Facilities relied on volunteers for care and support in Kilkenny

Workers minding their own children while simultaneously caring for residents and a failure to adequately report a serious choking incident where a resident lost consciousness, were among the shortcomings identified in homes run by Camphill Communities of Ireland (CCoI) in Kilkenny.

When inspectors from the Health Information and Quality Authority (Hiqa) visited three of the charitable trust’s centres earlier this year, they found:

• A reliance on volunteers to provide care and support in the absence of oversight by suitably experienced trained staff;
• Some volunteers, called house co-ordinators, who had responsibility for individual units, were minding their own small children while also looking after residents;
• While there was no evidence of financial irregularities, there was no policy to guide house co-ordinators as to limits on withdrawals from residents’ bank accounts. The decisions were at the discretion of the co-ordinator even where the charity was acting as de-facto guardian. Inspectors said this lack of oversight did not support safe practice;
• A serious choking incident occurred in March. The incident report did not give full details, such as that the resident lost consciousness and emergency services were called. While the risk management plan for the resident was revised, there was no training provided for staff in the management of choking until late May;
• Ten medication errors had occurred since January, six involved failure to administer significant medication. Inspectors said while these errors were noted, the actions taken to try to prevent recurrences were not satisfactory.

In relation to two of the Camphill centre inspections, a warning letter was issued by Hiqa and an action plan to improve safeguarding systems was requested.

Inspectors found evidence that in one centre, local management had failed to adhere to the policy for the management of an allegation of abuse and staff misconduct. The local management team did not report the allegation to the organisation’s national team so that it could be robustly investigated. This allegation was disclosed later via an external source. Inspectors also found staff were administering emergency medication without having been trained to do so.

Responding to the criticisms, CCoI said safeguarding officers had completed HSE training and were fully conversant with all national procedures.

In relation to medication errors, it has introduced the national incident recording log which includes medication errors. This provides for ongoing monitoring and review of incidents. Staff had also received training in administering emergency medicine and in dealing with episodes of choking.

It was also stated that a childminder will be used when the house co-ordinator is on duty. Money management has been reviewed and a limit set of €200 weekly which may be withdrawn from a resident’s account.

An inspection of St John of God Community Services in Louth found improvements had been made since the last inspection in September 2015 when significant areas of non-compliance were found.