Staff in disability centre told to leave resident behind during fire drills

Staff at a centre for adults with severe disabilities were repeatedly told to leave a resident behind during fire-drill evacuations, “and rely on the presence of fire resistant doors to protect” them, the health watchdog has found.

Fire safety failings identified in previous reports on the Drombanna Centre, operated by RehabCare in Limerick, had not been adequately addressed by March this year, the Health Information and Quality Authority (Hiqa) found.

Hiqa published 29 inspection reports on centres for people with disabilities on Wednesday, with the vast majority of them finding high levels of compliance with regulations.

The Drombanna centre, home to five residents, had been previously inspected in September 2014, May 2016, June 2017 and November 2017. This latest report is of an announced inspection on March 13th, 2018.

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In November 2017, says this report: “The inspector reviewed the records of simulated drills convened since the last inspection. Staff had failed to evacuate one resident on each occasion. The personal emergency evacuation plans (PEEPs) had been reviewed but did not provide assurance that every reasonable effort would be made so that residents could and would be evacuated in the event of a fire.

“Staff were still advised to leave the resident in the centre and rely on the presence of fire-resistant doors to protect the . . . resident.”

RehabCare had, in November 2017, provided a “satisfactory” confirmation that a plan was in place to ensure all residents would be evacuated in a fire. However, during the more recent inspection, arrangements for evacuation remained inadequate and “there was no agreed corrective plan”.

Oversight

In addition: “It was unclear what oversight and accountability was in place for medicines management practice. The inspector was concerned to find eight loose pharmacy-issued medicines labels in the medicine cabinet.”

The November 2017 inspection had found: “Residents did not live compatibly with each other. This impacted on the safety and quality of life of residents living in the centre.”

While there had been “some improvement” since a previous inspection in June, “peer-to-peer physical interaction incidents continued in the centre”.

While RehabCare had to address shortcomings, this latest inspection “again found unsatisfactory progress”.

“Residents were not in receipt of a consistently safe quality service.”

However RehabCare has, says the report, articulated a “commitment to improve” the service and reduce the occupancy and the plan was “on target”.

“Notwithstanding the provider’s plan the assessed risk of the impact of peer-to-peer behaviours was currently rated . . . as of moderate risk. A high level of peer-to-peer physical interaction incidents continued in the centre.”

There was also concern that the level of threat from some “core risks”, and the actions needed to contain them, had not been adequately identified.

Staffing issues remained, with RehabCare saying “there were challenges recruiting staff and these challenges were not particular to this centre.”

The centre was found to be non-compliant under six headings, including ‘risk management procedures’, ‘positive behavioural support’ and ‘fire precautions’; substantially compliant’ under two headings - ‘records’ and ‘staffing’, and, compliant under three including ‘general welfare and development’ and ‘persons in charge’.

RehabCare on Wednesday said: “Regarding the fire evacuation issue, RehabCare was following standard hospital and care home practice for the care of residents in the event of a fire, and strongly rejects any suggestion that any resident was left in any danger at any time.

“From the most recent Hiqa report on the Drombanna Centre from March 2017 it is clear that the vast majority of the issues pertinent to Drombanna have been rectified. RehabCare continues to work to ensure full compliance with Hiqa requirements.”