Plan for external expert to review management of Donegal disability centres

Minister of State for disabilities Anne Rabbitte plans to appoint an expert from outside the jurisdiction to review the management of HSE disabilities centres across the northwest, particularly in Co Donegal.

A source close to Ms Rabbitte said she was “not happy” with the HSE reviewing its management of disability centres across community health organisation (CHO) 1, which covers Donegal, Cavan, Leitrim, Sligo and Monaghan.

The appointment of an independent investigator, probably from Northern Ireland, comes on foot of damning correspondence from the Health Information and Quality Authority (Hiqa) where it says the HSE has repeatedly “failed to demonstrate fitness” to safeguard residents with disabilities in its centres in the region.

The HSE is the sole provider of residential disability care in Co Donegal, running 30 centres with 194 residents. Across CHO1, it operates 89 centres with 559 residents.

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The most recent incident and subject of correspondence from Hiqa concerns a centre for adults in north Donegal, where it is alleged a male resident accessed images of child abuse on three separate occasions, in 2016, 2017 and last year.

Formal caution

In correspondence to Yvonne O’Neil, interim national director of community operations, dated December 10th last, Hiqa’s chief inspector of social services Carol Grogan says the watchdog has “been informed that the social worker at that time informed An Garda Síochána and that this resulted in a formal Garda caution for the resident.

“The HSE as registered provider failed to notify or inform inspectors during inspections of the centre of either incidents in 2016 or 2017,” it says.

In its latest report on the centre, published the first half of 2020, Hiqa found the centre was compliant with 12 of the 13 standards examined, including governance and management, notification of incidents and protection.

Ms Grogan notes failings by HSE in CHO1 since 2016 have seen Hiqa summon the executive to seven cautionary meetings, issue it with 16 warnings; require it to undertake 32 “provider investigations”, and has resulted in Hiqa issuing four notices proposing to cancel the registration of designated centres - potentially closing them down.

“In summary, my office has taken ongoing escalated regulatory action in CHO1 since commencement...the HSE has repeatedly failed to implement their own surveillance of centres to identify and address areas of significant concern which have occurred in other centres in CHO1,” Ms Grogan wrote.

“Given the serious nature of the most recent incidents, I am of the view that the HSE as a provider has failed to demonstrate fitness through its scheme of delegation in CHO1.”

Governance

In letters to HSE chief executive Paul Reid and Minister for Health Stephen Donnelly, sent on December 10th, Hiqa notes its “serious concerns” about HSE governance of disability centre in CHO1.

Less than a week later the HSE published the executive summary of the ‘Brandon’ report which detailed 108 incidents of sexual abuse of 18 intellectually disabled residents at the Ard Gréine Court complex in Stranorlar, Co Donegal between 2003 and 2016.

In a statement on Tuesday, the HSE said it was “important to state that Hiqa have informed the HSE that there were no current safeguarding concerns” arising from their unannounced inspections, completed in January, across all disability designated centres in Donegal.

The HSE said it wrote to Hiqa in December and “acknowledged a shared concern” for Hiqa and the HSE regarding governance and safeguarding, including assessment of the need for and type of enhanced national oversight.