Hiqa cool on plan for undercover care centre inspections

The State’s health watchdog has expressed reservations about undercover inspections of care homes on legal and privacy grounds.

The Health Information and Quality Authority (Hiqa), whose staff carry out announced and unannounced inspections of care homes, says it has a number of issues with the proposal.

Responding to allegations of abuse at Áras Attracta, a Co Mayo centre for people with intellectual disabilities, HSE boss Tony O'Brien has suggested using undercover staff to root out unacceptable care practices.

Human rights

However, Hiqa chief executive Phelim Quinn says covert activities could impede the human rights of vulnerable individuals by invading their privacy and dignity.

Where it takes court action against a service provider, Hiqa has to be able to show it obtained evidence in an objective, transparent and fair way, Mr Quinn said, adding that covert surveillance is not used in this way in any other jurisdiction.

While the authority has the power to close a care home, he says this has not yet happened. There is a specific issue with HSE-run facilities like Áras Attracta because of the “limited stock” of alternative accommodation available for people with intellectual disabilities.

“But, where we need to take action, we will take action to close a registered provider,” he said.

Concerns escalated

Defending the authority’s actions in relation to Áras Attracta, Mr Quinn said that after an inspection of the home in Swinford last February, it immediately escalated its concerns with the HSE.

The executive put in place an action plan and Hiqa found substantial improvements on a follow-up inspection last May.

Mr Quinn said the revelations by RTÉ’s Investigations Unit about abuse at the home are appalling, but there are “specific limitations” to any inspection regime, which is reliant on good management systems and practices.

“We rely on people to tell us when they believe things are going wrong in a home. If anyone has uncovered anything in a home we want them to contact us.”

The authority began inspecting homes for people with intellectual disabilities just over a year ago.

‘Mixed bag’

Mr Quinn said the results present a “mixed bag” of issues.

“The sector has some very good practice but we have found some very challenging and concerning conditions within the homes.”

Earlier, Minister for Health Leo Varadkar backed the use of undercover investigations to identify possible abuse of patients in care units.

He said recommendations made by Hiqa on the Áras Attracta facility in Co Mayo had been implemented.

“So, obviously, the existing systems are not good enough. It is sad that we have to do it, but the only way to satisfy ourselves that this is not happening in other places is to have our own undercover inspections.”

The Minister said that some staff groups may not like this idea, but he thought “it has to be done”.