Staff at home for disabled adults ‘left in very difficult circumstances’ – Hiqa

Staff at a home for disabled adults were “unable to contact managers, unable to take leave [and] left in very difficult circumstances” while residents were “very unhappy”, a report from Health Information and Quality Authority (Hiqa) finds.

An unannounced inspection of the Court, Kingsriver, in Ennisnag, Co Kilkenny, took place on the 7th, 8th and 10th of December 2021 and found non-compliance with all 10 regulations inspected. It is home to eight disabled adults.

The report, published on Wednesday, is one of 30 from the health watchdog on centres for adults with disabilities. The Kilkenny centre is operated by Kingsriver Community Holdings, a company limited by guarantee.

“The inspectors were concerned on arrival to this centre that there was a complete absence of an appropriate management presence in the centre. This was found . . . to be negatively impacting on the safety and quality of care delivered to residents.”

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Staff were “unsure and unaware as to who was in charge” and a “safe and high quality service was not evident”. There was no evidence safeguarding plans were in place “to manage an identified and ongoing safeguarding concern in the centre.

“This involved a resident who engaged in behaviours of concern that placed themselves and others at risk.”

Hiqa’s inspector had to issue “immediate” instructions to Kingsriver Community Holdings to provide a ‘on call’ system to ensure staff had a manager available to them.

A centre in Cork city, operated by the Cope Foundation and home to four women with intellectual disabilities, lacked leadership and oversight, Hiqa found. The Cork City South 4 centre, inspected on 1st November, 2021, had a person in charge who was "not knowledgeable about the centre".

“Poor governance impacted on the quality of the service provided to the residents and resulted in findings of poor compliance with the regulations relating to governance and management, staffing, protection, training, complaints and notification of incidents.

“Despite these findings residents were observed, and reported, to be happy living in the centre,” says the report.

“The person participating in management told the inspector that they had not been in this centre for a number of months.”

The inspector was told of a potential safeguarding incident, but Hiqa had not been notified within the mandatory three working days.

“When reviewing the log of incidents in the centre, the inspector identified a number of other adverse incidents that had not been notified to Hiqa and, where appropriate, had not been followed up in line with safeguarding policies.”

Due to lack of staff, residents could not have individual outings, Hiqa found. One resident was not able to go for a walk some nights as they wished.

There was a lack of choice in the centre, and because it had no car “some activities were either not possible or were limited”. The lack of transport had resulted in “one resident not attending an [medical] appointment”.

The report says the centre “was not resourced to ensure the effective delivery of care and support. The management systems in place did not ensure the service provided was safe, appropriate to residents’ needs, consistent and effectively monitored.”

At the HSE-run Hawthorns centre, home to 15 adults with intellectual disabilities in Stillorgan, Dublin, an announced inspection on 25th November, 2021 found residents "appeared happy, comfortable and content".

However, there had been “a number of allegations of physical and psychological abuse between peers” in preceding months and safeguarding plans had “not proved fully effective in reducing this risk”.

In each of the reports the service providers outlined the steps they would take to address identified shortcomings.