We can expect more cases of abuse in care of vulnerable

Picture: Bill Binzen/Corbis

If we want to keep vulnerable people safe, we need to give them rights. But that will only happen if we make it a political priority, writes John Byrne

If the measure of a society is how it treats its most vulnerable citizens, then we should all reflect on how people with intellectual disabilities are treated in Ireland in 2017.

The principle of a welfare state is simple. Those who can work do so, and their taxes go toward providing services for the sick and the vulnerable.

There is nobody more vulnerable than a person with an intellectual disability (ID). On the severe end of the scale, someone with an ID cannot talk, walk, feed, clothe, or wash themselves. They will be utterly reliant on family and/or carers to meet their every need.

It is difficult to understand, then, why a person with an ID would be left (by state services) in a foster home long after allegations of their abuse had been made to the HSE. What is even more difficult to understand is why we seem to have learned nothing from the experience.

I recently spoke to a partly-trained social care worker. He had just completed a weekend shift (by himself) in a residential home for four adults with intellectual disabilities.

His shift started at 3pm on Friday and finished at 8am on Monday. He said that he was officially off-duty (though on call) between the hours of 11pm and 7am on each of the three nights. He did not get to bed before 12.30am on any night, as he had considerable amounts of paperwork to do.

When I asked him why he was the only staff member on duty, he said it was a low-support centre, and it was deemed that there was no need for a second staff member.

When I asked him what his duties entailed, he said he called the residents in the morning, bathed them, clothed them, and ensured that they had their breakfast before continuing on with normal daily activities.

I asked why people in a low-support house would need to be bathed, and he said that they had moderate to severe disabilities.

I then asked him how a concerned relative could be sure that he did not have sexual relations with any of the residents while he was bathing them. He said they couldn’t be sure.

As a social care educator, I found this response astonishing. It could not be further from safe practice, as it places the service users at very significant risk of harm, and the staff members at risk of false allegation.

The man told me that the home is fully compliant with current standards and has been passed by Hiqa, the health services watchdog.

In professional care practice, there are five levels to client protection. The first is the worker, who is trained to be self-aware, and to control their own impulses so that they never act in a way that is harmful or abusive to a client.

The second is peer monitoring, where staff raise their awareness of each other’s practice, so that, if one worker is behaving inappropriately, the other should notice and intervene.

The third level is management monitoring. The fourth is inspection and regulation by external agencies (such as Hiqa).

And the last level of protection is provided by visitors and family members of the service users.

In the aforementioned example, the staff member in question was not fully trained, there was no second staff member, the management had no way of knowing what happened in the bathroom, and I suspect that the families didn’t even know that the clients were being bathed by a single worker.

The consequence is an abusive interaction waiting to happen, which will no doubt be followed up by state investigations, reports, and recommendations, and everybody left wondering how it all could have happened in the first place.

In defence of the agency, they would probably say that they have not got the funds to fully staff the house. The reason for that is that people with disabilities in Ireland have no rights.

The Disability Act 2005 is the piece of legislation outlining the state’s responsibility to people with disabilities. It says that the only thing that a person with an ID is entitled to in Ireland is an assessment; everything else is subject to funding.

I am aware of children who have not even had their assessment because there is no psychologist available in their region to do it.

It doesn’t matter whether we are talking about the homeless, children in care, or people with disabilities, if we are serious about keeping vulnerable people safe, we need to give them rights, but that will only happen when the rest of us make it a political priority.

Until then, we can expect many more cases of abusive and improper conduct in the care of our most vulnerable people.

Not just because a child with an intellectual disability was left in a foster home long after allegations of her abuse were made, but because we have learned nothing from the experience.

John Byrne is a lecturer in social care practice at the Waterford Institute of Technology and a practicing psychotherapist.


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