FORCE FEEDING. DRAGGING vulnerable people along the floor. Shouting. Poking and prodding.
The RTÉ Investigations Unit’s Inside Bungalow 3 report last night into the treatment of people with intellectual disabilities at a Mayo care home made for disturbing viewing.
Bungalow 3 is located in Áras Attracta, a residential home in Swinford, Co Mayo. After whisteblowers told RTÉ that the standards of care were not up to scratch there, its Investigations Unit secretly filmed inside to see if this was the case.
What it discovered was shocking.
In 2013, HIQA began inspecting all residential disability services, to ensure they comply with new standards of care.
RTÉ Investigations Unit analysed the 420 inspection reports and found that less than 2% of services were fully compliant with the new standards.
Áras Attracta was among the 98%. A HIQA report found that some of its residents were underweight and went for up to 15 hours throughout the night without food.
A follow-up inspection noted a “significant improvement”, with the HSE assuring families “that management and staff will continue to work… to provide the highest standards of care in the unit”.
3,700 people live in residential services in Ireland, and the programme acknowledges it can be a “difficult and stressful environment to work in”.
After whistleblowers contacted RTÉ Investigations Unit about Áras Attracta, it sent a researcher to do work experience there. She secretly filmed her time there over three weeks.
During the time of filming in Bungalow Three, the daily roster was two nurses and two or three care assistants, responsible for the seven residents.
First, the researcher worked in Bungalow 4, where initially she saw staff members providing “quality care.”
Then she moved to Bungalow 3, which accommodates seven female residents. There were moments “when staff members provided quality care”. But within a short period of time in Bungalow 3, “we learned about another side of care in this unit”.
The programme introduced us to some of the residents, as well as experts who gave their opinion on the secret footage.
One of the residents, Ivy McGinty, is 53, autistic, and with a severe intellectual disability. She cannot speak, but can understand what is being said to her.
Ivy sometimes presents with behaviour that challenges, and when she is frustrated she can hit out at staff. One staff member is on extended sick leave after allegedly being assaulted by Ivy.
Her world is largely centred around two chairs in the bungalow. Over the three weeks of filming, Ivy was largely confined to these two chairs, which “flies in the face of good practice”.
Sometimes, staff rattled keys in front of her to get her to comply. But Ivy is frightened of keys as they have a negative association for her.
Professor Owen Barr, head of the School of Nursing at the University of Ulster, says:
The interaction is very much characterised by raised voices by staff standing up, by staff leaning over CUT by issuing what appears to be threats about what’s going to happen if they don’t behave. That can be very distressing for the individual who lives there. It will also in many many occasions result in an escalation in the behaviour.
At one stage, the programme shows how Ivy’s favourite armchair is taken from her, resulting in her hitting herself and lying on the floor.
“This treatment was a clear breach of the Health Act regulations. These require Aras Attracta to ensure each resident exercises ‘choice and control’ in their daily life,” explains the programme.
Prof Barr says that Ivy’s behaviour “was indicating increasing distress and increasing upset”.
More footage shows Ivy shouting, and a staff member telling her:
What is your problem now stop it. Now put that down if you want to put that down, just stop this tomfoolery, there’s no need for it… look at outside it’s pissing rain, you should be damn glad you have a roof over your head.
At another stage, the staff members are having a meeting at 4.30pm.
Ivy gets up from her chair. One staff member seems to push Ivy’s body into her chair, and points a finger in her face. She says: “You’ve got two choices: 1, stay in your chair; 2 bring up your PJs and go to bed”.
Later on in the evening, when another resident is sitting in Ivy’s chair in the room, a nurse says: “Watch this watch this, I love this.” She then encourages the other resident to “tell her to f*** off… tell her f*** back to her own chair”.
Sat on by the unit manager
At one stage, the manager of the unit, a male nurse, arrives into the bungalow. “Ivy does not like men and staff know it,” says the voiceover.
Ivy is chased back into the room by the male manager who sits on top of her. She tries to push him away.
He eventually gets off her. Ivy is told to apologise to the male manager.
On another occasion, when Ivy tries to move around and get out of her chair, a nurse handles her by the face. She then says “you’re wet, I know you are, but you can stay in it”.
On one evening, when Ivy presents with challenging behaviour, a staff member is seen grabbing her by her hoodie, pulling her from the chair to the floor and dragging her on the floor.
Professor Gerard Quinn, Director at the Centre for Disability Law and Police in NUIG Galway, describes it as “this deeply embedded idea that people with intellectual disabilities really are objects to be managed rather than human beings to be cherished. I find it bizarre.”
When Ivy communicates by pulling at her clothes to indicate that she wants to go to the toilet, one care assistant says:
If you died I won’t bring you the toilet, I haven’t a notion
Ivy goes to other staff, who are told to refuse her. Ivy then goes to the staff member, holding gloves. “You won’t go because you were bold,” she is told.
One staff member lifts up the folder she is holding and attempts to strike Ivy with it.
“This is atrocious behaviour. It is institutionalised in its worst form,” says Prof Barr.
Mary, 65, is from Co Mayo. Her sister Sheila Ryan explains that Mary can’t communicate, but is “a very, very gentle person”, who “knows what’s going on all around even if she can’t communicate”.
She has been living in Áras Attracta for 20 years and spends a lot of time on a particular couch in front of the TV. She communicates using sounds and hand signals.
The secret footage shows a staff member telling Mary she will “go in the porch”, which is isolated and smoky.
After Mary, who has brittle bones and arthritis, continues to make noises, staff “handle her roughly”. One staff member shouts: “One more word!” at her. Mary’s care plan says that she enjoys having her hand held or her hair stroked – which helps soothe her when she’s anxious.” This did not happen on this occasion.
Footage shows a care assistant using her mobile phone before moving Mary to an adjoining room. “Are you going to do that again? Put your head down,” says one staff member.
They move Mary – who can be heard from the next room calling – and then return to the room to chat.
“She’s clearly using her calling out to get attention, she’s clearly using it to try and communicate something. There’s no attempt by staff to establish what that is,” says Prof Barr. “That’s all very very intimidating behaviour. This is the individual’s house. This is where they live.”
Deirdre Corby of the School of Nursing says that it is Mary’s home, and “it should be her voice that is the most important one in the room”.
Mary’s care plan says she likes to go out for walks in the sunshine. The researcher witnessed Mary leaving the bungalow once during three weeks of filming.
Mary is also seen being slapped on the forehead with a piece of folded paper at one stage.
Prof Quinn: “I’ve seen footage like this before, but to be frank, it’s from Eastern Europe, it’s not from Ireland and I feel ashamed about this.”
Mary (75), who is unable to speak and has a severe intellectual disability, has spent her entire life in care.
During the filming, some moments of warmth were seen being shown towards Mary.
But the secret footage also showed a day where Mary was in the same room for nearly 11 hours. Mary’s care plan states that she should have one-to-one interaction and a structured day of activities.
Mary was unwell and needed regular food and drink. Footage shows a care assistant pinning Mary’s right arm back while forcing her to take a drink of milk.
At one stage, she places her hand over Mary’s eyes while making her drink.
Prof Owen Barr says that to him “is abuse of practise”, while Prof Gerard Quinn says it is “bad practise as well as raising very profound concerns over the human rights of the people who live in this institution”.
It was later discovered by the researcher that Mary can feed herself, with assistance.
The footage also shows a staff member saying “shut up” when Mary shouts.
Further footage shows one night when Mary has been in the one spot for nearly 10 hours, having had very little interaction from staff. When Mary falls as she attempts to sit up into the chair, a nurse laughs and says it is her own fault.
She then says: “And as for you – what’s wrong with you?” and roughly plops her in the chair.
Deirdre Corby says that Mary “should feel that she can reach out and communicate if she wants to”, while Prof Barr says “striking an individual with intellectual disabilities, indeed striking anyone, is assault and in those circumstances entirely unwarranted” .
Further footage shows Mary being pushed to the ground, a staff member picking up Mary and throwing her into an armchair. Mary’s hand is also slapped.
Sheila Ryan, Mary’s sister, says she was “shocked beyond words” after seeing the footage of what happened to her.
I’ve never seen anything like it ever in all my life. That they seem to think that she’s an object – that she doesn’t feel anything that she doesn’t understanding anything, but she does. Every human being does, Mary’s no different. I know its difficult work but there’s a line you do not cross – where you infringe on someone’s human dignity and you’re depending on people not to cross that line.
Sheila says she is “so proud” of her sister for not retaliating in the face of her treatment.
Breege Dolan, Ivy’s sister, says:
All the family are very hurt over this. Ivy can’t tell us exactly how she feels. It’s very hurtful to watch somebody do that to your own flesh and blood – they’re innocent people doing no harm to no one. Going into a place where they thought they’d be well looked after.
Of the incident where Ivy says she wants to be brought to the toilet, but is refused. Breege says: “She got the gloves and they still would not bring Ivy to the toilet. Now that’s very, very hurtful for, you know, a girl that can’t speak.”
“I will not rest until this is properly investigated,” says Mary’s sister Sheila. “The least we might expect [is] that people who are in care are treated with dignity and respect.
Says Breege Dolan: “I always thought Ivy being in Áras Attracta was a wonderful place and we were happy for her. I don’t know who to trust now, really and truly.”
Under the Health Act regulations, Aras Attracta is required to protect residents from abuse. One recorded incident shows that it failed to do so.
A care assistant searches for her keys, which Ivy is fearful of. She waves the keys in front of Ivy’s face, and then strikes Ivy with them across the leg.
The footage also shows the care assistant kicking Ivy, slapping and manhandling her.
“That’s very, very difficult to watch, and very, very poor quality care,” says Prof Barr.
Professor Ruth Northway, Professor of Learning Disability Nursing, University of South Wales, describes it as “clearly abuse”.
Prof Quinn says:
It’s as if the person’s being treated as invisible, as a non-person and when she tries to become visible is pushed back.
Later in the evening, the care assistant is showing confining and pinching Ivy. The next day, the nurse is caring for Ivy when she blocks Ivy’s path and Ivy drops herself to the ground. She reprimands her, telling her she is “chancing your arm” and “being very silly”.
Ivy remains on the floor for two minutes before the nurse challenges her again. Staff then discuss whether Ivy “deserves a chair”. The staff member shouts”pick a chair, any chair, that one?” When Ivy gets up off the floor and picks one, the staff member says “right, well you don’t get off it”.
Throughout the rest of the day, footage shows Ivy being slapped on numerous occasions by various staff members for attempting to get out of her chair.
The secret footage does show a staff member speaking out about practices at one stage.
When one care assistant issues a “mild threat”, another staff member says: “Oh you don’t say that to her, don’t say that to her”.
After three weeks of filming, the researcher was taken out of Aras Attracta. RTÉ reported the situation to the HSE, HIQA and An Garda Siochána, who are now carrying out a formal investigation.
Pat Healy, National Director for Social Care with the HSE, told Prime Time he was “disturbed” by what he saw in the programme.
Here’s what Minister Kathleen Lynch had to say about the matter.
RTÉ Investiations Unit: Inside Bungalow 3 is available for viewing on RTÉ Player.
All images RTÉ Investigations Unit
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