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No evidence of consent for use of restraints at Enable Ireland residential home

A HIQA inspection found the home was non-compliant across 18 different outcomes that it examined.

AN ENABLE IRELAND residential home for people with disabilities was found to be non-compliant across all 18 outcomes inspected by health watchdog HIQA.

A report on the inspection, which took place on 4 and 5 February 2014, was published yesterday.

Non-compliant

The centre, which is in Cork, was found to be non-compliant when it came to safeguarding and safety. There are two residents at the centre.

The centre had up-to-date policies and procedures in place for the prevention, detection and response to abuse.

“There was no evidence of efforts made to identify and alleviate the underlying causes of
behaviour that was challenging for each individual resident,” noted HIQA.

Training had not been provided for staff on how to manage challenging behaviours. However, when it came to the issue of restraints:

Residents on whom restraint was used (bed-rails, chair belts for upper and lower body) had not been assessed for their use. There was no evidence of consent for the use of restraint and no arrangements were in place for the checking of and regular release of the restraints

There was no evidence that an assessment of need was carried out prior to the residents’ admission to the centre.

It was also found non compliant when it came to residents’ social care needs.

Inspectors found that documentation regarding residents’ personal care
planning “did not adequately capture or describe the healthcare needs of residents”.

None of the care plans set out in a formal manner the services and supports to be provided to achieve a good quality of life and to realise their goals

On the issue of ‘safe and suitable premises’, it was also non compliant, with HIQA saying the design and layout of the premises required review so as to ensure that the premises was fit for purpose in accommodating residents with a maximum dependency and with complex medical conditions.

On the layout of the building, the inspectors said:

Residents could not access the garden. Doorframes were narrow and in need of maintenance; corridors widths could not accommodate two residents accommodated in a high dependency ambulatory chair passing one another, or a resident and a staff member passing one another.

There was no room available for residents to meet with visitors in private.

A ceiling mounted hoist track went from one resident’s bedroom through the
corridor, front hall and into another resident’s bedroom. “The privacy and dignity of
residents were compromised as a result of this design,” said HIQA.

Safety

The centre was also found to be non-compliant regarding the health and safety of residents, visitors and staff being promoted and protected.

Other issues flagged were:

  • Wet mops and buckets were stored externally outside the back door
  • Mops were used communally and not changed between rooms
  • A mop immersed in a bucket of water was located in the front hall near the entrance
  • door
  • Cleaning cloths were used communally.
  • Specific bags used for soiled laundry were not available.

The centre did not have a risk management policy or a risk register, and it was unclear if an emergency plan was in place.

While a fire evacuation plan was in place, a safe placement for residents in the event of an evacuation was not identified

When it came healthcare needs, the centre was also non-compliant, on a moderate level.

Generally residents’ health and social care needs were met. However, there was no evidence of continence programmes for residents.

Staff were knowledgeable about residents’ health and social care needs and were observed attending to residents in a dignified manner.

It was found to be non-compliant at a major level regarding the use of resources; governance and management; workforce; and records and documentation.

A 17-point action plan was drawn up to address all of the issues raised.

Read: HIQA report finds internal doors in disability care unit locked>

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