Inspectors have called for no further admissions to a residential centre for adults with intellectual disabilities in Co Cork after it was found to have “serious and significant non-compliance” with health legislation.
Health Information and Quality Authority (Hiqa) inspectors found residents regularly suffered minor injuries following assaults by other residents.
Inspectors reported concern about one resident being physically restrained for a routine blood test.
The centre had insufficient staff with unsuitable skills mix and inspectors reported poor quality accommodation with broken and rusty appliances, dirty mattresses, toilets and work areas, despite outside contract cleaning services.
Staff were insufficiently supervised, the report found.
An external review of the service was conducted early last year, which detailed a wide variety of issues that needed to be addressed but there was “no evidence of any learning or any improvements in the centre following the review”.
The unnamed centre run by the Cope Foundation had its first inspection by Hiqa on November 5th and 6th 2014, which was unannounced.
The centre has eight houses with residential services for up to 41 adults. The majority of residents have significant intellectual disabilities and some require significant additional supports for “behaviours that challenged”.
The report found that many residents required a high level of assistance and monitoring but were “not provided with a person centred and quality service that allowed opportunities for them to achieve their full potential”.
Some were provided with appropriate activities and outings but many were not and sat for long periods without any interaction.
Inspectors asked for no further admissions to the centre until significant improvements are made to meet the requirements of the 2007 Health Act.
The report said “staff generally were observed respecting residents’ dignity by the manner in which they engaged with residents”.
But “there was robust evidence that residents’ rights and dignity were compromised as they were not consistently provided with opportunities to achieve their full potential”.
They found “staff demonstrated a poor understanding and poor recognition of the abusive nature of residents physically assaulting other residents”.
The report said “staff were not appropriately supervised and there was not a sufficient number or suitable skill mix of staff employed in the centre to monitor residents and meet all of their needs”.
This had a “significant negative impact on the care for residents”.
There was “no evidence that all the required measures had been taken to protect residents from being injured following these incidents of peer assault”. And “this placed resident an ongoing risk of potential injury”.
Inspectors found some of the accommodation in poor condition with broken and rusty appliances, dirty mattresses, walls and toilets, cobwebbed ceilings and “visibly unclean” work surfaces, despite 1.5 hours of cleaning a week for each house from outside contract cleaners.
In one instance “one bed mattress had a large brown stain” with “a foul odour emanating from another mattress”.
The health care information of individual residents was “disorganised “ and kept in different files in various locations making access to up-to-date information difficult.
Overall, the inspectors found “serious and significant non-compliance in relation to a number of fundamental and essential components of the requirements of the Health Act 2007” including:
* Insufficient number and inappropriate skill mix of staff in relation to residents’ required support needs
*Inadequate supervision of care practices and staff
*Poor risk management processes and systems across the centre
*An unclean premises and in some areas poorly maintained premises
*Care plans that did not identify each resident’s actual needs
*Poor access to meaningful activities for residents with many residents sitting for long periods without any interactions
* Staff were not provided with access to appropriate fire safety training
The Cope Foundation, which runs a number of centres in Co Cork, has pledged to undertake advocacy awareness roadshows for staff and residents at all its centres. It said advocacy training will be carried out and a protocol for protecting residents from assault is being issued.
The Cope Foundation said staffing levels had been strengthened and a submission to the HSE was being prepared on staff requirements.
Maintenance work has commenced with areas of immediate concern dealt with. Contract cleaning hours have been increased with an audit system in place.
