Residents of a centre for people with disabilities were prescribed regular medication for “inappropriate sexual behaviour” without any consent or consultation, a report by a health watchdog has found.
The Health Information and Quality Authority (Hiqa) found two centres in Palmerstown in Dublin, run by Stewarts Care Limited, were not safe and failed to ensure the residents were protected from abuse.
Inspectors said institutional practices were continuing to impact negatively on residents’ lives, and the provider was failing to provide a safe and reliable service which appropriately met residents’ needs and protected them from abuse.
Hiqa on Tuesday published 21 reports on residential services for people with disabilities.
Twelve were found to have a good level of compliance, including four operated by Waterford Intellectual Disability Association, but areas of non-compliance were found in nine others.
During an unannounced inspection of the Stewarts Adults Services in July, inspectors noted “significant concerns” and “major non-compliance” with the regulations.
Restrictive practices were in use throughout the designated centre including “environmental, physical and chemical restraints, some of which had not been notified” to Hiqa as required.
Two residents were prescribed, and being administered, regular steroidal anti-androgen medication, the inspectors found.
“A staff nurse working in the area confirmed that this medication was for inappropriate sexual behaviour,” the report said.
“There were no risk assessments relating to the use of this medication, or forensic reports available for either resident. Inspectors were concerned with regards to the welfare and rights of both residents for whom this medication was prescribed.”
The inspectors said there was “an absence of consent, evidence of consultation with the residents or their family members, or independent advocacy services relating to this matter on the file of either resident”.
Hiqa said serious health and safety concerns were identified at the unit, where 29 people were living on the day of the inspection and residents’ rights, dignity and privacy were not upheld or respected in full.
Of a total of 47 incident records, 16 potentially met the definition of abuse. The incidents included peer to peer physical abuse, unexplained bruising to residents, and unexplained injuries to residents.
In the case of one resident who appeared in a distressed state, inspectors observed that by 11.25am they had not received breakfast and in the previous 14 hour period had no record of any fluid intake.
At another Stewarts Adults Services Centre (designated centre 3), also operated by Stewarts Care Limited, inspectors found one resident’s personal savings were used to build an extension to a building and provide the person with private bedroom area with an ensuite and a separate sitting room area.
In a statement, the board of Stewarts Care said it put “quality of care and the needs of its residents at the very top of its priority list”.
“Regrettably the inspections reported today found we did not meet the standards we have set ourselves and which we accept are required and appropriate,” it said.
“Over the past six months Stewarts Care, led by its board, has engaged with a significant process of change in the governance and operation of all its services. These changes are significantly advanced but are still in progress.
“They address both the specific issues raised by these reports and underpin a reinforced commitment across Stewarts Care services for the benefit of all service users.”
The organisation said it had been in “active dialogue” with its service users, their families and guardians, staff and the HSE on the detail of that change process.
“We recognise and accept the need for change and are fully committed to completing the planned response programme.”