Disabled residents ‘shouted at’ in Tipperary care centre

Disabled residents were shouted at and called names by staff of a Tipperary based centre for people with disabilities, inspection reports by the Health Information and Quality Authority reveal.

Inspections of St Anne’s Residential Services in Roscrea found units were under-staffed meaning residents’ activities were sometimes restricted to walking around an internal courtyard.

The reports identify an unsuitable mix of residents resulting in peer-to-peer abuse, including two instances where one resident pulled another from his bed and threw him onto the floor.

They found certain restrictive practices, including physical and chemical restraint, were not in accordance with national policy.

An initial inspection was carried out on December 19th, 2014 within days of Hiqa receiving allegationsof poor practice at the centre.

Ten staff members and one agency staff member were placed on leave. All remain off duty with pay.

The centre, run by Daughters of Charity Disability Support Services and funded by the Health Service Executive (HSE), houses 129 individuals with intellectual disabilities across 26 units.

An inspection in December of two interconnected bungalows accommodating 31 residents found:

- evidence of residents being shouted at and use of inappropriate language including name-calling

- inappropriate staffing levels: five of six staff interviewed said there was not enough staff and nursing staff

- an unexplained bruise on the body of resident had not been correctly recorded

The inspection of a further unit housing nine residents found staff did not have the appropriate knowledge and skills to respond to challenging behaviour. This was despite one resident in their care being involved in four significant incidents in the six days prior to inspection.

Immediate risk

Inspectors found this posed an immediate risk to the health and safety of residents and staff and directed management to take immediate action.

Further issues were identified during inspections carried out in two units on separate dates in January.

Inspectors found residents did not have an an opportunity to engage in meaningful activities. On weekends, residents’ activities were restricted to a walk on the grounds or within the internal courtyard.

One resident only participated in one activity in a full month and inspectors were told there were not enough staff to facilitate outings for the centre’s eight wheelchair users.

One record showed that one resident’s “activities” included emptying the dishwasher, bringing in groceries, doing laundry and making tea.

Some bedrooms were “significantly limited in size”, some areas were badly designed, in a poor state of repair or unclean.

During an inspection carried out on January 27th Hiqa recorded nine major non-compliances out of the 10 regulations inspected.

In a statement, the chief executive of Daughters of Charity Disability Support Services Denis Cronin said the organisation had developed comprehensive action plans to address all issues raised.

He said significant budget cuts and a moratorium on staff recruitment in recent years had had an effect on service delivery and that talks were underway with the HSE to address “key resource issues”.

However, HSE Mid West chief officer, Bernard Gloster disputed a claim that its funding was cut by 17 per cent in recent years. He said the service received €12.3 million in 2010 and €11.6 million in 2014.

“The HSE...is aware of pressures caused by the financial constraints and cut backs of recent years. I am, however, concerned that this is often the only reason cited when there are negative findings in services,” he said.

“While it will take us time and resource to deal with many of these legacy issues our immediate concern and attention has to be in relation to positive care practices and zero tolerance of any untoward, abusive or negative treatment of service users. These are not caused by resources or staffing levels.”