Residents of a centre for people with disabilities have been charged more than their contract of care stated they should have paid, according to independent watchdog HIQA.
Inspectors also found that the centre in West County Dublin failed to safeguard residents in the event of a fire and to notify the Health Information and Quality Authority that it was using a number of restrictive practices.
The centre comprises five units run by voluntary organisation Peamount Healthcare on its campus in Newcastle, Co Dublin.
At the time of last July's pre-announced inspection, it was home to 22 male residents with intellectual disabilities who require additional supports with mobility, behaviours that challenge, dementia care and medical needs.
Today's inspection report states that financial management did not protect residents' rights.
For example, the organisation's finance policy stated that it would supply equipment and aids as appropriate to the care required.
However, the contract of care stated they were supplied under the medical card scheme.
The report adds that the fees charged to residents were not as stated in the contract of care and that the sums paid - along with additional fees - "were having a significant financial impact on some residents".
Some of them were being charged significant amounts for external agency staff employed in the centre, a charge HIQA says was not detailed in their contracts of care.
Inspectors calculated that, after deduction of fees, one resident had €11 left for his weekly personal spending on items including social outings and clothing.
They criticise the practice of storing some residents' finances in units other than their own.
The report also identifies a number of failures to safeguard residents in the event of a fire, including:
- emergency exits in three areas which were inaccessible to residents with mobility aids
- only one fire drill was conducted annually and none took place at night time.
Among the restrictive practices not notified as required by the service provider to HIQA were:
- that "restrictive holds" were recorded on file as an intervention to be used on one resident
- the locking of one unit's front door for periods of time
- the placing of door alarms on some residents' rooms and of a bed alarm
- and one kitchen door was locked after a certain time in the evening.
The inspection found that the Person in Charge of the centre "was not engaged in (its) governance and management ... on a regular and consistent basis due to other responsibilities assigned to him/her" by Peamount Healthcare. And they report notes that a considerable amount of agency staff was working at the centre.
It adds that one resident's plan required that staff supervise him closely but notes that he remained in the unit unsupervised for periods of time.
On the front door of each unit, notices advised visitors that, in the event of nobody answering the door-bell, they should enter the unit and look for a staff member.
However, inspectors found that residents were sometimes left in the units unsupervised for periods of time and that, once inside, "visitors could compromise residents' rights and safety".
Major non-compliances were found under nine of the 18 criteria for registration which were inspected. And moderate non-compliances were found under a further four headings.
An action plan reproduced at the end of today's report lists HIQA's required improvements as of last July.
The report states that the service provider, Peamount Healthcare, "attended a meeting in HIQA's Dublin office following the inspection to discuss its findings and to provide reassurances to HIQA that the actions identified would be implemented".
Charity says it is now funding purchases
Peamount Healthcare has said it is now funding all purchases of aids and appliances for residents of its intellectual disability centres in west Dublin.
The charity's CEO, Suzanne Corcoran, told RTÉ News that at the end of last year it responded to negative findings on the matter during HIQA's July inspection by amending residents' contracts.
Ms Corcoran said the reform was one of the many actions PH has taken on foot of last year's HIQA reports on the charity's residential sevice for people with intellectual disabilities.
The report focused on Centre A1, which accommodates 22 men who require additional supports with mobility, challenging behaviours, dementia care and medical needs.
Ms Corcoran added that the organisation accepted HIQA's findings and that acting on them could only improve the service to residents and the quality of management - both of which were strongly criticised by the watchdog.
She said that recently the Person in Charge at Unit A1 had been relieved of some duties outside the centre in order to give him/her more time to manage the unit.
She said that spending on agency staff had been cut by 30% across the campus, which also provides rehabilitative care to patients from Tallaght Hospital and residential care to people with Acquired Brain Injury.
She added that work is progressing on adapting ten bungalows to make them comply with fire regulations
She said that unannounced weekly visits are now being made to a random three or four of the units for 108 intellectually disabled adults located in bungalows in and near the campus in Newcastle, Co Dublin.
Ms Corcoran was appointed to her post last December.