An inspection by the health and social services watchdog of a centre for adults with intellectual disabilities has found that the HSE failed to appropriately supervise two staff members, against whom an allegation of abuse had been made.
HIQA found that the centre at Cregg House in Co Sligo, which is managed by the Health Service Executive, was in major breach of regulations under four out of the ten headings inspected.
The centre, which is broken into five units, is home to 31 adults with severe to profound intellectual disability and associated mobility issues with complex needs including dementia and visual impairment.
It is on a HSE campus that provides residential accommodation for 107 residents with similar disabilities.
Last May, during an unannounced inspection, HIQA inspectors found that the HSE had not put in place appropriate safeguards to ensure residents were protected following an allegation of physical abuse of a resident by two staff members.
Inspectors reviewed the investigation that had taken place into an allegation which was made in January this year.
A disciplinary hearing had taken place yet key recommendations of the investigation had not been implemented.
One was that the staff members be rotated onto day duty to ensure adequate supervision.
The inspectors saw this had not occurred and that both staff members were on the rota to be on night duty on the night of the inspection without any supervision.
Furthermore, the staff had been redeployed to a new area without its manager being made aware of the allegations.
In today's report, HIQA said the issue was brought promptly to the attention of the HSE, which issued a directive with immediate effect to implement the recommendations to safeguard residents.
The report also criticises as ineffective the systems, which should ensure that management responded to staff concerns, about the quality and safety of the care and support provided to residents.
HIQA had previously inspected eight other units on the campus and identified serious non-compliance relating to governance, staffing levels, fire safety, a lack of social activities, institutional care practices and risk management, which resulted in the authority issuing immediate action notices.
In today's report, deficits are identified in governance arrangements of the centre.
HIQA says this has been a consistent finding in all of the inspections and the provider was requested to meet with the authority to discuss a plan for bringing the centre into compliance.
The report added that the need for a change of environment for residents was identified in several residents' risk assessments but had not resulted in any action to relocate residents.
The HSE outlined plans to relocate all residents on the campus to community houses, however the report said that difficulties in securing accommodation were delaying movement.
In a statement the HSE said it noted the issues of concern identified by HIQA and it has been working to implement all of the recommendations made by the watchdog.
It said the executive has already made a number of major improvements for residents of Cregg Services including redeploying staff involved in a disciplinary matter to an area fully supervised by a service manager and those staff have completed retraining and remain under supervision, which will continue for a further six-month period.
A Director of Services was appointed in May and a full schedule of training for staff has been arranged.
The HSE said that immediately after May's inspection the person designated to protect residents at Cregg House had ruled that the alleged abuse was a disciplinary matter and not a safeguarding concern.
Both staff involved were immediately redeployed to a fully supervised area for a recommended period for retraining, staff mentoring and evaluation of practice.
They remain under close supervision and will continue to be monitored for a further six-month period.