Concern for fire safety and staffing at centre for disabled children

Staffing levels, fire safety and the protection of children’s rights have been criticised in a new report on a centre for children with disabilities in Co Sligo.

The latest report from the Health Information and Quality Authority (Hiqa) on the children’s unit at Cregg House says little progress has been made since previous inspections.

The unit is part of a large residential centre 5km from Sligo town and accommodates four children with profound disabilities and complex medical needs. It was subject to an unannounced inspection last July after two previous inspections earlier in the year identified significant areas of non-compliance.

Hiqa inspectors say staffing remains an area of concern, with one staff nurse on night duty alone to meet the needs of the children. “It was unclear how an evacuation of five fully dependent children could be managed safely with one staff member on duty at night.”

Practices in the centre were not child centred and impacted on the children’s rights to privacy and dignity, according to the report. Children did not have the option of a bath or shower every day. In the morning, children were washed with wet wipes and in the evening one or two children received a shower or bath.

“Inspectors found that this was based on routine rather than need or choice. Privacy and dignity were not promoted for the children.”

They also observed that bathroom doors were not closed while children’s needs were being attended to, though a screen was placed in the door frame. Children’s bedroom doors were left open while children were in their room and while they were out at school.

While measures were in place to protect children, staffing levels impacted on the quality of care provided and the supervision of the children. “Staff were kind and respectful towards the children but the pressures due to limited staffing levels impacted on the quality of interaction with the children.”

Management roles within the unit were unclear and systems were not effective, according to Hiqa. Support and leadership was not provided to the staff team. An annual review was completed but this was not sufficiently detailed to give an overview of the quality and safety of care in the service. There were gaps in the training needs of the staff team.