A centre for people with a disability in Co Tipperary had soiled sheets, fecal matter around the centre, and was in such a state of disrepair health watchdog HIQA returned the following day to ensure immediate action was taken.
The inspection last February of St Anne's Residential Services Group H in Tipperary, operated by Avista CLG, uncovered such a range of difficulties that HIQA took the "unusual" step of returning the following day to ensure immediate actions were addressed.
Inspectors found that conditions at the facility, home to four residents at the time, were demonstrably unclean, with just one staff member in attendance.
"Every room in the designated centre presented as visibly unclean with high levels of dust, dirt, mould, and cobwebs observed throughout the centre," it said.
Inspectors noted a build up of dirt and dust, a stained mattress protector with fecal matter, and a heavily stained bedsheet. One resident's en-suite bathroom smelled strongly of urine, there was fecal matter on tissues, rusting pipes, stained flooring on the resident's bath, and a thick layer of dirt on the windows.
Another room had a heavily stained floor, and shared bathrooms were dirty, with fecal matter on a toilet seat and in the bowl. In an upstairs bathroom paper towels and toilet paper were not readily available to residents. The floor was heavily stained around the bath with pooling on the floor.
The facility needed substantive repair and on the second day of the unannounced inspection an external cleaning company arrived to address the problems highlighted on day one.
Some residents had limited verbal communication abilities but on the first day of the inspection due to a staff shortage, just one employee was present.
According to the report: "One resident was heard asking 'what about me?' when staff were discussing plans for activities for the day. Another resident was observed putting on their coat to leave the centre, the resident was then told by staff that it wasn't their turn to head out."
The report also noted among the string of non-compliances that "high levels of restrictive practices were noted around the centre secondary to identified risks posed to two residents. This meant that two other residents lived in a restrictive environment secondary to the risks posed to their peers." Highlighting overall governance and auditing issues, it said that not all restrictive practices in use in the centre were appropriately identified and reviewed by the provider.
"Overall, this inspection found that the registered provider had failed to demonstrate the capacity and capability to provide safe and quality care for the residents," HIQA said. "The management systems in place were not effective in identifying areas for improvement in the quality and safety of care and support being delivered to the residents."
The inspection report was among 25 relating to centres for people with a disability inspected by the Health Information and Quality Authority, many noting excellent compliance with standards. However, two other Avista CLG centres required improvements, and some issues were also detected at some centres run by Brothers of Charity Services Ireland CLG.