Transfer delay for care home patients

A HSE care home, where three residents went missing unnoticed by staff and where care was described as “institutionalised and medically focused”, will not now meet a commitment to transfer patients to the community this year due to lack of funds.

The Cluain Fhionnáin centre in Co Kerry was due to transfer patients to supported living in the community this year, as per national policy, but health watchdog inspectors have been told by the HSE the units will not now close before March 2017 because of insufficient funds.

The Health Information and Quality Authority (Hiqa) which has inspected the centre six times, most recently last August, found “an unreasonable level of restrictions on residents” including locked bedroom doors in a secure unit but, conversely, there was “also evidence of inadequate controls with three instances where residents had left the centre and had not been noted to be missing by staff”.

One resident had previously left the premises and was missing unnoticed for 30 minutes.

The failure to move people into community settings after over two years of a transition process was found to have had an unsettling effect on residents.

Inspectors said the planned move was “clearly seen as a positive by some residents as they spoke of their hopes for greater independence and normality in their new homes”.

Hiqa said the delay was of concern not just because of negative inspection findings but also “given the level of expectation that residents had and have had for a considerable period of moving to “their own house”.

One resident told the HSE during a consultation process that she felt like she had lived at the centre “for hundreds of years”.

Hiqa said it was “difficult to see how residents’ rights, choices and consultations were promoted and protected by the failure to expedite the transition”.

Inspectors also found that many aspects of normal daily living were denied to residents such as access to kitchenettes, personal shopping and laundry, personal hygiene and shaving.

“Some residents had little choice and control over the life they lived in this centre or their right not to live in it,” inspectors said.

Secure units in the centre were described as “impoverished environments that lacked any semblance of homeliness and personalisation” with locked doors into the unit, locked bedroom doors, water turned off in the bedrooms and access to the kitchen denied. There was one shared bedroom.

In response to the report, the HSE said the restrictive nature of the environment “will continue to be reviewed on an individual basis” and opposition by unions and staff had delayed proposals “to move some residents to less restrictive areas”.

A separate inspection by Hiqa of a COPE Foundation centre in Cork city north last August found that a plan to de-congregate the centre as per national policy was behind schedule “due to what was described as staffing reasons”. Five residents had been scheduled to move to community houses by the end of May 2016 and this move had yet to take place at the time of inspection.

Earlier this week, Hiqa CEO Phelim Quinn told a conference that delays in implementing the policy of decongregation “meant that a large number of services had systems in place that worked against the principles of safe, person-centred, integrated care”.