Patient isolated due to Covid was later found locked in room with excrement on floor, commission told

A care home patient was found on an excrement-strewn floor having been locked in their room overnight during the early months of the Covid-19 pandemic, the Workplace Relations Commission (WRC) was told.

In a decision published on Monday, the care worker who “blindly followed” what he said were the instructions of a HSE employee to stay outside the locked door has lost his claim for unfair dismissal.

The WRC heard the patient was found on the morning of April 1st 2020 “on his hands and knees” in his bedroom at the Ballywaltrim House care home in Raphoe, Co Donegal.

Another healthcare assistant who found the man was met with a “very foul smell” and discovered faeces on the floor – reporting the matter to his superiors as soon as he had helped the man shower, an internal disciplinary report submitted in evidence noted.

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The WRC found that there was “no malice or deliberate neglect whatsoever” on the part of care worker Varghese Matthew but that his actions on the night had been based on his “unquestioning adherence” to a direction given to him to stay outside the door.

Mr Matthew said he was given a direction by a member of staff at the care home to stay outside the door of the room at the start of his night shift and only found out the door was locked after the other worker left.

He said he understood his duties on the night to be one of caretaker, or doorkeeper; that he was not to intervene; and that he would communicate with the service user through the door.

He said the situation was “not normal” but that the patient, who had an intellectual disability, was “in isolation due to Covid”.

He told the WRC he had not been given the room key, didn’t know where to find it and would break the glass in the door in the event of an emergency.

The tribunal heard Mr Matthew was immediately suspended without pay pending an investigation following the discovery of the patient.

The HSE took initial steps, but then told his employer, Donegal Home Care Ltd, trading as Home Instead Senior Care, that it was “parking” the matter because of the crisis, the tribunal was told.

Mr Matthew was then left on unpaid suspension for a year until getting his own solicitor involved – and only then did his employer carry out the disciplinary process which led to his sacking.

His challenge to that decision under the Unfair Dismissals Act 1977 was rejected by the WRC in a decision published on Monday.

Mr Matthew’s solicitor Donna Crampsie of O’Gorman, Cunningham & Co LLP said her client got “no opportunity to confront his accuser”, “no opportunity to respond to the report”, and never received the outcome of an appeal.

She added that her client was “left to take the blame for what had happened” and that witness statements relied upon by a company investigator were taken from HSE staff without an opportunity for cross-examination.

Tommy Cummins of Adare HRM, appearing for the employer, said that although the HSE took preliminary actions under its Trust in Care Policy, a full investigation into what happened was never completed by the health service and the company was left with no alternative except to investigate on its own.

The adjudicating officer in the case, Janet Hughes, wrote: “Allowing that the complainant’s evidence was credible, no member of the HSE staff told him when or how he was to obtain a key if he needed one. In these circumstances it is not difficult to agree with the solicitor for the complainant when she says that he was the scapegoat for everything that happened that night,” she wrote.

“Any suspicion of the service user having Covid might provide some insight as to why that service user’s door was locked.”

However, although she found there was “no malice or deliberate neglect whatsoever” on Mr Matthew’s part, his actions on the night had been - according to his own evidence - “based solely on his unquestioning adherence to a direction given to him by a member of staff” to stay outside the door, she wrote – “blindly accepting a direction,” she added.

She found it was reasonable of his employer to decide that speaking to the service user through a glass panel in the door for four hours “reached a threshold of gross misconduct based on incompetence and failure to provide sound professional judgment”.

“It was reasonable to conclude that the complainant knew or ought to have known that his primary responsibility was to the service user and not to a member of the Ballywaltrim staff,” she added.

She found the investigation by the employer had been delayed and “limited” but that the “actions and inactions” of the Mr Matthew had been “fully and fairly investigated”, and upheld his dismissal.