Disabled residents ate alone out of fear of assault, Hiqa report finds

The risk of physical assaults at a disability centre in the Midwest meant residents often ate alone in their rooms and staff had objects thrown at them, according to a new report.

Following a two-day visit to the unnamed Brothers of Charity-run service in the Midwest, Health Information and Quality Authority (Hiqa) inspectors expressed concerns that neither staff nor residents were being sufficiently protected from harm and injury due to the threatening behaviour of some of the 10 residents.

It was said that the behaviour, which included incidents of striking, staff being “cornered” and other acts of physical aggression, impacted negatively on service users who have been diagnosed with a broad range of physical and mental disabilities.

Staff were advised by management to remove objects that could be thrown at them when interacting with residents, and management took the unusual step of authorising the use of “firm physical restrictive holds” in certain threatening situations.

However, Hiqa officials noted that some staff did not consider this a practical or safe solution, a point echoed by the visiting inspectors.

As such, the centre was deemed to be non-compliant in regard to regulations governing the safeguarding and safety of residents, but inspectors noted evidence of good practice in other areas such as residents’ rights and access to medical reviews.

The report was one of 20 released by Hiqa on Tuesday, all of which dealt with disability services nationwide.

Overall, nine Brothers of Charity centres were reviewed as part of a series of announced and unannounced inspections earlier this year.

Three of these services demonstrated an ability to adequately meet residents' needs, but a variety of issues were identified in relation to other facilities in Limerick, Cork and Waterford.

Significant risks were recorded in three of eight centres run by St John of God, with failures to meet safeguarding, health and social care needs of residents among the primary criticisms voiced by Hiqa.

A St John of God campus in Dublin 8 which housed 14 residents did not meet any standards tested against, with major non-compliances identified across nine categories during an unannounced visit in May which was prompted by unsolicited information from a member of the public.

At another large centre in Louth, Hiqa inspectors came across a case where a resident who suffered self-inflicted swelling and bruising around the eyes was not taken to hospital. This directly contradicted the recommendation of the nurse who flagged a risk of concussion.

The person in question was eventually taken to see a GP some six hours after the bruising was initially noticed, and they were in hospital by the time of the inspection visit in May.

An excerpt from the Hiqa report read: “Prior to the GP visit, there was insufficient documentary evidence available to show that an evidence-based approach to managing a resident at risk of concussion had been implemented.

“Records of neurological observations were not available to track any deterioration in the resident’s condition.”

In a statement released today, the health watchdog said: “A third St John of God centre did not have effective governance and management systems in place. Improvements were required in healthcare plans, activity provision and fire safety procedures.”