Residents at HSE centre didn’t know who was in charge - HIQA
A HIQA inspection of the Gweedore Services located in Sligo town found women with intellectual disabilities had to leave their bungalow to access a suitable bathroom in a separate house on their campus.
HIQA said there were “significant levels of non- compliance in the centre which consisted of seven houses with a maximum capacity for 32 people.
The provider had failed to appoint a person in charge with sole responsibility for the designated centre as required in an improvement notice issued on the 19 of May 2016, following the previous inspection.
Staff spoken with were unable to clearly identify the current person in charge.
Inspectors found that there had been several changes in the role of person in charge resulting in a negative impact for residents. For example, a recent change in management arrangements resulted in one person resuming overall responsibility for the centre in addition to two other centres. This had not been effectively communicated with all residents. Residents told the inspectors that they had not been informed of this change. Some residents affected were reliant on support with medication and finance from the person in charge but were at the time of inspection unaware who the person in charge was.
Inspectors found insufficient changes had been made on foot of the improvement notice to improve the overall quality of life and service provided to residents. The quality of social care assessments was found to be poor and residents had limited opportunities to participate in any meaningful activities or engage with their local community. Some improvement had occurred in healthcare and medication management. However, failings were identified across a number of outcomes.
Residents were being moved between houses without any consultation or involvement in this change to their life.
The inspection took place over three days last August. Inspectors identified significant levels of non compliance with the regulations in May 2016. As a result HIQA took the extraordinary measures of issuing a notice of improvement to the provider prescribing the actions to improve the quality and safety of services provided. Residents spoke with inspectors during the latest visits regarding the support they received and care provided. They expressed satisfaction regarding the care received.
However, residents spoke about the difficulty in accessing the community or achieving personal goals they had identified.
Three of the houses were located beside each other and the remaining four houses were dispersed throughout the town.
The centre provided services to females over the age of eighteen with a primary diagnosis of intellectual disabilities.
During the inspection, inspectors met with nine residents, and nine staff.
Failings included, ineffective governance and management systems, including the allocation of a person in charge with sole responsibility for the centre; lack of a meaningful day for residents; lack of assessment regarding residents’ needs and supports required; absence of recognition of residents’ rights and consultation with residents; safeguarding and safety issues due to a lack of staff training in the management of abuse and regarding behaviour management.
The inspectors also found failing in relation to admissions which were inappropriate and an absence of contracts of care, the premises were not fit for purpose, inadequate fire management systems and inadequate health and safety and risk management systems.
From September 10th 2016 a new management structure began and the centre was divided into three separate areas. A clearly defined management structure in the designated centre is in place that identifies the lines of authority and accountability, specifies roles, and details responsibilities for all areas of service provision.
All staff is aware of the new management structure. Roles and responsibilities have been discussed with staff through management supervision framework agreement.