Inspections alone not enough to protect people in care
WHILE Prime Time aired last night, someone in a similar facility to Áras Attracta sat in their own urine; someone else was being bullied or assaulted; and many people were experiencing some form of cruel or degrading treatment.
Over the past 12 months, numerous reports by the Health and Information Quality Authority (Hiqa) have raised issues with the treatment of people in such facilities.
In October, a Hiqa inspection of a centre in Offaly found residents were not afforded basic privacy and dignity when using showers and toilets and that there were insufficient safeguards to prevent harm and abuse of residents.
In August, an inspection of a centre in Kilkenny was found to employ unqualified staff sourced through a European volunteer programme and with no experience of working with persons with an intellectual disability. The centre was found to have “significant deficits” across most inspection headings, including Garda vetting of staff.
Another report found persons with an intellectual disability living in care with no access to social work, psychology, or therapeutic supports available. It described residents as engaging in “severe institutionalised behaviour”.
Specifically in relation to Áras Attracta, Hiqa carried out two inspections, the first on February 25/26 and the second on May 26/27. The first inspection is what Hiqa calls a “single issue inspection”, on foot of unsolicited information which examined just three outcomes, but, curiously, Áras Attracta was informed in advance of Hiqa’s visit.
Hiqa allowed the HSE six months to bring the centre up to the required standard despite major concerns in the areas of safeguarding and safety of clients, healthcare, and governance and management.
The issues identified by Hiqa included that not all staff were trained in abuse protection; use of a bedroom as a “seclusion room”; unreliable personal records; no drinks offered during meal times; cold food; lack of meal choice; and residents waiting up to 15 hours between meals.
The RTÉ Prime Time investigation highlights the limitation of relying on inspections alone to protect vulnerable people in residential care from abuse and degrading treatment. It is clear Hiqa is not the mechanism through which abuses uncovered can be investigated or prevented in other centres.
Given the failings in governance and management uncovered by Hiqa, and the numerous reports over decades of abuses in institutional living in Ireland, it is almost certain that these types of abuses are happening elsewhere now.
For example, in 2011, hospitals and community healthcare facilities recorded 10,000 incidents of violence, harassment, aggression, or abuse against service users, including people with intellectual disabilities.
And there are few safeguards.
Independent advocates, who could help identify and report these abuses, rely on the goodwill of disability service providers to access persons with a disability living in residential care.
The legislation giving independent advocates statutory powers to visit residential centres and make enquires about persons is already on the statute books. It just needs to be commenced.
Addressing reform of day services, the programme for government states: “As part of this review, we will move a proportion of public spending to a personal budget model so that people with disabilities or their families have the flexibility to make choices that suit their needs best. Personal budgets also introduce greater transparency and efficiency in funding services.”
This practice has long since been established in the UK and other jurisdictions and is being requested by a growing number of people across Ireland.
In the absence of this commitment being fulfilled, no real reform will happen any time soon. Five large organisations control 50% of the total disability spend of circa €1.4bn and they serve nowhere near 50% of persons with disability who require support.
After the shocking revelations detailed in the Prime Time programme last night, the following things need to happen now to trigger real action: n The recently established Irish Human Rights and Equality Commission, the independent body with statutory powers to investigate human rights abuses, should investigate the abuses revealed in last night’s report and in similar cases of this kind; n The Government has also promised to close these institutions before 2019. To this end, a clear and realistic action plan, with adequate resources, should be published without delay; n Finally, the legislation giving statutory powers to independent advocates should be commenced immediately.
The events in Áras Attracta are not freak events; abuse happens where others turn a blind eye. The Department of Health, the HSE, the Department of Public Expenditure and Reform, and the Government are turning a collective blind eye to reforms needed to prevent the abuse of persons with a disability who are too dependent on institutionalised provision of supports.
CONNECT WITH US TODAY
Be the first to know the latest news and updates
