Fire safety and lack of privacy in disability homes criticised

Staffing levels, bedroom layout, fire safety and respect for privacy and dignity have been criticised in a number of Hiqa reports into disability care homes in Dublin, Limerick and Tipperary.

The latest report from the Health Information and Quality Authority (Hiqa) into St Anne’s Residential Services in Roscrea, Tipperary, carried out in August, reported a “continued high level of non-compliance against the regulation at this inspection”.

A Hiqa report earlier this year found disabled residents at the centre were shouted at and called names by staff.

Inspectors in August found the centre did not meet the social, emotional, developmental and safety needs of the residents, despite warnings from previous inspections. They reported parts of the centre were in “a poor state of repair” and that all units had limited storage space, with some wheelchairs stored in the courtyard area.

Unannounced inspection

The centre was subject to an unannounced inspection last August following up on non-compliances from previous inspections. It was the fifth Hiqa inspection of the centre.

Inspectors observed that practices at the centre were compromising the privacy and dignity of residents after discovering bedroom doors left open between 8.30am and 9am.

It reported that in one of the bungalows, “a bedroom door was wedged open by a rug and a resident could be observed in their nightclothes”. It also found a resident was restrained in her chair using a lap-belt for long periods of time during the day when she should have been free to move around.

Space was also an issue at the centre, with bedroom sizes presenting a challenge in terms of the safe movement and handling of residents by staff. Inspectors witnessed one resident hitting out at another resident in a wheelchair who was in her/his way due to lack of space.

Following allegations in December 2014 of inappropriate language used towards residents, Hiqa inspectors reported that staff at the Tipperary centre were conversing with residents “in an appropriate manner”.

The staff had also developed a new protocol to administer medication to residents “in the least restrictive manner” following complaints of forced administration of food and medication last December.

Inspections of a care centre for people with disabilities operated by Daughters of Charity Disability Support Services in Limerick warned the building is not suitably designed to meet its residents’ needs.

Mobility restrictions

They found two residents who had requested to live in a bungalow with no steps or stairs were being accommodated in the upstairs bedrooms of a two-storey house, despite their mobility restrictions.

Staff told inspectors that one of the residents, who required supervision at all times when ascending or descending stairs, would ask to go to her room up to 20 times a day.

The report revealed that “following a number of falls at the bottom of the stairs” and incidents of residents falling down the stairs during the night, stair gates were installed at the top and bottom of the stairs.

Hiqa inspectors also raised concerns over fire safety requirements for residents sleeping upstairs who were unable to walk down the stairs without supervision and reported that night-time staffing arrangements at the centre did not meet the needs of all residents.

Bed rails were not checked between 11pm and 7am as staff were not “on-duty” during these hours and one resident, who was fully dependent in terms of mobility, was left from 11pm to 7am positioned on one side of the body, according to the report.

A Hiqa report carried out in October into a disability care centre in Dublin 15 highlighted the risks faced by one resident whose bed was pushed up against a radiator due to inadequate space in the twin bedroom.

Risk of burning

It warned that the radiator’s temperature was recorded at 60.4 degrees, which placed the resident at risk of burning.

The inspector reported that the centre’s emergency evacuation plan did not take into account the location of one resident’s bedroom, which was isolated from staff and the main exit and situated next to the kitchen.

It found there was no fire door separating the bedroom and kitchen and warned that with night staff sleeping upstairs in the building, “in the event of an emergency the possibility of staff being unable to get to this resident [was] not considered”.

Inspectors at the disability care centre in Dublin 15 also found that one resident, who only stayed at the centre three nights a week, was paying the same fees as all other residents, totalling €120 per week.

“Staff members spoken to stated this resident paid a reduced fee, although this was not reflected within the contract,” said the report.

The centre later confirmed the contract had been revised to reflect payment on a part-time basis.