The Health Information and Quality Authority has expressed concern over "persistent poor findings" at a number of centres for people with disabilities in Galway.
The watchdog has warned that "escalatory action" will be taken if there is failure to ensure the safety and wellbeing of residents at centres run by Ability West.
Inspectors found poor identification of the potential safety risk to staff and residents at one centre and a lack of urgency to manage residents' falls.
The centre in question has been inspected three times so far this year.
A January inspection sought an urgent review of staffing levels, following an incident that resulted in a resident sustaining an injury.
The provider assured the Chief Inspector of actions taken but a warning letter was subsequently issued by HIQA's Chief Inspector, in relation to the operations of the centre.
While there were some improvements found in February, further "urgent action" was requested from the provider - this time in respect of residents' fire evacuation arrangements.
A compliance plan was submitted after the February inspection.
HIQA's Chief Inspector undertook a "targeted inspection programme" with the provider across all designated centres, focusing on five regulations including - the person in charge, staffing, governance and management, residents’ assessment and personal planning and risk management.
The provider submitted an action plan to the Chief Inspector, outlining the steps they would take to improve compliance across all designated centres.
The latest inspection in June was the first since the programme commenced and further urgent action around the safety and welfare of a resident who was experiencing a number of falls was issued.
The inspection found that the provider was non-compliant in all five regulations inspected against and where it had previously improved aspects of the service - such as, staffing and residents' assessment arrangements.
It found poor identification of the potential risk posed to staff and residents' safety and an overall lack of urgency in the area of falls management.
'Repeated failings'
HIQA said that the "repeated failings" found in the latest inspection had not resulted in improved lives for residents.
In response, the provider acknowledged that at the time of the inspection, the person in charge was responsible for two designated centres and that this was not sufficient to assure effective governance and oversight in the centre inspected.
Among the actions taken in response to the findings was the implementation of additional supports to enhance governance and management.
At another centre run by Ability West, inspectors said oversight was required around "investigation and learning" from "serious incidents" including financial abuse.
"There was no evidence available that an incident reported to the Chief Inspector in September 2022 regarding an allegation of financial abuse relating to a resident had been fully investigated by the provider," it said.
The inspection report published this morning pointed out that there was "no learning" as a result of the incident because staff were not aware of any investigation.
In one unit on the campus, staff put a system in place on their own accord where two members checked individual residents' money balance sheets each morning and evening as an additional safeguard.
However, inspectors noted that there was no protocol in place to guide staff in these arrangements and it was not being implemented by staff in the other house on the campus.
Cope Foundation
Another report on a centre in Cork run by the Cope Foundation found there was an inadequate number of staff in April.
Based on discussion with staff members and records reviewed, HIQA inspectors said there were times when minimum staffing levels per unit would be lower than required.
This made it challenging for staff to meet the needs of residents particularly at certain times.
Staffing in the centre had been risk assessed as being a high or red rated risk.
"This did not provide assurance that suitable staffing arrangements were in place to meet the needs of residents on a consistent basis," according to the report.
Some 40 inspection reports on designated centres for people with disabilities have been published by HIQA this morning.
Inspectors identified non-compliance with the regulations and standards on 24 inspections and a good level of compliance with the regulations and standards in 16 centres operated by a number of providers.
At a centre in Tipperary operated by Avista CLG, staff spoke about the positive impact of recent human rights training on the care and support provided to residents.
They spoke about how they had supported one resident to live at the centre more independently regardless of their advancing years, which was reflected in the resident's home being adapted over the last number of years to meet their changing needs.
At a centre in Roscommon operated by Brothers of Charity Services Ireland CLG, residents could choose whether to access a day service in their local area or have a bespoke home-based service provided by the centre's staff.
