Residents in Donegal HSE centre restricted due to layout of home

Residents with intellectual disabilities living in a HSE centre are subjected to a number of restrictive practices due to the layout of their home, an independent report has found.

Under the Health Act 2007, a restrictive practice is defined as “the intentional restriction of a person’s voluntary movement or behaviour”.

The HSE's Sean O'Hare unit, in Stranorlar, Co Donegal, which houses six residents with intellectual disabilities, has a number of these practices in place, including bed rails, bumpers, key codes on front and rear doors and shared bedroom facilities.

The practices are in place in response to safety concerns, healthcare needs and environmental facilities, an inspector for the Health Information and Quality Authority (Hiqa) said.

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However, the inspector found that residents’ bedrooms were in shared dormitories that “did not promote residents privacy and dignity”.

The report states the inspector found “the ethos and culture of the centre was one which placed the resident at the centre of care” but changes to the current environment “would further promote residents’ rights and assist in implementing the least restrictive practice possible”.

In its response to the inspector, the HSE said it was addressing these restrictions through the provision of alternative accommodation, due for completion by December 2019.

Restrictive practices

The inspector found that this plan would potentially reduce the use of some of the restrictive practices, such as the removal of locked doors to the centre and the removal of shared bedroom facilities.

The inspector added that this could also have a positive impact on the rights and dignity of residents.

The inspection report into the Co Donegal facility was one of 16 reports published on Tuesday by the health and safety watchdog into restrictive practices in homes for individuals with disabilities.

The 16 inspections found that overall, there was good practice in relation to the management of restrictive practices in all centres.

However, some inspections found that although residents received a good, safe service, their quality of life would be enhanced by improvements in the management and reduction of restrictive practices.

For example, residents in a Cheshire Foundation in Ireland centre required staff support to access certain parts of their home.

Hiqa said a reduction in these environmental restrictions would enhance residents’ quality of life and their ability to do whatever they chose to do.