The "wrong" model of care was provided at the Áras Attracta centre for adults with intellectual disabilities in Co Mayo with residents there generally treated as if they were "eternal children", an independent report into the facility found.
The Swinford Review Group said there was a “compelling case” to change the model of care provided at Áras Attracta and that there must be “no sitting on the fence” by senior HSE management in ensuring that happens.
Issues at the centre came to light after a RTÉ Prime Time Investigates programme broadcast in late 2014 raised concerns about the treatment of some residents in Bungalow 3 of the Swinford facility.
A review group, chaired by Dr Kevin McCoy, was commissioned to compile a report on life at the centre, which was found to be “bleak” at times.
Dr McCoy said now was the time to “face up to the failures”, listen to what residents and their families have said, and “concentrate on a better future for people with intellectual disability”.
The report described a lack of strong leadership and direction at Áras Attracta, low staff morale and “widespread institutional conditioning and control” of its 96 residents which limited their freedom.
‘Widespread control’
Such “widespread control” was generally imposed for the convenience of staff and management and the model of service was structured to suit staffing constraints rather than the needs and aspirations of residents.
Some residents had their own bedrooms, there were up to four people sharing others and few had keys to their own rooms, the review group noted.
Much “patient, kind and sensitive support” was shown by staff but the residents were generally treated as if they were “eternal children”, the report says.
There was evidence of disrespect towards residents and some of their health issues were not adequately investigated. Some staff were insufficiently trained and there was no formal supervision of them.
The report recommends 13 actions for change be taken by the HSE to improve the quality of life of residents - these include moving to a rights based model of care, listening to the voices of residents and their families, and strengthening leadership and management.
It also proposes an action plan for moving intellectually disabled people, provided they wish to do so, into smaller domestic units in the community. Some 27 people are being moved from Aras Attracta this year.
In response, the HSE said the recommendations would inform its six step programme, established in 2014, of measures to improve service quality and safeguarding practises in disability services.
Disciplinary process
The HSE also said investigations and a disciplinary process was continuing arising from the Prime Time programme and there have been management changes at Áras Attracta.
Dr McCoy said his team expects the HSE to report within 12 months on its progress in implementing “deep transformational change” at Aras Attracta and elsewhere.
Pat Healy, HSE national director of social care, said the report was a "roadmap" for future service provision nationally for people with disabilities.
Mr Healy said people were “shocked and dismayed” at what the TV programme had shown in relation to the treatment of some residents. He reiterated the HSE’s apologies to residents and their families.
Tony Canavan, chief officer of the HSE area where Aras Attracta is located, said a new director of services has been in place since 2015, Áras Attracta had been divided into three separate centres with their own management, and safeguards were in place to address any incidents that might occur.
Mr Canavan said the HSE was buying properties in Co Mayo to move residents into the community and had engaged residents in discussions about that.
