HIQA has expressed concerns over two separate centres for people with disabilities in Kildare, highlighting issues in several areas including social care and safety.
Both centres are run by the St John of God order.
The first report, into a residential centre catering for 13 people with disabilities said residents had very limited opportunities to express meaningful choice.
Residents did not have the option to cook or prepare any food in the centre with the last meal arriving in the designated centre at around 3.45pm.
Inspectors noted that residents who required higher levels of support for transferring/personal care were being put into bed early every evening to accommodate the designated centre's staffing roster.
The inspectors clearly observed residents being put to bed from 7pm so they were in bed before the night staff shift change at 9pm.
Overall, the inspectors did not find that residents had meaningful opportunities to partake in activities appropriate to their assessed needs, interests or preferences.
While inspectors found that residents had individualised assessments in place, these did not adequately reflect residents' social care needs.
The unannounced inspection took place on 5 March.
The second report expressed concern that institutional practices observed in another Co Kildare centre for people with disabilities might have a direct negative impact on the lives of residents.
The report found non-compliance across all the areas it inspected.
The inspection was carried out in March at the centre, which caters for 18 full-time residents, with one bed for respite.
The report found residents' rights and dignity were not fully respected or promoted in the centre.
The report said the centre was not treated as a home for residents, but as an open building.
Inspectors noted 13 different access points into the centre with numerous visitors coming in and out of the centre throughout the course of the day without knocking, or signing the visitors' book.
HIQA inspectors arriving at the centre observed a resident being supported with personal care through the open door of his bedroom.
Residents' personal folders and daily record books were stored in the communal living room in a broken press, from which the door had fallen off.
There was a HSE dentist's office located within the designated centre, where residents from other designated centres attended for dental treatment on a regular basis.
The report found there was inappropriate space for residents to store and maintain their own belongings.
Inspectors found the inadequate design and layout of the centre was posing risks, including poor manual handling due to insufficient space, cross-infection risks and the risk of unwanted visitors having free access to the building unsupervised.
The report noted that the person in charge of the centre had previously voiced concerns to the service provider about the unsuitable nature of the building and the need to re-located.
Inspectors found that there were very few meaningful activities available to residents, with long periods of the day were residents had no meaningful activation or engagement.
The report stated that inspectors were not satisfied that there were systems in place to meet the diverse communication needs of all residents.
It found residents with behaviours of concern were described as "disruptive" by staff when the residents were observed vocalising.
The inspectors raised concerns that there were inadequate protocols in place for the reporting of suspected, alleged or witnessed abuse in this centre.
The HIQA inspectors found practices and care in the centre were institutionalised and resource-led, with the direction of the day determined by staffing routine and resources available.
Concerns raised over use of restraints
Inspectors expressed concerns over the use of restraints.
Inspectors found one resident who had been wearing arm splints since 2003 was facilitated during the day in an external day programme to remove these splints for periods of time as staffing numbers facilitated this.
The inspectors found the use of this restraint was not in the least restrictive manner for the least amount of time, due to inadequate staffing levels.
Inspectors also reviewed an incident log which detailed that a resident had left the building without staff knowledge.
The report found residents were not supported to buy, prepare or cook their own meals due to a lack of appropriate facilities, a lack of staff training in food safety and the set daily routine of the centre.
Some residents were given their meals without being told by staff what they were eating.
The report found the person in charge of the centre did not attend handover meetings and staff meetings, and was not often in the centre.
Inspectors expressed concern that the centre was not being managed appropriately in accordance with the requirements of the Regulations and Standards.
