Parts of intellectual disability centre to shut after Hiqa inspections

Units to shut at St Raphael’s centre in Kildare run by St John of God Community Services

Parts of a Kildare-based centre for people with intellectual disabilities are to be closed after inspections found serious concerns over their welfare and health and safety.

The Health Information and Quality Authority (Hiqa) carried out 10 unannounced inspections at the St Raphael’s centre run by the St John of God Community Services in north Kildare last year after earlier inspections found major concerns.

Some 137 residents in total are accommodated on the site in seven designated centres.

It said the inspections found evidence of poor institutional practices, poor outcomes for residents and areas of risk to residents relating to safeguarding and health and safety.

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Poor managerial oversight and governance arrangements were also a recurrent finding in these designated centres, Hiqa said.

“Due to the seriousness of the concerns, Hiqa issued a series of immediate actions, warning letters and held regulatory and escalation meetings with the provider and members of senior management.

“Due to a failure of the provider to implement effective improvements for residents, Hiqa issued notices of proposal to cancel the registration of three of the centres on this campus.”

Safety and welfare

Hiqa said the provider subsequently issued plans for the closure of one designated centre, and transitional plans to provide alternative living arrangements for a number of other residents which addressed their safety, welfare and quality of life.

“The most recent inspections have confirmed that the provider has undertaken substantive changes in governance and management across this campus.”

In one centre, inspectors found a high level of reported accidents, incidents and near misses.

“Inspectors found that in the four months since the previous inspection there had been 111 recorded incidents. These incidents ranged in severity and included instances of residents hitting other residents, resident falls and suspected falls, residents grabbing/hitting out at staff, residents’ self-injurious behaviour and unexplained injuries to residents.

“The provider had failed to put in place adequate control measures to reduce or prevent adverse incidents and events from reoccurring since the previous inspection.”

In one serious incident, a resident exhibited “complex behaviours and had ingested an inedible object”.

Residents continued to be exposed to “an unacceptable level of risk”.

One of the 10 reports published by Hiqa on Wednesday said the system of health and social planning was “not effective to support residents’ health and social care needs on a consistent basis”.

Insufficient staff

Staff numbers were also insufficient.

Inspectors were “very concerned” in one case that there were systems in place to protect the residents from financial abuse.

In another instance, staff did not have a clear understanding of which residents had epilepsy and of whether they had been prescribed emergency rescue medication.

St John of God Community Services regional director Phil Gray said the improvements required were accepted fully and that corrective action plans had been submitted to Hiqa.

“In the intervening months, staff at the designated centres together with members of the management team, who are committed to the provision and development of quality person-centred residential services, have brought about significant improvements in the quality of life of the residents in these designated centres.”

The service was also working in partnership with the HSE and with the residents and their families to prioritise the transitioning of residents from these designated centres.

It was fully committed to these plans being completed this year.