Hiqa demands new laws on care centres; Survey finds inappropriate staff behaviour

Hiqa is demanding legislation to protect those most at risk in the country’s care services from abuse, harm, and exploitation, after it found inappropriate staff behaviour, and unsafe practices across institutions.

The health watchdog’s 2016 overview of social care and healthcare services raised issues in disability, elder care, children’s services, and healthcare institutions.

The overview highlights “poor governance, inadequate safeguarding, a lack of clear policy direction and/or timely implementation of policy, and poor accountability, particularly in terms of how those funding services assured the best use of public money”.

In disability institutions, Hiqa said that, while many people received a quality service, a significant number had a quality of life “well below that which would be expected for citizens in 21st century Ireland”.

“These people have been living over a long period of time in institutionalised services that do not promote person-centredness and where abuses of their rights have happened. In some instances, Hiqa has assessed the care being provided as unsafe.”

It found instances where people were placed in appropriate services which placed the safety of either themselves or other people they lived with at risk.

“In some centres, residents have told inspectors that they are afraid; this has been borne out in inspectors’ observations,” Hiqa said.

It found cases where centres did not have effective governance and management arrangements in place to protect vulnerable people.

“As a result, unacceptable care practices were neither identified nor considered inappropriate,” said Hiqa. “These practices manifested in a punishment custom which included the withholding of privileges and preferred foods.”

During 2016, there were 11 cases in which the office of the Chief Inspector issued notices of a proposal to cancel registrations of designated centres for people with disabilities. Those would have shut the centres if taken to their conclusion. The registrations of three centres run by the Irish Society for Autism were cancelled and the HSE took over the operation of the centres.

In relation to older people, Hiqa found nursing homes where staff did not know how to interact properly with residents.

“This meant that residents were rushed at mealtime; staff used language which was not age-appropriate and one staff member was heard to mimic a resident,” it said.

In children’s services, Hiqa found that a number of children in residential care and a significant number in foster care did not have an up-to-date care plan.

In three of the four statutory foster care services inspected, Hiqa found updated garda vetting of carers and formal reviews of their ability to care for the children did not take place.

“A significant risk was found in one service in relation to safeguarding practices. Within this service not all child protection concerns were identified as such and were not always managed in line with Children First.”

Hiqa said “significant” risks were identified in two foster care services, four residential centres and onel care unit.

“These risks related to ineffective safeguarding practices to promote children’s safety,” it said.

The publication, on Hiqa’s website, listed all the centres that were found to be fully compliant at inspection.