Centre for people with disabilities ‘failed to protect residents from abuse’

Services provided at a residential centre for 38 people with disabilities in Dublin were “not safe” and failed to protect the residents from abuse, a report by the health standards agency has found.

The Health Information and Quality Authority published 17 reports on designated centres for people with disabilities on Tuesday.

The reports included two on services run by Stewarts Care in Palmerstown, where Hiqa had previously found had serious failings and had said it was considering cancelling the centres' registration.

An unannounced inspection at the designated Centre 3, where 38 residents were living, found a “very high level of regulatory non-compliance” with health and social care regulations.

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Previous inspection

Hiqa said 19 of the 28 actions which arose from its previous inspection were found not to have been satisfactorily implemented.

“Overall, inspectors found that the service provided in the designated centre was not safe and had failed to protect residents from abuse,” the report said.

At Centre 4, also in Palmerstown, the inspectors found that efforts had been made to improve the privacy and dignity of the 27 residents there.

“However, institutional practices and facilities in the centre continued to compromise these rights,” it said.

“There was evidence of institutional type practices in the centre. While there was evidence that some personalised bedlinen had been purchased for residents’ use, communal bed linen remained in use also in one unit.”

The inspectors observed a notice board listing residents who were to have a shower.

“A staff member confirmed that residents do not receive a shower daily, and there were days recorded on the board whereby staff were instructed not to shower residents. Staff stated this was due to staff shortages in one case, and in another case, due to an inspection by the Health Information and Quality Authority (HIQA) the previous day,” the inspection report said.

The centre had previously been inspected in May 2017 and significant failings had been identified during that inspection, Hiqa said.

Subsequently the provider was informed of Hiqa’s proposal to cancel its registration.

Compliance

The provider then outlined actions it was taking to improve services for residents and to bring the centre into compliance with the regulations.

Hiqa said in its latest report that although the provider had made positive changes to the management teams, at the level of senior and middle management, at the time of inspection it was not evident that these revised arrangements were impacting positively on the quality and safety of care for residents.

“Inspectors found significant failings and five major non-compliances were identified in nine of the outcomes inspected against.

“While the provider had implemented some of the action plan from the previous inspection, and significant improvements in the quality of life for some residents were identified, risks in relation to the provision of healthcare and medication management practices remained a concern on the day of inspection.”

In a statement, the Stewarts Care said it was already “well advanced in the management of a detailed and multifaceted programme of change to address these and other similar issues that have been highlighted both in other Hiqa reports of similar profile over recent months and in third party assessments commissioned by Stewarts Care directly”.

It said the scale of change required was “substantial and requires investment beyond the resources ordinarily on hand to Stewarts Care”.

The programme of change is being managed under the terms of a governance improvement plan agreed with Hiqa for change across Stewarts Care services, which cater for 260 residents.

"The implementation of that plan is subject to monthly reporting to HIQA with a particular focus on safety and quality of life."

Stewarts Care said the “detailed critique in Hiqa’s reports reflect the extreme challenges faced in delivering change in a resource constrained environment”.

“Notwithstanding, the board fully accepts that the conditions described in these reports are unacceptable, that governance and management systems were not effective and that the standards on risk assessment and safeguarding, including the condition of the physical environment clearly did not meet the standards of care we expect of ourselves.”