‘Smell of urine’ reported by inspectors at residential facility

Hiqa inspectors reported a “strong smell of urine” in two bedrooms at a residential facility for adults with intellectual disabilities during an unannounced inspection last year.

Inspectors found that while some residents were happy in the centre, others said they were unhappy, and appeared upset, frustrated and anxious. Staffing levels and high staff workloads were criticised, shifts went unfilled, and there were “insufficient resources” at times, which served to “adversely impact the quality of life of residents”. A resident was unable to use their bathroom as it was not wheelchair-accessible.

St Clare's Disability Service in Meath, which is run by Dundas Ltd, provides residential services for people with intellectual disabilities and brain injuries who may have complex care needs and challenging behaviours.

Rooms in the centre were also being used to support other residents from separate centres. The inspection also identified numerous internal and external doors that were locked “without any clear rationale”. The inspectors also witnessed a resident being restrained by four staff members, but “it was not clear that this was the least restrictive option available”.

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While many risks were identified and managed, the Hiqa team also found oxygen cylinders unsecured and beside radiators.

‘Not homely’

The premises was “not designed to meet the individual needs of residents” and “not homely”.

“The centre was unclean in areas and was not in a good state of repair in others,” inspectors said.

Residents’ health plans were not always implemented into practice, while allegations had been made that were not investigated through the centre’s safeguarding vulnerable adults policy.

Reports published on Thursday show that non-compliance was detected in eight centres

Inspectors were “not assured that the current systems of governance and management were effective in ensuring a safe or appropriate service to the residents”.

The Hiqa inspection teams, which made a combination of announced and unannounced visits at the centres in the last six months, surveyed a total of 20 premises. Reports published on Thursday show that non-compliance was detected in eight centres. Across the other seven centres inspected, there were multiple incidents of non-compliance with staffing levels as well as medication management and governance.

Residents’ rights

A facility at Ardnacrusha in Co Clare run by the Brothers of Charity was found to be not compliant on six of the seven regulations it was assessed under, including general welfare and development and residents' rights.

The centre provides facilities for four residents with mild to moderate intellectual disabilities. While residents said they were pleased with support from staff, they also expressed unhappiness with support for weekend and evening activities. Residents were often unable to leave the centre in the evening, and targets set in compliance plans issued after the last Hiqa inspections had not been reached. The Hiqa report said that a lack of staffing resources “impacted on residents’ freedom to exercise choice in their daily lives”.