standard. As a result of this the relevant required policy an audit tool has been developed for a standardised approach across the service.

4. A senior Psychologist with expertise in challenging behaviour has visited the service and reviewed the care plans and the management of challenging behaviours for individual residents. His recommendations are being used as a guide in drawing up a revised plan of care of the individuals concerned.

5. A named nurse has been allocated to each individual care plan of each resident they have now been updated. A key worker system was introduced in June; this key worker plays an important role in the life of the residents and in linking in with their family.

6. A Dietetic Service and a Speech and Language Therapy service has commenced in the service and is currently providing a three day service. All residents dietetic needs have been reviewed and work has been undertaken with the catering department on Modified Diets, food consistency, calorie value of food, menu planning.

7. The existing policy on Nutrition, Hydration and Dysphagia was reviewed and amended. New ordering and stock control system has been put in place in each area. Daily diet record sheets are being maintained and residents are receiving appropriate modified diets.

8. Two weekly menu cycles and a modified diet system are now in place. Meal times have changed in order that they are conducive to enhancing nutrition and are served in a regular fashion.

9. The new Speech and Language Therapy service has provided basic training on swallowing, positioning, consistency and grades of thickness of food to all staff. Further training and workshops will be provided for staff directly involved in caring for residents with swallowing difficulties, once all assessments have been completed.

10. Two additional support staff have now been employed to provide support during mealtimes for residents.

11. The seclusion policy has been reviewed and is in place. At no time is seclusion used to manage behaviour it is used as an emergency strategy, when a named service user loses control and is at risk of causing harm to themselves or others. The use of seclusion is infrequent and any use is fully reviewed and in accordance with policy

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