A designated centre for adults with disabilities in Co Waterford run by the Brothers of Charity failed to protect residents from “all forms of abuse”, amid a “very limited” management presence.
“Very poor findings” were noted by inspectors of Comeragh High Support Residential Services, a centre comprised of two houses on the outskirts of Waterford city, which failed to comply with 18 regulations in total.
A Health Information and Quality Authority (Hiqa) inspection in August found that a limited presence of the management team in the centre had resulted in poor oversight and management of day-to-day practices.
From a review of the visitor log and discussions with staff, “it was clear that there was a very limited management presence in the centre”, the report reads.
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“For example, the visitor log indicated that the person in charge had been present in the centre only 12 times in 2024, further formal visits to complete audits were noted on four occasions,” the report reads.
The inspection found that a lack of management presence and sufficient oversight, alongside a lack of written updated guidance, resulted in the residents’ lived experience being negatively impacted.
In particular, the report noted that the provider failed to protect all five residents “from all forms of abuse”.
Residents relayed concerns about their safety, with one noting that another resident “was always tormenting” them.
Of particular concern to inspectors was an allegation that one resident had been touched on the breast by a peer.
Inspectors reviewed multidisciplinary team meeting minutes where this incident had been discussed although it had not been formally reported on the centre incident system and no corresponding records were available.
The minutes noted that the resident was upset by the incident, however, there was no recorded follow-up to this meeting. A similar incident relating to the same resident occurred subsequently.
Inspectors reviewed a sample of the incidents recorded, noting that associated documents “demonstrated poor awareness of and oversight of potential abusive engagements between residents.”
Overall, the inspectors found that there was “very poor practice” concerning safeguarding, while the provider also failed to ensure that residents’ privacy and dignity were respected.
When alleged safeguarding events were reported, these were not reported or investigated as required and although the provider’s unannounced audit report stated that work on safeguarding recognition was required, no action was taken.
On review of the provider’s incident and accident reports, it was found that three incidents of an alleged safeguarding nature were not notified to the Chief Inspector of Social Services as required.
Separately, medication was inappropriately stored and administered at the centre while records were not well maintained.
For example, one resident’s plan stated that if they did not recover following an administration of their medication then this could be repeated, however, no timelines were given, no maximum dosage was noted and no second dose was available for use.
Inspectors also noted that medication prescribed for one resident for emergency use was at the centre while they were elsewhere.
There was no specific risk assessment or written guidance in place for one resident who was regularly having seizures and had a seizure on the day of inspection.
Inspectors were told by management that the resident’s epilepsy alarm no longer worked, but that there were systems in place around the management of this risk.
However, staff practices differed on how the resident was supported at night with some staff saying the bedroom door was left open while other staff said it was closed.
In response to the findings, the provider furnished a plan outlining how the centre would come into compliance.
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