Residents spat at in Kildare disability centre, Hiqa finds

A disability centre in Co Kildare failed to ensure residents were safe, according to a report from the health watchdog.

The Health Information and Quality Authority (Hiqa) said “verbal aggressions and attempted physical aggression was a daily occurrence” for residents of Broadleaf Manor, run by Nua Healthcare Services.

An unannounced inspection was carried out by Hiqa on May 2nd, the fourth inspection at the centre. An inspection conducted in February 2017 identified significant failures in the quality and safety of care provided to residents.

“Residents had been spat at by other residents. On one occasion, a resident was directed by staff to go outside for a cigarette to protect them from assault from a peer,” the report said.

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Inspectors found that staff employed in the centre did not have the knowledge necessary to support residents based on their assessed needs.

“As a result basic areas to promote positive behaviour such as adequate fluid and nutrition were not being recorded to demonstrate that individuals’ needs were being met,” the report said.

“There was a focus on training of breakaway techniques and physical restraint. This resulted in physical restraint being the primary intervention.”

Physical restraints

Over a 10-week period, there had been 78 physical restraints while in one incident a resident was restrained for a total of 40 minutes, the report found.

The most recent inspection was undertaken to ascertain if action taken by the provider following the February inspection was effective in ensuring residents’ safety.

Despite the provision of additional staff and the discharge of residents, the report said “the impact of these actions did not result in a safer service”.

Inspectors identified that the primary purpose for the additional staff was to “stand between residents and physically intervene to prevent assaults from occurring”.

As part of the inspection, inspectors met three residents along with staff and reviewed documentation such as residents’ personal plans, health and safety documentation and audits.

Inspectors found there was an absence of therapeutic interventions for some residents including occupational therapy for sensory integration. They also found staff were “not clear” on who was accountable for ensuring appropriate referrals were made.

‘Challenging’

The report noted the person in charge stated that it was “challenging” to provide a consistent approach due to the high level of staff turnover in the centre as a result of sick leave and annual leave, which resulted in inexperienced staff supporting residents.

Inspectors found there was “an absence of proactive planning in place” to support residents to be discharged in a safe and planned manner.

The report also noted there were issues regarding access to a fire extinguisher and an evacuation route. A fire drill record submitted to Hiqa stated that it took staff seven minutes to evacuate the residents and there had been challenges evacuating some residents.

In response to the inspectors’ report, Nua Healthcare detailed a number of measures that would be implemented in the coming months to address the issues raised.