Unlike the care scandals of the past, this one is unfolding before our eyes and those involved, frontline staff, health managers, and those responsible for funding services, are acting in our name and with our full knowledge.
One Hiqa report after another, especially unannounced ones, uncovers behaviour that is, no matter what the reasons, cruel and unacceptable.
This reality is behind the fact that six people were yesterday charged with assault on residents at the Áras Attracta care home in Swinford, Co Mayo.
It is behind the report on the St John of God-run centre in Co Louth that found major non-compliances in nine of the 10 areas inspected.
The two houses at the centre, where 16 people live, were the focus of an unannounced inspection in April which found ineffective leadership, governance, and management arrangements that placed residents at unacceptable risk.
Another report, this time on the HSE’s Cregg House in Co Sligo, home to more than 100 adults and children, uncovered major breaches of care standards.
One resident was chemically restrained on 13 occasions in previous months, with a nurse telling inspectors it was “better to give the chemical restraint at the start of the outburst otherwise it could go on for up to two hours”.
Children remained in bed until 1pm on occasion, as there were not enough staff on duty.
A supplement to the Irish Longitudinal Study on Ageing, based on a national representative sample of people with an intellectual disability aged 40 and older, found that just over half of people with learning disabilities living in residential centres are being prescribed powerful antipsychotic drugs which can be used to control behaviour.
Support groups have expressed concern at the frequency with which “chemical cosh” drugs are used and say the practice suggests that the quality of life for thousands of people living in institutions or other settings is not what it might be.
Another Hiqa report, this time on a centre for people with disabilities, operated by Resilience Healthcare Limited in Kerry, found non-compliance in children’s care planning, risk management, fire safety, medication management, statement of purpose, review of service, and training.
There are many more instances of failings but the pattern is clear and the challenge obvious.
The common theme, the central theme indeed, is a shortage of staff making it impossible to provide a secure, comfortable and dignified lifestyle for service users — and indeed the peace of mind so very precious to the families of anyone dependent on the kindness of strangers in a residential home.
Scarce resources do not, however, justify cruelty or indifference bordering on neglect, neither are they an excuse for ineffective management. Staff shortages may be the core issue but there seems much more to this unfolding scandal than that one issue.
This time we cannot say that we didn’t know there was a problem.