Disabled residents sought refuge from attacks in bedrooms - report

Residents at a disability centre in Limerick sought refuge in bedrooms and staff offices because they feared attacks from peers, a report has found.

An inspection by the Health Information and Quality Authority (Hiqa) conducted in April found there was a “palpable atmosphere of fear” in one particular section of the St Vincent’s Residential Services centre in Limerick.

A report produced following the unannounced inspection said staff were on constant high alert when residents were in the compound, which comprises two bungalows each housing six residents with intellectual disabilities.

Concerns were raised in relation to two residents in particular who continually lashed out by hitting, kicking and shouting at other residents and staff members, and Hiqa officials concluded that the service provider had “failed to act” to protect those in the centre from peer-to-peer abuse.

While staff did their best to maintain a calm atmosphere, they were working in a “volatile situation which had the potential to compromise both their safety and the safety of residents”, according to the report released on Thursday.

Inspectors witnessed a member of staff being kicked on the day of the inspection, and the two problematic residents in question were also prone to “frequent verbal outbursts” and “taunting type behaviour”.

The report said the mix of residents in the centre did not ensure protection from peer-to-peer abuse.

The centre was found to be either fully or substantially compliant in 11 out of 18 standards tested against by Hiqa. It forms part of a broader campus operated by the Daughters of Charity in Limerick.

Responding to a recommendation from Hiqa for more tailored behavioural support services, the care provider said a clinical nurse specialist has been enlisted to review the behaviour management of individual residents in an attempt to prevent future violent outbursts.

Despite their concerns inspectors did note that residents were well cared-for overall, and they appeared to be happy and comfortable in their homes.

A separate inspection in another part of the campus carried out in August found that a building housing residents was not constructed “in a manner capable of containing a fire”.

The building in question can accommodate nine people, but internal walls “would be incapable of containing a fire” due to the way they were constructed and the presence of glazing within the walls, according to the report.

Furthermore, an open cavity in the roof space above the ceiling meant that heat and smoke could easily enter that area and travel around the centre, bypassing all walls and doors.

“This could potentially lead to occupants being trapped due to the unseen movement of heat and smoke throughout the centre in the roof space before descending in an area of the centre remote from the fire,” inspectors said.

Management for the centre agreed to arrange for a logistics planner to review escape routes, and said funding will be requested to implement recommendations arising from the review.

The results of visits to four compounds within the St Vincent’s campus were released as part of a raft of 20 reports on residential services for people with disabilities published by Hiqa on Thursday.

Elsewhere, inspectors recorded a "significant level and frequency of aggressive behaviour" at the Highwater Lodge centre in Wexford, which is home to three residents, and medications were stored in an unsecured treatment room in the Hollybank centre in Dublin.

The reports contained good news for four centres run by the Muiriosa Foundation in various parts of the country which generally ensured a good level of compliance with regulations.

Similar findings were made for services run by the Western Care Association, Northwest Parents and Friends Association for Mentally Handicapped Children, and Three Steps disability support.