Hiqa finds staff felt unsafe at adult care centre

An inspection of a centre for adults with autism and intellectual disabilities has found some staff felt unsafe while at work and discovered allegations of abuse by a staff member.

The inspection was conducted by the Health Information and Quality Authority (Hiqa) and found areas of major non-compliance with required standards.

It also found management systems were not in place “to ensure that the service provided is safe, appropriate to residents’ needs, consistent and effectively monitored”.

The inspection of the designated centre for people with disabilities operated by St John of God Community Services Ltd took place in July and was the first at the facility, which is a detached house in the countryside which can accommodate up to five residents with a diagnosis of autism and/or moderate to severe intellectual disability.

According to the report, since July 2014 Hiqa received unsolicited information on four different occasions highlighting major concerns there, “primarily relating to inadequate governance and management and failure to have management systems in place to ensure that the service provided is safe, appropriate to residents needs, consistent and effectively monitored”.

Some staff felt unsafe working with particular residents, there were claims of inequitable rostering and inadequate supervision of staff, and concerns over absenteeism from work with replacement by agency staff members. According to the report, these staffing issues had a negative impact on residents’ care.

According to the report inspectors reviewed documentation regarding statutory notifications involving two incidences of abuse allegedly perpetrated by a staff member. “This matter has been investigated in line with the centre’s policy and procedure, national guidance and legislation and the findings are currently with an external organisation who have not been able to progress it as the staff member is absent from work,” it said.

A report of the outcome of the investigation of the alleged abuse is to be forwarded to Hiqa.

Inspectors saw from the training records that not all staff had up-to-date knowledge, including de-escalation and intervention techniques and skills, to respond to challenging behaviours shown by residents.

This was central to some issues at the centre in circumstances where staff were either hit by residents or ‘targeted’ and in some cases had to retreat to the office for safety.

While staff said the situation at the centre had been improving of late, the report found that none of the residents had a day care placement or participate in any form of training or education and it pinpointed a number of shortcomings, including areas such as residents’ rights, dignity and consultation, communication, and medication management.

An action plan was issued and the care provider said efforts were being made to meet the requirements, including getting a new dining table after the report said the existing one was not large enough to allow all of the residents and staff to have a meal at the same time.