A litany of failures at the home is an insult to the work of its founder and disturbing for anyone with relatives in care, writes Catherine Shanahan
As wedding albums go, most contain pictures of unbridled joy, but one image stands out from my parents’ big day. Taken on the lawns of Cheshire Home in Cork, it shows my mother and father, in all their finery, sharing their happiness with less fortunate friends.
My mother, a former nurse, worked in the Cheshire Home and regarded its residents as human beings no less deserving than herself. It was the 1960s, an era when those with disabilities were sometimes “put away” and where visitors could be thin on the ground.
Judging by the photographs, my parents’ wedding day gesture brought a little colour and excitement into what were often fairly dreary lives.
Fast-forward half a century (my parents celebrate their golden wedding anniversary this year) and my mother is heartbroken to hear the Cheshire Home in Cork is no more.
Even more heartbreaking are the reasons behind its demise, principally an inability to provide a service in any way acceptable in this day and age.
The Health Information and Quality Authority, the arbiters in this saga, describe a litany of failures — appalling by any standards, but a sickening read for those with loved ones in care. Despite receiving a warning notice from the health watchdog nearly two years ago and despite repeated inspections and opportunities to show they could improve, the home failed to demonstrate any real commitment to improving the lives of the 18 or so residents in its care.
The shortcomings in the physical environment are hard to stomach: Dirty food trolley and cutlery container, rusty radiators, dirty shower trolleys with no evidence of cleaning, some shower chairs with urine and faecal staining, and dirty hoists.
The clinical and social care failings are even more disturbing. Under the national standards for adults with
disabilities, each person has a personal plan detailing their needs and outlining the supports required to maximise their personal development and quality of life, in accordance with their wishes. However, a perusal of personal care plans (PCPs) at Cheshire Home left inspectors unconvinced they were in any way adequate to enrich people’s lives.
“The social aspect of the residents’ PCP reviewed did not capture or identify any goal a resident may like to achieve, the arrangements required to be put in place to help the resident achieve a goal and who was responsible to support the resident and by when.” This, inspectors said, “impacted on residents’ opportunities to experience social inclusion” and to participate in activities of personal importance.
The neglect of healthcare needs was so severe in some cases that two people ended up in hospital, among them a resident whose wound deteriorated because it was not tended to in line with a documented specific guideline that was captured neither in the nurse’s notes nor in the resident’s care plan. Another resident with maximum dependency needs on restricted fluid intake required emergency admission to hospital — inspectors discovered his intake had not been properly measured in the six days prior to admission.
The findings of these inspections — that ultimately resulted in the decision by Hiqa to seek cancellation of the Cheshire Home’s registration as a provider of services to some of the most vulnerable among us — is an insult to the work and memory of Captain Leonard Cheshire.
The Cheshire Foundation, with care homes globally, was set up not, as many believe, as a result of the effect the atomic bombing of Nagazaki in 1945 had on him as the only British Service observer but because he subsequently contracted tuberculosis, was invalided from the RAF, built up a mountain of debt in various community welfare ventures, and eventually opened his doors to an incurable patient. That was the start of the Cheshire Homes.
Nonetheless, his motivation was purely honourable. According to his obituary in The Telegraph, the doors of his Cheshire Homes “are open to anyone who is unable to make his way in society without assistance”. The cancellation of registration of the Cheshire Home in Cork is not only the end of an era. It does no justice to the spirit of the man who regarded his final illness, motor neurone disease, as a blessing more than a setback.
“Already it is giving me new insights into how disability affects one’s life and what one needs to do to try and rise above the limitations it poses.” That generosity of spirit is recorded on Cheshire Ireland’s own website. Last night, the most it could offer was to plead an inability to meet “the increasingly complex medical needs of the service users at the facility”.
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