Hiqa told of abuse allegations at care unit

The first set of inspection reports in relation to services for people with disabilities reveal the health watchdog was notified of allegations of abuse at one Dublin-based centre late last year.

Stewarts Care Ltd in Palmerstown, which caters for 184 intellectually disabled children and adults, notified the Health Insurance and Quality Authority (Hiqa) of the abuse allegations on December 5 last.

Hiqa requested further information but was not reassured that residents in the service were safeguarded and protected. Due to the “the lack of assurances and the seriousness of the allegations and ongoing concerns regarding the protection of residents”, Hiqa requested a meeting with Stewarts Care on December 9, but the meeting did not go ahead because the information sought had by then been provided.

Hiqa was assured “no staff subject to an allegation was currently providing care to residents” and that a formal investigation by an independent investigator was under way.

Hiqa subsequently carried out an unannounced inspection of the premises on December 10 and found while residents were safe, there was a moderate level of non-compliance in overall safeguarding arrangements.

The inspection did, however, show that the level of management and clinical supervision had escalated since December 5 and that senior nurse managers had discussed with staff, inter alia, the importance of good practice in relation to the issues of concern.

The inspector also found that policies and procedures were in place to protect residents, and staff were trained in the policies.

The inspector visited and spoke with staff from nine bungalows/units on the campus.

All knew what constituted abuse and knew what to do in the event of an allegation.

Inspectors also looked at use of restraint in the unit, which they found was kept to minimum levels, but they were concerned that one unit had locked internal doors “which impinged on the liberty of some residents”.

Stewarts Care subsequently informed Hiqa that the practice of locking internal doors had ceased.

All staff had been Garda Síochána vetted.

The publication for the first time of disability services inspection reports has been welcomed by Inclusion Ireland chief executive Paddy Connolly, who described it as “another important step towards ensuring people with disabilities can expect a certain standard from State-funded services”.

Of the 12 reports published, most were substantially compliant, although Enable Ireland Disability Services in Cork was found to be non-compliant in a couple of areas, including staff training. Hiqa said staff had not been trained in how to manage challenging behaviour.

Hiqa also criticised leadership, governance and management, saying while the respite centre was well managed locally, there were no clear lines of accountability and “little evidence of a robust and regular organisational review of the quality and safety of care in the centre”.

Enable Ireland said that a Challenging Behaviour Policy will be implemented by the organisation, followed by training and that they will “provide a clear statement detailing levels of accountability”.

Enable Ireland also said it was in the process of recruiting a person in charge for the unit.