AN INSPECTION REPORT on a care centre in Kilkenny has expressed concern about an abusive situation at the facility and about distress caused by a lack of cooperation from a number of staff members.
The inspection at Camphill Community in Ballytobin took place in July this year. The centre was previously operated by Camphill Communities of Ireland, but due to high levels of non-compliance and risk to residents, Hiqa issued a notice of decision to cancel registration of the centre in May.
The centre provides long-term residential services to children and adults with moderate to severe intellectual disability, people on the autism spectrum and with physical and sensory disabilities.
One house on the campus is currently dedicated to children and younger persons.
Alternative arrangements were made with the HSE to take over the running of the centre and this was the first inspection since the cancellation of the registration.
Hiqa said that while a commitment was made for “a smooth transition in the best interests of the residents”, this had not occurred in practice.
Efforts to implement appropriate safeguarding practices were again not supported by a significant number of longterm members of the staff with whom the current provider was in a process of engagement.
Abusive
The report today referenced a notification to Hiqa of one particular situation which it said was “both physically and psychologically abusive to a resident”.
“This incident took place after the HSE took over the running of the centre and continued for some hours. It is of concern to HIQA that during that time no management in the centre were alerted to the situation by agency or employed staff present at the time in order to protect the resident,” the report said.
“It is acknowledged that when the managers were alerted immediate action was taken and the person responsible suspended from duty in accordance with the requirements for the protection of vulnerable adults. However, due to the status of the person this matter can only be fully investigated and dealt with by the previous provider.”
The report went on to say that there was a “deliberate lack of adherence” to the interim safeguarding plan following this situation.
Two co-workers living in one unit and two others who were requested not to enter in the interests of residents’ safety, pending full due process investigations and without prejudice, failed to cooperate.
Hiqa said this “placed residents at potential of serious risk”.
Despite significant intervention by the current provider, staff and managers, the persons concerned refused to cooperate despite the impact on the residents. This ultimately necessitated the traumatic and immediate removal of a number of residents for their protection.
Inspectors saw evidence of and confirmed the distress and confusion this caused to residents. The previous provider who retained control over the person concerned did not intervene effectively for more than 24 hours.
Locked doors
The inspectors found that in one unit significant challenging behaviours were not being reported and therefore no supportive mechanisms for the residents were implemented.
In the absence of such supports, some restrictions were being implemented such as “the wearing of a particular garment and the use of locked doors”. However, these or other interventions were not implemented with clinical oversight or review of their effectiveness, or necessity, as part of an agreed care plan.
The HSE, as the new provider, had made some positive changes, the inspection found. Systems were also being implemented for a full review of all historical allegations of abuse, which the HSE will oversee but which will be undertaken by an external independent body on behalf of the previous provider.
At this early stage inspectors were satisfied that the new provider and managers were in the process of identifying all such issues and putting suitable systems in place with clinical oversight.
In a statement, the HSE said it acknowledges that recent months have proven to be a difficult time for residents and families and it is working to minimise any inconvenience.
It said it has been ensuring that serious concerns noted by Hiqa are being full addressed, with a particular focus on safeguarding. An experienced disability care manager has been allocated to the centre as well as professional staff in each of the houses on a 24-hour basis.
It also said Camphill Communities of Ireland is in discussion with individual co-workers as regards alternative arrangements for those who have, on a long term basis, been resident at or involved in service delivery at Camphill, Ballytobin.
The HSE is planning to transfer management of the centre to an alternative service provider.
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