People with disabilities are living in overly restrictive settings, in homes with inadaquete fire plans and their care plans are not being properly monitored and updated, according to the latest review of residential centres by the health watchdog.
The Health Information and Quality Authority (Hiqa) published 19 reports yesterday on residential services for people with disabilities.
Good levels of compliance and a focus on promoting quality of life were found at centres operated by Peacehaven, Three Steps, Walkinstown Association for People with an Intellectual Disability, and Western Care Association.
Inspections into seven Daughters of Charity centres found that while improvements were required, four centres were providing safe services which focused on meeting the needs of residents. In these centres residents were supported to be independent and taught life skills to participate in community-based activities.
At one Daughters of Charity centre in Co Tipperary, infection control was poor with facilities visibly unclean, fire drill records were not sufficient, and residents did not have proper access to psychological services. It also found inconsistent care plans and that staff had substituted medication without first seeking clarification from the prescriber. The nurse on duty has since been sent on medication management training.
A second Daughter of Charity service in Co Tipperary, with 11 residents, was inspected in response to notices proposing to refuse and cancel registration of the centre issued by Hiqa. This latest inspection found “increasing compliance with the regulations over the previous two inspections”.
The centre was previously found to be unsuitable for the assessed needs of residents with for example, residents “in a more restrictive environment than they required” and that in another house, “the environment had been identified by a psychologist as not being conducive to supporting residents to progress and to reduce levels of behaviours that may challenge”.
Another centre operated by this same provider had an inappropriate number of residents living together whose “social care needs were incompatible” and were not being met.
At Little Angels Association in Letterkenny, Co Donegal, it was found that “the governance, management and financial viability of this centre were a serious concern”. Following the inspection, the service provider sought a review by a qualified person who confirmed that “high risk” works had been completed.
Further fire safety concerns were found at a centre operated by North West Parents and Friends Association of Mentally Handicapped Children. Staff had not completed fire safety training, fire doors were ineffective, and fire drills had not taken into account night-time staffing arrangements.
However, there was evidence of good management in the centre including systems to support residents’ healthcare needs.
Major non-compliances around the safeguarding of residents, infection control and risk management were identified at Nua Healthcare in Kildare after a complaint.
Reports on three centres run by St Catherine’s Association for children with disabilities found while there had been improvement, there continued to be significant failings in areas such as healthcare oversight, admissions and contracts for the provision of services.
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