HIQA concern at use of chemical restraints at Cregg House

The State’s health watchdog has raised serious concerns over the use of drugs to restrain vulnerable residents at a HSE-run centre for more than 100 adults and children with disabilities.

A highly critical report by the Health Information and Quality (Hiqa) into Cregg House in Co Sligo also shows major breaches of care standards relating to understaffing, institutional practices and unsafe care.

Among the key findings of the report, based on inspections carried out between December 2014 and April 2015, include:

* One resident was chemically restrained on 13 occasions in the previous few months, with a nurse telling inspectors it was “better to give the chemical restraint at the start of the outburst otherwise it could go on for up to two hours”

* Challenging or disturbed behaviour among residents was often due to frustration at a lack of stimulation and boredom

* Some residents had not been able to access day services for several years since the campus service closed

* Children remained in bed until 1pm on occasion, as there were not enough staff present to attend the children’s needs

* Residents were provided with their meals at midday because staff lunch was usually between 12.45 and 2pm

In all, the centre was measured against 23 care standards and found to be in major breach of 19 of them.

No area was deemed to be fully compliant.

A number of immediate action notices were issued during inspections dealing with insufficient staffing levels, fire safety concerns and other risks.

Further inspections have taken place with inspection reports due to be published in the coming weeks.

Cregg House was previously at the centre of controversy over poor staffing levels and lack of access to activities for residents when it was operated by the Daughters of Wisdom, a religious order.

The HSE took over running the centre in October 2013 and the number of residents at the complex was reduced.

But the Hiqa report says understaffing remains a key issue and found poor governance and very high sick leave rates.

The low staffing levels meant a number of residents had not left the campus for several months.

Adequate arrangements were also not in place to allow staff raise concerns about the quality and safety of the care provided to residents.

There was also evidence of negative outcomes for children due to staff shortages.

In a statement, the HSE said the report also highlighted positive aspects of care such as respectful engagement and knowlege of residents' needs, along with evidence of a warm and friendly interaction between staff and patients.

But it said it was working to implement all the issues of concern highlighted, including staffing levels.

Inclusion Ireland, the umbrella group for people with disabilities, said the findings were “shocking” and underlined the urgent need for investment in moving residents into appropriate community-based settings.

Paddy Connolly, the group’s chief executive, said; “There are 3,000 people living in similar congregated settings. Just 150 moved out last year, and 150 will move out this year. This is going to take 20 years unless the Government is prepared to invest in this area.”