Almost six years ago, RTÉ broadcast a documentary featuring the Áras Attracta care facility in Co Mayo, which showed some residents being mistreated by certain staff. The HSE immediately launched an internal disciplinary process. Six years later, that process has yet to formally conclude and has cost the taxpayer more than €3 million to date.

There was a public outcry when the RTÉ Investigates documentary Inside Bungalow 3 was broadcast in December 2014. The programme featured disturbing undercover footage of residents at the Áras Attracta facility in Swinford, Co Mayo – which cares for people with intellectual disabilities – being mistreated by some of the staff at the facility.

In the wake of the programme, the HSE suspended 14 workers on full pay pending the outcome of its internal disciplinary process. Five of those workers subsequently resigned from their posts. Separately, the Health Information and Quality Authority (HIQA) and An Garda Síochána each launched investigations. The Garda investigation led to criminal charges being taken against six members of staff.

Now, as the sixth anniversary of the documentary approaches, new records released to RTÉ Investigates under freedom of information show that the HSE wage bill for the workers – suspended on full pay, pending the outcome of its investigation – had reached around €3 million by August of this year.

At present, nine workers remain suspended on full pay, with their cumulative wage bill totalling €34,860 each month.

The long-running saga illustrates the complexity of employment-related disputes for both staff and employers where healthcare workers are accused of mistreating care home residents.

Meanwhile, the criminal cases involving some of the Áras Attracta workers have long since concluded. But the fact that the HSE's inquiry has not concluded raises questions about the length of time this process can take – as well as the enormous cost to the taxpayer of such investigations.

Trust in Care

Following the documentary, as part of the disciplinary process into the staff members alleged to have mistreated residents, the HSE quickly formed a 'Review Group'. This later became known as the 'Disciplinary Investigation Team'. As part of this investigation, it requested - and was provided with - an additional 197 hours of undercover footage filmed by RTÉ.

However, some of those staff members later successfully complained that this disciplinary process was flawed. They said that the HSE wasn’t following its procedures contained in a policy document called 'Trust in Care', which sets out procedures for when staff members are accused of mistreating patients or residents in the care of the health service.

The matter came before the High Court in February 2016, when five psychiatric nurses sought injunctions restraining the HSE from continuing with the process carried out by the Investigation Team.

According to a High Court ruling from Ms Justice Deirdre Murphy, "To date, the only complaints levelled against the plaintiffs are of potentially abusive interactions." She noted that the nurses were not subject to criminal proceedings and were suspended on full pay.

One of the issues that the psychiatric nurses complained about related to the composition of the Investigation Team. They said they had no input into this, which they were entitled to under established HSE protocol.

In an affidavit, a HSE official explained the logic behind this exclusion. "It was incumbent on the HSE to move with all due expedience to appoint appropriately qualified persons to conduct an investigation without delay and/or protracted debate/negotiation about the composition of any such investigation," the official said.

This explanation was criticised by Ms Justice Murphy, who said that the court failed "to understand how the seriousness of the issues and the urgency of the matter required [the HSE] to depart from established procedures."

'Procedures were not followed'

It was also argued that the HSE did not follow fair procedures because the Investigation Team had multiple, overlapping roles in the disciplinary process. Ms Justice Murphy noted in her ruling that the Investigation Team "appears to hold three roles simultaneously. They are gatherers and collators of the evidence, they are the complainants of abuse, and they are judges of whether or not the abuse occurred."

Ultimately, the High Court granted the nurses injunctions restraining the disciplinary procedure that was underway at that point. This effectively meant that a new process had to be constituted, which became known as the 'Trust in Care' investigation. This was independently chaired by Brendan Byrne, a former director of nursing at Carlow/Kilkenny Mental Health Services, and began in May 2016.

Six-figure legal bill

Records released to RTÉ Investigates show that the HSE’s legal bill in the High Court case came to €92,000. As it lost the case, the HSE had to pay the plaintiffs’ legal fees. It refused to say how much this amounted to, citing commercial sensitivity, but it seems likely that this was a similar amount.

Meanwhile, in March 2016 four workers at Áras Attracta, who had been found guilty in the District Court of assault, were sentenced to community service. (Another worker was initially given a four-month prison sentence but this was later reduced to community service following an appeal.) A sixth worker was acquitted of assault in November 2016.

According to other records released to RTÉ Investigates, by May 2016 the HSE had spent €48,000 on legal advice for the criminal cases involving the workers.

The records also show that by the end of 2019, additional outgoings – such as venue costs, secretarial fees, other investigation costs as well as legal fees other than those incurred in the High Court injunction and criminal cases – amounted to more than €300,000.

(That figure excludes the wage bill for the various workers suspended pending the Trust in Care investigation.)

Nine staff currently suspended on full pay

According to the HSE press office, initially 17 workers at Áras Attracta were subject to investigation, following the broadcast of the RTÉ documentary. Of those, the HSE said that 14 were suspended on full pay, as required by the Trust in Care process, while two of those staff were employed by an outside agency. (The agency staff member no longer works at the facility.)

Furthermore, one staff member remained "at work in line with the Trust in Care process," the press office said.

Last month, the HSE press office said that the Trust in Care investigation has been completed and that the staff members have accepted the draft report and have had a chance to respond to it.

It said "the HSE is reviewing the report" but would not say when this report is expected to be finalised.

RTÉ Investigates also asked the HSE to comment on why the whole process could take such an inordinate amount of time. It declined to comment.

In total, factoring in the wage bill for the suspended workers, as well as assorted legal and investigation fees, it appears that the costs to the HSE in the wake of Áras Attracta are likely to be well in excess of €3.5 million.

Two nurses allege personal injury

Meanwhile, RTÉ Investigates can reveal there are two other legal cases associated with the Áras Attracta facility. Two psychiatric nurses at the care home – Lyndsey Conway and Carmel Rooney Doherty – are now suing the HSE in the High Court for alleged personal injury.

According to High Court records, the cases were lodged in 2017. Ms Conway and Ms Rooney Doherty were part of the group of five psychiatric nurses who were granted High Court injunctions in February 2016, over the disciplinary procedure conducted by the HSE. They are currently suspended on full pay and have not been subject to criminal proceedings.

Their solicitor, Kirsty Kavanagh of Kavanagh & Co Solicitors, told RTÉ Investigates that the cases are currently ongoing. She declined to say if the cases related to the investigation.