Action on ‘unsafe practices’ not taken at Sligo centre - Hiqa

Notices requiring immediate action on unsafe practices at a HSE-run centre for people with intellectual disabilities in Co Sligo have not been acted on, the State’s health watchdog has said.

Previous reports, from the Health Information and Quality Authority (Hiqa), found under-staffing and inadequate care at Cregg House, a large congregated setting about 5km outside Sligo town. The centre is home to 108 people.

Two follow-up reports on the centre have been published along with a report on two units which had not been inspected previously.

The follow-up inspections were conducted on February 10th and 11th, and on the April 9th and 13th.

The February inspection report, which focuses on two units, comments: “On previous inspections the Authority had identified non-compliances relating to governance, staffing levels, a lack of social activities and risk management. On this inspection the provider had not adequately addressed these areas of concern.”

‘Insufficient governance’

The April report, which looks at regulatory compliance across the Centre, comments that while there had been improvement “governance and management in the centre continued to be insufficient...inspectors continued to find non-compliances”.

Ongoing issues include:

-staffing deficits “which were having a direct impact on the quality of life for residents”

- opportunities for residents to participate in meaningful activities are “very limited”

- assessments of residents’ care and support needs are inadequate

- all staff had still not completed mandatory training in fire safety, manual handling and infection control

- menus are monotonous and kitchen arrangements inadequate at weekends and over bank holidays.

Two units at Cregg House were inspected for the first time on February 20th at 10.30 am and again at 9.30 pm.

These units accommodate 10 residents – seven women and two men with learning disabilities and other complex needs. A sixteen year-old child was also accommodated in one of the units. The unit “inappropriate” for the child.

“The child’s family had sought a community placement in a house with other children but no suitable place was available in the region.”

Staffing low

The inspection found:

- staffing levels were critically low

- residents had limited opportunities to participate in meaningful activities or engage with the local community

- staff had not completed training in managing challenging behaviour

- management arrangements were ineffective in ensuring a safe service

- menus were the same each week, offered no variety and residents had no input into planning their meals.

“Inspectors found that the residents’ lives were generally focussed in the centre,” says the report. “Staff described going to local coffee shops and restaurants but care records indicated that such events took place infrequently.

“A mini bus was available for outings, however, this needed to be booked in advance as it was shared with other units and not all staff could drive the bus.”

Following the inspection, Hiqa called the HSE management to attend a meeting at which “serious concerns in relation to the safety of residents and the quality of life for residents in the centre” were raised.

The HSE told the authority governance improvements were being introduced and there were plans to move all residents to more suitable, community-based accommodation within two years.

Hiqa told the HSE that notwithstanding plans “they were required to address the areas of non-compliance and ensure their actions resulted in significant improvements to the quality of life for residents”.

The HSE was provided with a list of required actions and a timeframe in which to achieve this.