Report by Hiqa finds ‘tension’ at St Michael’s House

A Hiqa report into a centre for people with disabilities operated by St Michael’s House in Ballymun, Dublin, found residents “living in an atmosphere of heightened tension on an ongoing basis”.

Six residents were present on the day of the announced inspection on May 11th-13th this year. Overall, inspectors said evidence was found that all residents’ social, personal and healthcare needs were not being fully met.

Residents had access to general practitioner (GP) services and a full-time medical officer, and although there was some access to health professionals, these services were limited.

It was found that repeated referrals for clinical inputs, such as psychology, dietary advice, occupational therapy and psychiatry, some requested up to 12 months previously, had not yet resulted in an appointment or, in some cases, even a response.

Inspectors noted interpersonal conflicts that were causing some residents to live in an atmosphere of heightened tension. During the inspection, an incident relating to a resident’s challenging behaviour was observed, and residents were noted to be upset following this.

Also noted was an inability of the service to manage escalations of challenging behaviour by residents consistent with a deterioration in mental health.

Inspectors said that at the time of inspection the residents had a variety of health, personal and socially complex needs, but there was limited evidence that these needs were being managed holistically in a timely and responsive manner.

The report said interpersonal relationships within the centre had broken down between some residents, which resulted in a tense atmosphere. “Emotional and behavioural needs associated with inability to share, attention-seeking and high anxiety levels within the client group had been identified.”

Inspectors said residents’ needs required a high level of skilled and one-on-one supports regularly, but these were not always in place.

In a response, St Michael’s said a new strategy had been implemented by the senior psychologist to support the resident displaying challenging behaviour. It said incidences of challenging behaviour had diminished considerably since one resident moved from the centre.