Residential care staff carry-out unauthorised use of physical restraint

Staff absences over weekend periods led to “unnecessary restrictive practices” being used at a residential centre for adults with intellectual disabilities in Co Roscommon, a report from the State’s health watchdog says.

Inspectors from the Health Information and Quality Authority (Hiqa) said the use of such practices at Heather Services impacted upon resident's rights and dignity.

The unannounced inspection, which took place over two days last October, found the centre, which is run by Brothers of Charity Services Ireland, was not compliant with seven out of 13 regulations.

Of the 25 inspection reports published by Hiqa on Thursday on designated centres for people with disabilities, a good level of compliance with regulations and standards was found in 17 centres.

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Inspectors said staffing arrangements were not always appropriate at Heather Services to meet the needs of residents and this had an impact on arrangements for the use of restraint.

“As a result there had been unauthorised use of physical restraint on two separate occasions and it was not demonstrated that the provider was upholding residents’ freedoms and right to liberty,” the inspection report said.

“While the provider had ensured that there were sufficient staffing levels being provided to meet the complex needs of the residents on most days, staff absences due to sickness during weekend periods had led to staff members utilising unnecessary restrictive practices due to a reduction in staffing numbers.”

Management structure

Inspectors also found that the management structure in place was “not effective”. They said a sample of residents’ personal plans outlined they were not being supported to achieve their individual social care goals.

The provider also failed to ensure that information regarding financial safe guarding measures for residents were available for the inspectors to review.

“Residents living in one of the houses that made up the centre had been supported to purchase a vehicle for their use. The inspectors sought to review the contracts that had been drawn up regarding the purchasing of the vehicle which should have been in place to ensure that residents’ financial interests were safeguarded,” the inspection report said.

“However, these contracts were not available for review on the day of the inspection. The provider could not therefore demonstrate that appropriate controls and consultation had been put in place to safeguard residents.”

‘State of repair’

Separately, inspectors at Le Cheile, Co Limerick, also run by Brothers of Charity Services Ireland, found a number of buildings on the campus were "in an evident state of repair".

Inspectors found that while efforts had been made to decorate, there was an obvious need for maintenance works in all parts of the centre.

“A number of surfaces were marked and paintwork was chipped throughout the centre. Although clean overall, food stains were observed on a wall in one house and on a ceiling in another,” the inspection report said.

“The bathroom facilities available to the majority of residents in two houses were of a poor standard; dust and cobwebs were also evident.”

Staff also acknowledged that some bedrooms were not a suitable size for residents who use wheelchairs.

Inspectors found that when walking through the centre, with the exception of one recently refurbished bedroom, “fire doors were not installed”.