Care centre residents are ‘threatened’ before inspections

Staff in residential care centres are “threatening” and “frightening” disabled people into not speaking out or making complaints about their treatment during inspections of their facilities, according to new evidence.

The findings of the National Disability Authority are in a review of the inspection and regulation regime of the State's health watchdog, the Health Information and Quality Authority (Hiqa) of care centres for the disabled.

The Government-commissioned report, seen by The Irish Times, says advocates for residents “voiced concerns about staff frightening residents about the outcome of inspections if they communicated complaints or concerns to the inspector”.

Two residents were told “no complaints please” by a staff member before an inspection. Another said: “Staff have threatened people and said, ‘Don’t say anything or they’ll close us down.’”

Other participants talked about staff making remarks such as: “You did a great job, you didn’t let the side down” after an inspection.

Fear

The report said the issue of fear “arose in many discussions” with participants, and served to “disempower” residents before, during, and after inspections.

Staff were also said to have used inspections to make residents comply with house rules.

During interviews, residents were asked if they felt they could talk to inspectors if they had concerns.

There was a “mixed response” to the question. Some said that they would prefer to talk to a member of staff, a manager or an advocate.

One woman said: “I’d be afraid to say anything. I wouldn’t tell her. You never know what would happen.”

By comparison, a “significant number” of people felt that they would have no difficulty talking with the inspector about concerns or issues.

“You could talk to them if you wanted to; if there was anything wrong in the house you could say it to them,” said one.

The report noted the issue was not a feature of all centres or inspections, but arose on “a number of occasions”.

It recommended that staff and service providers “should not use the Hiqa inspection process as a way to encourage, persuade or bully residents”.

The report noted that “a number of individuals and groups” raised issues in relation to the Prime Time programme on Áras Attracta which alleged mistreatment of people in a residential facility.

The broadcast caused “huge concern” to residents, who suggested Hiqa inspectors should go into centres undercover “to see what happens”.

Regarding Hiqa itself, the report found that some residents were unhappy that inspectors enter bedrooms and private spaces without consent.

Also, “most residents” did not recall being asked for consent when it came to accessing personal files.

Analysis

The report also carried out an analysis of a sample of Hiqa inspection reports and found a “significant degree of non-compliance” in the reports in terms of basic standards.

In the sample of 192 reports, covering 2,075 residents, there was compliance in 45 per cent.

However, more than 40 per cent were found to be at either a moderate or major non-compliance level.

The review is the first report of its kind and it is expected to be distributed to stakeholders this week before it is published.