One in five disabilty centres fail to fully comply with any of regulations inspected

Almost one in five residential care centres for people with disabilities failed to fully comply with any of the regulations which Hiqa inspectors assess.

Health Information and Quality Authority (Hiqa) inspectors assess up to 18 regulations (or “outcomes”) in residential centres for adults and children with disabilities, including checks that residents’ healthcare and social care needs are being met; that residents are housed in safe and suitable premises; that there are appropriate staffing levels and expertise to cater to their needs; and that the rights and dignity of residents are respected.

In the inspection reports published to date, Hiqa has assessed the individual regulations almost 1,900 times.

Analysis by The Irish Times of the outcomes in each case show that, in two-thirds of cases, the provider did not fully comply with the regulations inspected.

Where failures were recorded, almost one in five (18 per cent) involved major non-compliances with the regulations.

In 37 inspections (18 per cent) the provider being assessed failed to fully comply with any of the regulations assessed by Hiqa inspectors.

Major non-compliance

A centre for people with disabilities operated by

Autism West

Ltd in Galway was found to have major non-compliances in 11 of the 12 areas assessed. Issues raised by inspectors included a lack of appropriate systems to protect the health, safety and welfare of residents; mould on some walls and the identification of risks around medication management.

In a response, the provider detailed actions being taken to address issues raised, adding that where improvements had not already taken place they would be carried out by autumn 2014.

Four inspections of three units run by Stewarts Care in Dublin also failed to fully comply with regulations.

In one unit inspected in December, inspectors identified issues around the excessive use of locked doors, and care plans which did not specifically detail the physical care interventions required to assist certain residents.

The provider responded saying all matters raised would be implemented by mid-2014. In a subsequent inspection of the same unit in February, Hiqa said two of four outcomes had been satisfactorily addressed and that the provider had committed to a process to implement systems and practices to ensure compliance.

In the HSE-run Arás Attracta in Swinford, Co Mayo, "major" non-compliances were found under all three outcomes inspected in February, including residents being left without food for up to 15 hours; some residents being under weight and residents being rushed at mealtimes and offered spoonfuls of food before they had swallowed the previous bite.

In a further inspection carried out in May, “moderate” non-compliances were recorded in six of the nine regulation areas assessed, but inspectors said issues around nutrition and the use of restrictive practices had “significantly improved” in the interim period.

Repeat inspections

Since inspections of residential centres for people with disabilities began in November last year, Hiqa has published more than 200 inspection reports covering 192 centres which are home to more than 2,100 individuals across Ireland. Repeat inspections have been carried out in 10 locations.

Phelim Quinn, director of regulation with Hiqa, said further engagement with service providers would commence in September 2014 with the aim of addressing some of the patterns and issues identified in the inspections carried out thus far.

Mr Quinn added that inspection reports, which are published on the Hiqa website, comment on all areas of the service, highlighting good standards of care as well as looking at areas where improvement is required.

There are approximately 9,800 people with a disability living in 1,300 residential care services in Ireland. These centres are run by 88 service providers, both HSE-provided services and those run by voluntary providers.

Hiqa inspects residential services against the National Standards for Residential Services for Children and Adults with Disabilities, published by the organisation in May last year, as well as assessing on relevant legislation and regulations.