Inspectors have urged a health board to tighten up procedures for administering medication at a children's home in the eastern region after it emerged one child was given twice as much medication as was prescribed.
There were also times when part of the child's course of medication was missed, a team from the Irish Social Services Inspectorate found when it inspected St Mary's Children's Residential Centre in Dublin. It is run by the East Coast Area Health Board and houses 10 children, both boys and girls, aged eight to 18 years.
The inspectors' report, which has been seen by The Irish Times, said there were "significant problems" with the manner in which the administration of medication in the home was recorded. "In one instance, a child received twice as much medication as prescribed and in other instances, parts of the course have been missed," it said.
"Staff also spoke of medication being taken to wherever the child was, for example, in the dining room or watching TV and of there being no record kept of the administration of the tablet.
"Medication was seen by inspectors in several places in the centre: on the top of a filing cabinet in the office, in one of the staff bedrooms and in a first aid box. Children did not have direct access to these, but it is not acceptable that some medication is kept other than in one locked cabinet secure and large enough to ensure safety in each unit. There is a clear need for a tighter and more accountable system so that there is no room for error between staff members and between changes in shift," the inspectors said.
The standard of safety and material condition of the building was also a matter of "serious concern" to inspectors. They pointed out that a health and safety adviser had in April 2001 identified 68 hazards, 10 of which were considered high risk and were to be dealt with immediately. However, at the time the unit was inspected by the inspectorate last October, only 10 of the adviser's recommendations had been followed up and eight of the identified high-risk hazards had not been tended to.
"This is totally unacceptable . . . the board is urged to ensure that all the recommendations of the assessment are responded to without further delay, and that priority be given at all times to the health and safety of the children in the board's care," the report said.
It was pointed out to the inspectors that fire doors would be installed early this year if funding was provided. The inspectors said funding should not be in question for something like this.
Inspectors also found that checks were not carried out on all staff before they took up duty. However, they found the quality of day-to-day care of the children in the unit was good, staff were caring and committed, they had warm relationships with the children and the centre was effectively managed.
A spokesman for the East Coast Area Health Board said significant steps had been taken to improve residential childcare facilities in its area since the inspection was carried out. "We are continuing to develop policies and procedures to ensure our homes meet the required standards," he said.
These included a policy on the safe keeping and administration of medication. A policy had already been put in place for the vetting of permanent and temporary staff, he added. On issues of safety raised in the report, "some work" had been undertaken. "We have sought and are awaiting a financial allocation from the Eastern Regional Health Authority for further renovations at St Mary's."