Recent inspections at three residential centres for people with disabilities run by Camphill Communities of Ireland found they were not adequately protecting residents from the risk of abuse.
The Health Information and Quality Authority published 23 reports on residential services for people with disabilities today, 11 of which found the provider was generally ensuring a good quality of life for residents.
The inspectors at three centres run by Camphill Communities of Ireland had major concerns in relation to health and safety and risk management.
The report on the Grangebeg centre in Kildare found that measures were not in place to ensure residents were protected from suffering abuse.
The inspectors said there was a policy in place on the prevention, detection and response to abuse but they found this policy did not accurately guide staff on the reporting procedures required in order to ensure a timely response to allegations or disclosures of abuse.
The inspectors also found the policy was not in line with the Health Services Executive policy on Safeguarding Vulnerable Persons at Risk of Abuse.
There were also some safety concerns.
There were also some very positive findings in these reports. Staff members in Grangebeg were observed to treat residents with warmth and respect.
Inspectors reviewed 18 questionnaires received by residents and also by residents' representatives and overall they felt residents were safe in the centre.
Choking incident at Ballytobin
One report says a serious choking incident occurred in the Ballytobin centre in March 2016 but full details of what happened were not in the incident report including the fact that the resident had lost consciousness and emergency services were called.
The inspector found that while the risk management plan for the resident was revised there was no training provided for staff in the management of choking until late May 2016.
At the same centre there were ten medication errors since January 2016 with six of these involving failure to administer significant medication and one administered at the incorrect time.
Inspections into seven Daughters of Charity centres found that while some improvements were required, three centres were providing safe services that met the needs of residents.
However, the provider was failing to provide a suitable service to support residents in four of the centres.
Concerns at Western Care Association centres
Four of today's reports concern centres operated by Western Care Association.
Inspectors found that residents in one centre had a very good quality of life and there was a high level of compliance with the national standards and regulations.
However, the provider was found to be failing to provide residents with an appropriate service in two other centres.
Five major non-compliances were found on inspection in one centre relating to premises, health and safety and risk management, social care needs, governance, and management and workforce.
Four major non-compliances were found in another centre in the following outcomes: Health and Safety and Risk Management, Notification of Incidents, General Welfare and Development, Social Care Needs.
At one of the centres, HIQA had not been notified of an allegation or suspicion of abuse in respect of this centre since the commencement of regulation.
Inspectors found through speaking with staff and reviewing documentation, indicators of abuse were present.
The indicators had not been identified by staff and therefore there was an absence of a preliminary screening as required by national policy.
As a result, inspectors were unable to determine if there was a requirement to initiate a full investigation.
Inspectors also observed a resident engaging in socially inappropriate behaviour during the course of the inspection.
There was no reference to these behaviours in the resident's assessment. Therefore, there was an absence of appropriate supports identified.
In a separate centre, the inspector identified serious risks to three residents living in two houses due to a lack of appropriate supervision at night.
Furthermore, in another house two residents were not adequately supervised at night. One resident with severe uncontrolled epilepsy was not appropriately assessed or supervised at night.
Under the safeguarding and safety heading, the inspector found there was a lack of therapeutic interventions for residents' that displayed complex behavioural and protection issues and where in some cases communication assessments were not complete.
The inspector also identified some residents had experienced peer-on-peer abuse in this centre and despite regular complaints to staff that this was an ongoing problem and that no action was taken to adequately safeguard residents.
The concerns raised were not escalated through the protecting vulnerable procedures as per organisational policy and procedures
At this same centre, one of the houses was deemed not suitable for use.
The design, layout, heating and ventilation, bathroom and bedroom facilities of this seven bedroom house used for respite care were inadequate and did not meet the needs of the residents, the inspector found.
Inspectors also found staff training was not appropriately managed as per organisational policies and procedures.
Staffing allocation in two of the four premises did not meet the needs of the residents and exposed them to potential physical and environmental risks, when left unsupervised at night.
