HIQA have just released a report into a centre for people with disabilities operated by the HSE.
The health watchdog has just published a 44 page report into a designated centre for people with disabilities operated by the HSE in Westmeath. The inspection was unannounced and took place over two days, the 13th and 14th of November last year.
Two community houses are part of a designated centre that’s operated by the HSE. The centre consisted of nine community hosues. There were ten residents in the two houses involved in the inspection. The service provieds services for male and females who have a diagnosis of intellectual disability. The residents also had additional needs like mobility needs and behaviours that challenge.
LISTEN: Lunchtime's Paddy McDonnell reports on the HIQA report on today's show
There was major non compliance in 14 categories:
1. Residents rights, dignity and consultation.
2. Admissions and contract for the provision of services.
3. Social care needs.
4. Safe and suitable premises.
5. Health and safety and risk management.
6. Safe gaurding and safety.
7. Notification of incidents.
8. General welfare and development.
9. Healthcare needs.
10. Medication management.
11. Statement of purpose.
12. Governmance and management.
13. Workforce
14. Records and documentation.
An immediate action was issue to the provider on the first day of inspection as inspectors identifired a risk in the ability of staff to safely evacuate residetns in the event of an emergency.
A meeting was held with the local health office manager in HIQA’s office on 18th November becuase immediate and sustatined action was needed.
The action plan at the end of this report identifies the failings and the actions the provider/person in charge is required to take to ensure compliance with the Health Act 2007 (care and support of residents in designated centres for persons (children and adults) with disabilties) regulations 2013.
The HSE replied with the following statement:
The HSE acknowledges the HIQA Investigation Report into four community houses which are part of St. Peters, Castlepollard designated centre for people with disabilities based in Westmeath.
The report highlights a number of significant failings in the safety and quality of services provided at the four community houses.
The HSE have taken a number of immediate actions to address these deficits as part of its efforts to guarantee that a safe and caring environment exists for the residents. The following are some of the actions that have been completed or in the process of being completed:
1 The Governance structure of the houses has been strengthened and a working group has been established with agreed Terms of Reference. The purpose of this group is to manage the actions to be addressed following Inspection by HIQA and to systematically address any issues that would negatively impact on the community housing receiving HIQA registration.
2 An investigation has been conducted into incidents of unexplained bruising which had not been documented or investigated in line with HSE Policy on Abuse. Action plans based on the recommendations of the investigation have been implemented.
3 A System Analysis Review is currently been undertaken in the houses to look at system failures in reporting and follow up of unexplained bruising.
4 The roll out of updated training on the policy on the Protection of vulnerable adults is complete.
5 A Service Plan is currently being developed to look at the service requirements and skill mix of staff.
6 Immediate provision was made for an additional staff nurse on night duty in one of the designated centre.
7 Provision has been made to increase support to staff in the implementation of multi-element behaviour support.
8 Further training requirements that were identified are currently being provided in the areas of medication management, wound management, prevention of pressure sores, CPI, documentation and record keeping, assessment, care planning, implementation and evaluation, fire safety, positive behaviour support, management of complaints, role of key worker, risk management, infection prevention and control, HIQA regulatory requirements, making evidence based practice a reality (70% complete).
9 Each service users person centred plan has being reviewed and updated.
10 The behavioural support plans of residents with anti-social behaviour have been reviewed by the Behaviour Therapist
11 The Clinical Psychologist visited the house to assess the support needs of the residents who have anti-social behaviours which are impinging on quality of life.
12 All behavioural assessments and behaviour support plans are being reviewed and updated to reflect the individualised support needs of each individual (85% complete).
13 Reviews and assessments for speech and language, physiotherapy and occupational therapy have been undertaken and concerns addressed.
14. Since the HIQA inspections in November/December 2014, two further houses have been successfully registered with HIQA (9 people are supported in these 2 houses).
In addition to the above two staff have been registered as Person in Charge with HIQA and a further five staff have submitted their information to HIQA for appointment as the Person in Charge.
The Regional Director of Nursing and the Nurse Practice Development Coordinator are working very closely with staff to support them and to ensure that services are delivered to the highest standard.
These findings of the HIQA investigation are unacceptable and the HSE Management has adopted a robust approach to ensuring that the quality assured processes and procedures in place are adhered to. The immediate actions taken will address the deficits highlighted in the report. The HSE are committed to working with staff and residences to ensure services comply with standards, striving to implement best practices and work towards continuous improvement.
The HSE will continue to work with HIQA in order to improve safety and quality of services. Ongoing monitoring and supervision will remain in place to provide assurances that those vulnerable individuals receive the highest level of safe and respectful care.
