A HSE-run centre for children and adults with disabilities had major levels of non-compliance with care regulations and more than a third of staff did not have a Garda vetting report in place, an inspection report has found.
The Health Information and Quality Authority (Hiqa) carried out an unannounced inspection at Cherry Orchard Hospital over five days in May and June after concerns about conditions at the centre emerged in five earlier inspections.
The centre, in two buildings on the hospital campus in west Dublin, provides care for 27 residents with a disability over the age of 18, both male and female.
An inspection report published by the health standards watchdog on Thursday found that, overall, each resident’s care and support needs were not fully assessed, and some did not have healthcare plans in place in line with their assessed needs.
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Some residents had limited opportunities to participate in meaningful activities, appropriate to their interests and preferences. They also had limited opportunities for education, training and employment.
There were also insufficient staff numbers with the right qualifications or skill mix to meet the residents’ needs.
Absences
Concerns were raised by the inspectors about the risk management policy at the centre and the practices in place in relation to the unexplained absence of a resident, or accidental injury to residents, visitors or staff.
There was also no guidance in place to staff on measures and actions in place to manage aggression, violence and self-harm.
The inspectors said they found the risk register referred to control measures being in place which were “not actually in place”, including a statement that all staff in the centre were Garda vetted.
Inaccuracies were found in a number of risk assessments, such as different residents’ names in the same risk assessment. Some 84 per cent of staff had not completed training in the risk management policy.
The inspectors said they found “evidence of improvement” in relation to the number of staff who were Garda vetted, but 37 per cent of staff did not have their completed vetting report in place.
The inspectors also found a number of residents were experiencing unintentional weight loss, with one person losing almost 10kg in six months.
“A number of residents who were identified by staff as being at risk of dehydration or malnutrition did not have appropriate assessments or care plans in place, and there was no system in place to record their food and fluid intake,” the report found.
The inspectors acknowledged that there had been an increased focus on residents’ social care needs in the centre but said social care goals were “in their infancy” and required further development.
Barrier
Residents who spoke to the inspectors said transport was a barrier to engaging in meaningful community based activities.
“One resident described waiting three hours for a wheelchair accessible taxi which resulted in their planned activity being cancelled, and two other residents described waiting a prolonged period the day before to get home from a local shopping centre due to lack of availability of transport,” the report said.
Inspectors also said residents’ privacy and dignity was still being compromised due to multiple occupancy bedrooms.
The HSE has informed the healthcare watchdog that a new building will be completed by 2021 to provide older persons' services and that this would facilitate the relocation of one of the units in the centre.
It also outlined to Hiqa a number of measures it has taken to address the issues at the centre, including a plan to reduce two multi-occupancy rooms to single-occupancy.
Hiqa on Thursday published 19 inspection reports on designated centres for people with disabilities and said it found a “good level of compliance” with the regulations and standards in 14 of them.