Residents at care home punished with fines

Residents at a centre for people with disabilities were punished through the removal of personal items, restrictions on food, and the issuing of fines. Hiqa has ordered that the practices be stopped immediately, writes Noel Baker.

The unannounced inspection of Highwater Lodge, in Wexford, which is operated by Stepping Stones Residential Care Limited, was conducted in response to a notification to Hiqa of serious injury, and to monitor progress towards the agreed actions from a previous inspection, last July.

At that time, Hiqa found significant non-compliance with the regulations.

According to the Health Information and Quality Authority (Hiqa), the notification that triggered the follow-up inspection related to one resident striking another, causing a head injury.

“The inspectors were not satisfied with the information submitted, both in relation to the immediate care of the injured resident and in relation to control measures to ensure the ongoing safety of the resident. Further information was requested, and the document submitted did not address these issues.”

The follow-up inspection found the provider had not safeguarded residents.

As previously, the inspectors found that there was frequent aggressive behaviour, which required residents to be moved from their living areas to protect them from injury.

Residents were not adequately protected from fire risks.

Care plans outlined how residents had to give their mobile phones to staff when they went to bed, for no apparent reason other than “health and safety”, and when residents did not comply they were punished.

According to the report: “Inspectors found that the use of negative controls was prevalent, involving the removal of personal items, restriction of food items, and fining of residents. The inspectors issued an immediate action in relation to these practices and required that they were discontinued immediately. Furthermore, there was a significant level, and frequency, of aggressive behaviour in the centre that required residents to be moved from their living areas, in order to protect them from injury.”

Among a range of non-compliances, inspectors noted that “guidance for staff, in relation to behaviours which might result in the damage of items, was that the resident involved was to pay for the item, and that the staff on duty were to apply this charge immediately”.

It also said: “Some of the guidance, in relation to the management of behaviours of concern and in relation to ensuring compliance with activities of daily living, included the withholding of snacks and treats.”

Hiqa also asked that this be discontinued immediately.

As for the injury which resulted in Hiqa receiving the notification, “the response to this head injury, at the time, was inappropriate, and medical attention was not sought until the following day. However, there was no guidance available to staff as to the correct procedure in the event of a head injury, or in the management of other emergency healthcare issues”.

The report also read: “Due to the high level of risk in relation to fire safety, the inspectors issued an immediate action.”

While there were improvements in staffing numbers since the previous inspection, staff training was not adequate.

The report was one of 22 published at www.Hiqa.ie

This story first appeared in the Irish Examiner.