Kilkenny disability centre criticised over safety issues

A Kilkenny-based centre for people with disabilities has taken steps to address serious deficiencies highlighted by the Health Information and Quality Authority (Hiqa), including health and safety risks to residents and a failure to have Garda vetting procedures in place for volunteer staff, according to a report published today.

Two inspections took place at the Kingsriver Community centre in Stoneyford, Co Kilkenny earlier this year.

The second inspection in May found progress had been made in relation to compliance with the Health Care Act and other regulations.

The inspectors found that many of the clinical issues identified had been remedied. But others remained “partially unresolved”.

Inspectors also found improvements in assessment tools for nutrition, skin integrity, behaviours and incontinence care.

But the inspectors’ report acknowledged that the time scales for the completion of some of the actions had not yet lapsed. These are due to be addressed by the end of August.

Founded in 1986, the HSE-funded centre had six employees as at the end of 2012, with a total wage bill (including pensions) of almost €251,000.

Among the major deficiences discovered during the first inspection in March were that parts of the building were in a state of disrepair and were unsuitable for the residents. It found medication administration practices were “unsafe” and that in some cases medication was stored on top of a press, and in a fridge also used for storing food.

During the inspection on March 12th, inspectors found deficiencies in some aspects of residents’ health care. In total, they found 58 areas of non-compliance. Some residents had “multi-complex care needs”.

They found residents did not have timely access to certain services and that not all their personal care plans were revised on an annual basis.

Staff knew the reporting procedure in relation to abuse, but there were no documented records available that staff were trained in abuse detection and prevention as required by the legislation. Inspectors said that “ all reasonable and proportionate measures were not in place to ensure the protection of a resident”.

The inspectors were not satisfied that the numbers and skill mix of staff available during the inspection was appropriate to meet residents’ needs.

“The person in charge was the only staff member with experience in intellectual disability to cater for residents’ needs.”

The five other staff were sourced through a programme called the European Voluntary Service (EVS).

"All five staff were unqualified and had very little experience of working with people with disabilities. There was no evidence on any staff file of Garda Síochána vetting."

The report also found there were “significant deficits” in core areas, fundamental to the quality and and safety of care provided to residents, such as medication management practices, fire safety, the process of care planning, infection control, health and safety and risk management.

There was evidence that residents were supported to maintain their independence where possible and many residents attended various workshops on site.

With regard to the physical infrastructure, the centre was situated on approximately three acres of land adjacent to a stream and the ruins of a building, over 100 years old, which was in a state of substantial disrepair.

There was no fence to prevent access to the river adjacent to the premises and there were no warning signs about the hazard of drowning or accessible life buoys in the event of somebody entering the river. There were also fire safety issues.

Inspectors form Hiqa also found that overall, governance arrangements were inadequate. There was no evidence of a tailored training programme to meet the assessed needs of residents and there was no evidence of continued professional development plans in place.

The centre engaged a structural engineer and began substantial repair work on the premise following the inspections. It also reviewed risk management policies and put in place new procedures for infection control.