Hiqa inspection: Three disability centres found not compliant
Inspections of disability centres have found that in one facility master keys used by staff were repeatedly taken, and some residents were threatened and intimidated; in another, high levels of adverse incidents continued to occur despite reviews.
The inspection reports were among a number published by the Health Information and Quality Authority (Hiqa), highlighting good practice in a large number of centres, but concerns in a smaller number of facilities.
Among them was the HSE-run Leeside facility in Kilkenny, a secure unit for four adult males with intellectual disability and severely challenging behaviours.
The Hiqa report found that “management systems were not fully effective to ensure the service was safe and suitable for all the residents”, and said while many issues identified on the previous inspection had been addressed, “further, more proactive approaches to the management of the complex needs of the residents was found to be necessary”.
Noting seven areas of non-compliance with regulations, the report said: “There were a significant number of peer-to-peer incidents and behaviours which had serious consequences. For example, on a number of occasions the master keys used by staff were taken. This impacted on the safety of other residents and staff.
On occasions, other residents were threatened and intimidated to leave certain areas of the centre. Residents were being negatively impacted upon and this had not been acknowledged as a safeguarding concern, except in the most serious of incidents.
Hiqa also noted many good aspects to the care available at the centre, but the inspector found there was a lack of comprehensive review of care needs, risk and incident management, and insufficient access to psychological, psychiatry, and other specialist clinicians.
It said restrictive practices were not sufficiently assessed, the person in charge had failed to notify Hiqa of a number of relevant safeguarding incidents, while the provider had failed to notify the chief inspector of the planned absence of the person in charge for a period longer than 28 days.
There was also good practice at Iona House, run by Praxis Care in Monaghan, but Hiqa found that a high number of adverse events were occurring in the centre.
There had been 27 adverse events recorded since the previous inspection, in addition to 39 behavioural incidents, and the report said despite reviews they continued to occur.
It said the centre was not suitable for the purposes of meeting the assessed needs of all the residents, and that resident contracts did not clearly include all the fees to be charged.
From a sample of contracts reviewed, it was unclear why a resident was being charged for certain items.
The report into the HSE-run Suaimhneas centre in Sligo found frequent injuries to both residents and staff, and said while the person in charge was suitably skilled, they were directly responsible as a person in charge for seven other designated centres, which Hiqa said “impacted on the effectiveness of governance and management oversight at the centre”.
The report also said there were not clear protocols in place for all restrictive practices used, in particular, physical restraint.
All three centres were issued a compliance plan.
