Hiqa considers Cork Association for Autism home action

The health watchdog is considering cancelling the registration of a home run by the Cork Association for Autism (CAA) because of concerns regarding the quality and safety of the service.

The Health Information and Quality Authority (Hiqa) issued a notice of proposal to cancel the registration of Greenville House in Carrigtwohill, Co Cork, on February 24.

Asked where the process was at, a Hiqa spokesperson said they can not comment further in light of “an ongoing legal process”.

Once a notice is issued, CAA has 28 days to argue its case to Hiqa as to why registration should not be cancelled. This can trigger an inspection, after which Hiqa may decide to register the service; register with conditions, or cancel the registration. If the decision is to cancel, CAA has 28 days to notify Hiqa of intent to appeal to the District Court.

The most recent inspection of Greenville in January was triggered on foot of on-going concerns despite written reassurances from CAA’s board of directors after a November inspection.

A number of key issues remained, including that the system for managing risks was ”not robust and involved a recent occasion whereby a resident was placed at an unacceptable level of risk to their personal safety”.

Inspectors found “there were times when staff had no line of sight for the supervision of residents”.

Inspectors also found that the person in charge did not have the skills and expertise to manage the centre. CAA did appoint a second person in charge in response to that criticism.

One resident accessed an emergency medicine and shattered the administration device, after which medical attention had to be sought - staff did not know if some of the device had been ingested.

Inspectors did find some areas of good practice during the inspection of the campus which can accommodate 13 residents and includes a main house and six cottages. Residents who communicated verbally said they liked where they lived. Staff were observed to interact with residents in a supportive and appropriate manner.

A second Cork city home for intellectually disabled women, the St Vincent’s Centre, previously run by the Sisters of Charity but now run by the HSE, is also under close surveillance by HIQA.

The Sisters of Charity pulled out of running the home, which can cater for 60 residents, earlier in the year after a number of critical Hiqa reports and a threat from Hiqa to cancel its registration. The HSE has run the home since March 29. An inspection report published yesterday based on an inspection conducted last December was damning saying the centre “could not meet the healthcare needs of all residents”. It found that wounds were “not being assessed regularly to ascertain progress or deterioration”.

On the date of inspection, some residents needed to be repositioned twice an hour to prevent deterioration of a wound. However, in one case, there was a gap of of 5.5 hours.

There was also failure to update records in relation to weight loss. The GP identified one resident who had lost a “stone in weight in previous 10 months”. However, the nursing care plan for this resident said that “there was no recent weight loss”.

The HSE said the focus of its involvement was to ensure that services continue, that residents were prioritised, and that an appropriate alternative provider was in place as soon as possible.

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