CCTV used in resident’s bedroom at disability care home, watchdog finds

A health inspector found “significant use of restrictive practices” at a Dublin disability care home including the use of CCTV cameras in resident apartments and in one resident’s bedroom.

State watchdog the Health Information and Quality Authority (Hiqa), found that SVC-SDN care facility at Ashtown in Dublin 7 had not appropriately considered the individual rights of residents under Article 14 of the UN Convention on the Rights of Persons with Disabilities.

The inspection of the Daughters of Charity Disability Support Services centre found “mixed findings” including good compliance with staff, complaint-handling and infection control rules.

However, the inspection on December 17th identified “a number of concerns including the use of restrictive practices, the management of behaviours of concern, the manner in which residents were supported to exercise their personal rights and the management of risk,” Hiqa said.

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One resident was restricted from accessing running water even though it was found from a trial ongoing since August 2019 that free access to a tap had not resulted in any negative issues.

“The inspector found that the individual justifications for, or risks associated with, the use of some of these restrictions were unclear,” the report said.

“ The restrictions were not applied in line with national guidelines and in many cases the use of these restrictions was not recorded or logged.

“The restrictions were found to have a significant impact on the freedom of movement and civil liberties of residents.”

The inspector found deficits in staff training across a number of areas, including first safety, food safety and the management of behaviours of concern.

During a walk-through of part of the centre with the person in charge, the inspector did not enter certain parts of the home because they were deemed to be “in crisis.”

Hiqa said some parts of the centre were “not maintained to an appropriate standard” with broken tiles in bathrooms, stains to floors, dirty walls and a broken toilet seat in one bathroom.

“Overall, the inspector found that the premises of the centre were not designed or laid out in line with the statement of purposes and did not meet the individual needs of residents,” it said.

“In some cases, the internal space available to individual residents was limited and sufficient outdoor space was not available for some residents.”

The findings were included in one of 25 inspection reports on designated centres for people with disabilities published by Hiqa. The regulator found a good level of compliance with regulations and standards in 17 centres but non-compliance on eight inspections.

HSE-run services

Among the residential care facilities that Hiqa expressed concern about was a publicly run Donegal care facility for people with disabilities, where it found ineffective management of suspected Covid-19 cases after an inspector observed staff not following isolation measures.

Hiqa found that the Health Service Executive-run St Martin’s House in Donegal had staff looking after a resident who was self-isolating on the advice of public health as well as other residents at the centre. The facility cares for four adults in a three-bedroom detached bungalow.

Hiqa said that the centre’s Covid-19 response plan stated that staff members assigned to isolated residents should not interact with other residents and have “minimal interaction” with colleagues during the shift but that the inspector found one resident interacting with all staff.

“The overall physical environment continued to be unsuitable for the numbers and needs of residents, and the response plan for managing isolation requirements required improvements,” said the inspection report.

At another HSE-run care facility, Tonyglassion Group Home in Monaghan that looks after five residents with complex needs, Hiqa found high levels of restrictive practices including locked doors, bathrooms, kitchen cabinets and storage presses, and restricted access to running water.

“The dignity of some residents was impacted by the high levels of use of restrictive practices in the centre,” said the inspector following a visit on January 28th.

Hiqa found that while there was access to independent advocacy services, there was no active involvement from these services “despite the significant restrictions which residents experienced.”