THE HEALTH INFORMATION and Quality Authority (HIQA) has found that the main provider of residential care for disabled adults and children in Co Mayo does not have the oversight and governance practices in place to ensure the wellbeing of residents.
The Western Care Association – which provides 144 of the 242 residential places available in Mayo and is mainly funded by the Health Service Executive- has come under fire this year.
In February it came to light that a dossier detailing a series of allegations related to the charity, including claims that staff witnessed the “abuse” of vulnerable services users.
The dossier also contained claims that staff were afraid to report incidents, over fears they would lose their jobs.
The Chief Inspector of HIQA stated today that the Western Care Association had a good record of achieving compliance with its standards, however, since November 2022, inspectors have found a “significant and increasing level of non-compliance”.
In October of last year, the Chief Inspector started to receive information of concern about what was happening at the centres.
From November through to February of this year it carried out inspections of 16 centres owned by the charity.
It found that compliance with standards was low across the board, and issued a notice of a proposed decision to cancel the registration of one centre.
Due to HIQA’s concerns that Western Care is unable to monitor its own centres, it then conducted a further round of inspections of centres, meeting with 54 residents and 74 staff members, including those in charge in March of this year.
It found that there is still a high level of non-compliance across the provider’s centres.
A lack of governance and management structure in place means that often, reports of incidents at homes are not escalated and brought to the attention of senior management.
HIQA had particular concerns about restrictive practices being used on residents.
In some centres this included residents not being allowed into areas of their home, the cupboards being locked, and audio and video devices being installed in their rooms – without the need for this level of surveillance being reviewed.
In one case inspectors were particularly concerned that a resident’s privacy was being invaded as they had surveillance devices in their room since 2019.
The charity at some stage had a ‘Rights Committee’ set up that was meant to objectively review restrictive practices to make sure they were necessary.
However, staff told HIQA inspectors that this committee stopped being active sometime around 2021, though other staff were not aware of this, and were still flagging cases with the committee but getting no reply.
In other cases – the staff were not adequately trained to care for the residents.
Residents with epilepsy were being cared for – one-on-one – by staff who didn’t have any training in caring for people with epilepsy.
In another centre, there was mould in the food storage area.
A lack of sufficient behaviour support planning was an issue identified as well.
Though staff in a centre flagged that some residents had a serious risk of self-injurious behaviour, there was no support plan in place for these residents.
A lack of safeguarding was another issue that HIQA identified in the centres.
In one case, a recommendation for psychological support had been made in December 2021, but was not responded to until May 2021.
An occupational referral for a resident who fell in the shower that was made in 2019 was still not acted upon when HIQA carried out its inspections in May 2023.
HIQA found that when auditing did take place at centres by the charity – which is a legal requirement – often area managers inspected centres that were under their authority, rather than inspecting other centres.
The regulator did however find in its interviews with residents, that they were treated kindly by staff, and that they could avail of interesting daytime activities, including personalised activities if they didn’t want to participate in groups.
It also noted that it did not witness incidents of abuse against staff, but that there was a lack of safeguarding to prevent residents from having a negative impact upon one another.
HIQA has stated that as a result of the findings from these inspections, it will now require the Western Care Association to implement a governance improvement plan to improve the safety and quality of life of the residents in its centres.
Inspectors will monitor the implementation of the plan over the next six months, to see if the care provider is upholding the rights of its residents.
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