Inspectors have expressed concern over the safety of disabled residents in a residential centre where staff were not trained to deal with their challenging behaviour.
The concerns are reported in an inspection report published today by the Health Information and Quality Authority (Hiqa) into a centre in Co Meath run by St Michael’s House, one of the biggest disability service providers in the State.
The unannounced inspection into the five-bed unit, which provides care for adults with disabilities, was prompted by information provided to the authority by a whistleblower. The inspection took place between January and February of this year.
Among the key concerns flagged included evidence of residents being secluded on occasion, front doors locked on an ongoing basis, no needs assessments being conducted and a lack of access to outside advocates.
In one incident, a resident was locked into a room after getting involved in an altercation with another resident, even though the practice of seclusion is prohibited at the centre.
In another, a resident displayed ongoing self harm, however there was no formal behavioural support plan on how the person should be supported and protected.
Inspectors found that while there was evidence of some good practice in the service, there were mandatory improvements required in order for the centre to comply with seven key care standards.
Many of these related to under-staffing or a lack of training. Some of the key findings included:
* The designated centre did not undertake an assessment of needs for residents, as required under care regulations
* Residents were not enabled to make choice about how they lived in a way that reflected their individual preferences
* It was was documented in daily notes that service users hit out at other service users, but many of these incidents were not recorded
* Residents had no access to an advocate and the service had no advocacy programme.
Overall, inspectors found there were insufficient staff numbers in the centre to meet all needs of all residents.
Staff reported that service users required various levels of support. Four required full assistance with most activities of daily needs and one required more verbal prompts than full assistance.
However, inspectors were unable to confirm this as there were no assessments of needs in their individual care plans.
In addition, the person in charge of the unit told inspectors there were insufficient staff numbers to allow for records and personal plans to be updated.
The inspection report added: “Considering the complex needs of the service users and the high number of incidents read in the file of one service user alone, staff were not appropriately skilled in reacting to behaviour that challenged.”
In response to the inspection report, St Michael’s House pledged to deal with all the breaches highlighted.
Among the actions it says it has undertaken include ensuring parents and family members are actively involved in supporting their family members to participate in all aspects of their care; a clears complaints policy; and access to advocacy services.
It also pledged to ensure a comprehensive assessment of all residents’ health, personal and social care needs, along with extra training for all staff members.
