Patients at ‘risk’ due in understaffed centre

Low staffing levels at a residential and day care facility in Sligo for people with intellectual disabilities poses a risk to patients, as well as to the staff themselves, according to a report.

The risk is "substantial and increasing rapidly as people age and their levels of dependency rise", according to a report by The Wolfe Group into Cregg House in Sligo, which is run by the Daughters of Wisdom, a religious order of the Roman Catholic Church that traces its origins back to 18th century France.

The Wolfe Group is an audit company whose specialities include advising health care institutions preparing for inspections by the Health Information and Quality Authority (Hiqa). Its report into Cregg House found there had been two “recent significant near misses”, in which service users could have been seriously injured.

Potentially catastrophic
"The evidence points to a highly likely occurrence of serious harm befalling a service user or staff, with a potentially catastrophic consequence, due to the existing inadequate staffing levels," added the authors.

The review of staffing levels and of the facility’s ability to comply with national safety standards was commissioned by the board of Cregg House, which has been run by the Daughters of Wisdom for 58 years. There are 186 patients in residential care, and a further 24 attend day services.

Urgency
The Wolfe Group report states that staffing levels at Cregg House are "ultimately wholly inadequate to provide a safe service". The authors concluded that a considerable increase in staffing levels is needed "as a matter of urgency".

Among the findings was that unexplained injuries among service users at Cregg House increased from 26 in 2011 to 56 the following year, while incidents of slips, trips and falls rose from 85 to 151 in that period. Incidents of violence, harassment and aggression rose from 180 to 240, according to the consultants.

The authors commented that, having extensive experience of services for people with intellectual disability nationwide, Cregg House was “the most understaffed service that we have seen”.

Staffing levels were described as “ minimal” to a degree that service users in many situations were getting “custodial care” only.

Funding shortfall
In April 2012 the order said it was pulling out of Cregg House because a shortfall in HSE funding meant it could no longer stand over the service. In June the HSE obtained a High Court injunction preventing the order from ceasing operations before responsibility for the patients could properly be transferred. The HSE is due to take over on October 1st.

The Daughters of Wisdom have been criticised by the trade union Impact, who accused the order of failing to sign a termination agreement.

Union members at Cregg House recently backed a no-confidence motion in the board and the order by a margin of 90 per cent.

In a recent statement, Sr Jean Quinn, provincial of the order, said it had come to realise that “at present, it is too much to expect adequate support to meet the needs of persons with intellectual disabilities from the HSE or the State” .

The number of full-time equivalent posts had dropped from 336 in 2008 to 292 at present, with one staff member often responsible for six to seven service users, the report stated.