Res­i­dent strapped to chair at care cen­tre for dis­abled

Irish Examiner - - News - Noel Baker So­cial Af­fairs Cor­re­spon­dent

At a cen­tre for peo­ple with dis­abil­i­ties, one res­i­dent was strapped to a chair and an­other had a ‘sleep suit’.

An in­spec­tion re­port into the Adults Ser­vices Palmer­stown Des­ig­nated Cen­tre 5 fa­cil­ity, in Dublin 20, found no ev­i­dence of ap­pro­pri­ate fol­low-up in any of the 16 in­ci­dents that po­ten­tially met the def­i­ni­tion of abuse. These in­ci­dents in­cluded peer-to-peer phys­i­cal abuse, un­ex­plained bruis­ing to res­i­dents, and un­ex­plained in­juries. The cen­tre, op­er­ated by Ste­wart’s Care Ltd and home to 29 res­i­dents, was highly crit­i­cised by the re­port, con­ducted by the Health In­for­ma­tion and Qual­ity Au­thor­ity (Hiqa). It found ma­jor non-com­pli­ance with all nine stan­dards that were in­spected. Hiqa found the ser­vice “was not safe and had failed to en­sure that res­i­dents were pro­tected from abuse, and to en­sure that res­i­dents’ health­care needs were met”.

“In one unit, in­spec­tors ob­served a res­i­dent re­strained in a re­clined chair with a lap belt in place,” it said. “Staff present stated that the res­i­dent could mo­bilise in­de­pen­dently. The use of this re­stric­tive pro­ce­dure had been pre­scribed. How­ever, in­spec­tors found that it was not be­ing used as out­lined in the as­so­ci­ated pro­to­col. Staff present at the time con­firmed that this re­stric­tive pro­ce­dure was used in re­sponse to re­duced staffing lev­els.

“In­spec­tors re­viewed as­so­ci­ated doc­u­men­ta­tion and found that this re­stric­tive pro­ce­dure was used for 90 hours for this res­i­dent, over a 19-day pe­riod prior to in­spec­tion.”

Hiqa also found that two res­i­dents in one unit were be­ing ad­min­is­tered reg­u­lar steroidal an­tian­dro­gen med­i­ca­tion for in­ap­pro­pri­ate sex­ual be­hav­iour, yet a re­view of doc­u­men­ta­tion showed no in­di­ca­tors for its use.

The re­port high­lighted in­ad­e­quate staffing at the cen­tre, not­ing: “In one unit, the most ex­pe­ri­enced staff mem­ber had worked in the area for three weeks.”

In­spec­tors ob­served that one res­i­dent still had not re­ceived break­fast by 11.25am and, in the pre­vi­ous 14-hour pe­riod, had no record of any fluid in­take.

As for the in­ap­pro­pri­ate use of some re­stric­tive prac­tices: “In one in­stance, a staff mem­ber con­firmed that a re­stric­tive prac­tice was be­ing used in re­sponse to staff short­ages. In an­other case, in­spec­tors found that a ‘sleep suit’ was in use for a res­i­dent at night time.”

A plan was is­sued in re­sponse to the find­ings, as was the case at an­other Ste­wart’s Care Ltd fa­cil­ity, the Ste­wart’s Adults Ser­vices Palmer­stown Des­ig­nated Cen­tre 3. That re­port iden­ti­fied a num­ber of prob­lems and ma­jor non-com­pli­ances, among them an in­ap­pro­pri­ate mix of res­i­dents, de­lays in pro­vid­ing break­fast, and “a com­plete lack of ap­pro­pri­ate fol­low-up” to 14 in­ci­dents of po­ten­tial abuse.

A re­view of a file of a staff mem­ber, against whom an al­le­ga­tion of mis­con­duct was made, high­lighted that there was no ev­i­dence of any dis­ci­plinary ac­tions taken by the provider, in re­sponse to the in­ci­dent of con­cern.

IN the 11 years since it was es­tab­lished to reg­u­late and mon­i­tor the qual­ity of res­i­den­tial care in cen­tres for chil­dren, older peo­ple, or peo­ple with dis­abil­i­ties, the Health In­for­ma­tion and Qual­ity Au­thor­ity (Hiqa) has un­cov­ered some un­ac­cept­able prac­tices and con­demned build­ings no longer fit for pur­pose. The agency stepped into a role that had not been vig­or­ously dis­charged but that has changed. Hiqa is an agent for pos­i­tive change and helped im­prove the qual­ity of life en­joyed by many of those un­der its re­mit.

A new Hiqa re­port shows that a Dublin cen­tre for peo­ple with dis­abil­i­ties had one res­i­dent strapped to a chair and that a “sleep suit” was used on an­other res­i­dent at night. The cen­tre, op­er­ated by Ste­warts Care Ltd, failed on all nine head­ings of a Hiqa in­spec­tion.

This new cul­ture of ac­count­abilty is won­der­ful but it puts us in a tight corner — now that we know about these abuses we must con­front them with re­sources or se­vere sanc­tions so that can no longer be a part of our care cul­ture.

We can no longer say we didn’t know.

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