Hiqa finds conditions in disability centre may constitute neglect

Hiqa said the inspection was triggered by information it received indicating the provider had not implemented actions identified in a previous inspection to improve the safety and quality of life for residents.

 Health watchdog Hiqa referred a centre for people with disabilities to the National Safeguarding Office after finding that its failure to provide residents with a safe and comfortable home may constitute neglect.

Inspectors found a string of serious issues at the Dublin-based Liffey 6 centre, operated by St John of God Community Services, including that the heating had been broken since last November, meaning one resident had to wear multiple layers of clothing to bed during the winter months.

Hot water access in one house was limited to the kitchen sink, while there were heightened infection risk concerns due to the poor state of repair in the building, particularly in the context of the Covid-19 pandemic.

The Short Notice Announced Inspection of the centre, which is in Clondalkin, took place in July and found six areas of non-compliance.

Hiqa said the inspection was triggered by information it received indicating the provider had not implemented actions identified in a previous inspection to improve the safety and quality of life for residents.

The centre, home to seven residents at the time, had two houses. While in one, residents had a warm, homely living environment, those in the other house had a very poor living environment.

In some areas conditions in the defective house had regressed: a January 2019 inspection found that there was mould present in one bedroom, but on this inspection, mould was found in multiple areas throughout the centre, including on a resident's pillow and bedding.

There were numerous damage and repair issues, such as broken blinds in three rooms, exposed fixtures, inadequate lighting and a missing toilet seat.

According to the report: "Inspectors found that there had been a substantial loss of heating in the premises. 

Inspectors saw records which stated that the heating loss was reported to the maintenance department and escalated to senior management in November 2019. 

While temporary heating arrangements had been put in place, it was not effective and records stated that a resident was required to wear multiple layers of clothing to bed during the winter months.

"In addition, residents had limited access to hot water in hand wash basins in the bathrooms or in the level access shower and maintenance records noted that this had been the situation since November 2019. 

"It was noted that the only sink which had consistent hot running water in the house was the kitchen sink.

"Because of the hot water issue, two residents had been using another resident's en suite shower facility for a number of months; the provider could not evidence that this practice had ceased at the onset of a public health emergency."

The inspection report said that while the person in charge maintained a record of adverse incidents in the centre, not all incidents were notified as required by the regulations - specifically loss of heating and water.

Brightly coloured tape attached to the facilities in the bathroom, such as support rails, had been put there to help a previous resident identify the facilities but had not been removed, presenting an infection risk, heightened further by the coronavirus pandemic.

"While there were safeguarding arrangements in place to identify and respond to potential safeguarding concerns for individual residents, inspectors found that the provider was failing to provide residents with a safe and comfortable home, and that failure may constitute neglect," Hiqa said. 

"On that basis, immediately following the inspection, inspectors made a referral to the National Safeguarding Office.

"The provider had not responded to requirements for upkeep and repair in the house and it was a very poor living environment. This could constitute neglect of residents and may be a form of institutional abuse."

A compliance plan has been issued for the centre.

A follow-up inspection last August found that the provider had implemented the improvements and the report for this inspection will be published in due course.

Update: St John of God Community Services this afternoon apologised for the situation which had taken place at the centre and said the shortcomings had now been rectified.

"St John of God Community Services accept the findings of this report and has taken the steps necessary to fully and comprehensively rectify the situation following the July inspection," it said in a statement. "The facility in question has since been fully upgraded and refurbished. An inspection by HIQA in August found that all issues previously raised had been addressed in full and within the set time frame and that it is now suitable to meet the needs of its residents. It had also found that new systems to ensure that residents' personal plans are in place and actions required in relation to fire safety and infection prevention and control had been carried out in full.

"HIQA expressed satisfaction that the centre was now adequately resourced to safely meet the needs of residents, and that effective governance and management arrangements are in place to monitor the ongoing quality and safety of the service. Residents and families have also expressed their satisfaction with the renovations and refurbishments.

"St John of God Community Services accepts that this situation fell below the acceptable standard of care that would be expected of it and wishes to apologise to the residents of this facility and their families."

*www.hiqa.ie