Serious shortcomings in the quality and safety of care provided by a Tipperary-based HSE-run home for people with an intellectual disability have been found by the State's health services watchdog.
Damien House in Clonmel provides full-time long-term care to 12 adults with a primary diagnosis of intellectual disability and comprises of three houses and an apartment.
Inspectors from the Health Information and Quality Authority who made a "short notice" announced visit to the centre in November and December last year were concerned about how it was run.
“This service was not well governed and managed and there was a negative impact on the quality and safety of care delivered to residents as a result,” their report states.
Inspectors were particularly concerned that two serious choking incidents that resulted in residents being taken to hospital had not been reported to Hiqa.
They found that oversight of the service by management was poor and the system for reviewing the quality and safety of care and support offered to residents was inadequate.
Staff were not always deployed appropriately. The inspectors noticed that two staff members charged with minding one resident had both gone to make the resident's tea.
Also, there were regular occasions where a nurse was not available at one of the houses and only care staff were on duty.
Inspectors found no evidence had been provided to management that agency staff employed at the centre had been Garda vetted.
They also raised a number of infection control issues, including a strong smell of urine in two of the bathrooms in the centre.
Fire safety concerns were also highlighted. Fire doors did not shut properly in one house and in another, there were holes in at least one of the fire doors and badly damaged surroundings to others.
Overall, residents were safeguarded from abuse and improvements had been made in the protection of vulnerable adults from abuse since the last inspection.
However, inspectors found that residents' rights were not upheld in some areas including the standard of living accommodation and consultation.
“The state of disrepair of many aspects of the centre did not show respect for residents,” their report states.
The premises were institutional and did not provide a home-like environment. Some of the bathroom facilities did not meet the needs of residents and were in a state of disrepair.
Residents did not have access to appropriate transport. One vehicle was out of service and another two had maintenance issues and had broken down. One of the vehicles had to be evacuated at the roadside.
Inspectors also found shortcomings in the way the HSE is operating a home that used to be run by the Cork Association of Autism.
The health authority took over Greenville House in Carrigtowhill, Co Cork, in June last year because of concerns regarding the quality and safety of the service.
Inspectors made an unannounced visit last December to the centre that provides residential care for 14 adults with autism and found deficiencies in governance and management, service contracts and medicines management.
However, they did observe that the centre was maintained to a good standard and was warm and homely.