Staff ‘frequently injured’ at Chapel View residential centre

Residents of a home for intellectually disabled men were given sedatives in response to challenging behaviours, administered without appropriate guidance.

An inspection of Chapel View residential centre in Co Kildare, run by Nua Healthcare Services, also found that despite three previous inspections, improvement was still required to ensure a safe and quality service.

While residents and their families spoke positively about the service to inspectors from health watchdog Hiqa, inspectors said systems in place for the management of risk “did not protect residents or staff”.

Inspectors found that “fundamentally, the service was not safe due to an overall failing by the provider to ensure that the governance and management systems in place were implemented effectively”.

The admissions procedure was “impacting negatively” on the quality of life of residents and did not adequately take account of the need to protect them from abuse by their peers. One resident had complex needs with associated high risks to other residents and staff. However, the impact of these risks to the safety of others had not been adequately assessed.

A review of incident records showed staff were frequently injured. Five of these injuries required notification to the Health and Safety Authority in a one month period. Incident forms provided to inspectors did not demonstrate that incidences were being appropriately reviewed as required by policy.

Physical restraint was regularly used within the centre. One resident who had been physically restrained by staff on three occasions did not have a personal plan in place at the time to authorise this intervention.

Inspectors also found that when an area was re-audited there was minimal improvement.

On the upside, inspectors found staff engaged with residents in a dignified and respectful manner. However, staff resources were not organised in a way to meet the assessed needs of residents. Inspectors spent approximately 90 minutes with four residents.

The assessed needs of all the residents combined stated that there was a requirement for a total of four staff however there was only one staff present. An unwitnessed assault had occurred in the centre, despite both residents involved requiring the support of 1:1 staffing levels. The provision of high staffing levels was identified as a safeguarding measure in response to allegations and suspicions of abuse.

In response to the criticisms, Nua Healthcare said its admissions process was undergoing “a full review”; that personal plans were being reviewed to ensure they identified key risks to each resident; that a governance plan has been compiled to improve governance; that the person in charge will oversee the outcomes of any use of PRN psychotropic medication or sedative medication, supported by the clinical team and behaviour specialists.


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