AN INSPECTION REPORT on a HSE-run home for people with disabilities in Tipperary has found that there was a “significant discrepancy” in the account of one resident at the time of inspection.  

The unannounced inspection at Damien House took place on 16 April. A total of 14 areas, such as protection, risk management procedures, fire precautions and infection control, were examined by the Health Quality and Information Authority (Hiqa) during the inspection. Just three areas were found to be completely compliant. 

During the inspection, a sample of the residents’ financial records were reviewed. Inspectors found there was a “significant discrepancy” in the monies which should have been available in a resident’s main cash account. 

“While this had been noted by the providers auditors for some time, there was no evidence that this had been investigated or the monies returned to the residents’ account. The provider was requested to address this as a matter of urgency on this inspection,” the inspection report states. 

Subsequently, in the area of protection, the HSE-run facility was found to be non-compliant. 

“Residents were not sufficiently protected from abusive interactions, some matters were not recognised as abusive and financial management systems were not safe in this regard,” inspectors said. 

Following the inspection, Damien’s House held a meeting on 3 May with the general manager from the chief officer’s office. 

The report states that “recommendations were made to ensure the historic issue identified is resolved and also that systems are streamlined to provide protection to individuals’ money”.

‘Significant concerns evident’

Damien House, which is made up of three houses and an apartment, provides full-time long term care to 12 residents – male and female over the age of 18. Care is provided to residents who have a primary diagnosis of intellectual disability and physical disability. 

One of the houses is a community-based residence, and the other two houses and the apartment are campus-based and are some distance from each other.

The inspection was a follow-up on a previous inspection in November 2018 that identified a lack of adequate management and oversight. There were 13 significant noncompliance’s found by inspectors on this previous inspection.

In its most recent inspection report of Damien House, Hiqa determined that the quality of life and safety of the residents differed across the units.

In some instances, Hiqa found that resident’s care, activation and recreational needs were well supported, however, this was not a consistent finding.

Residents access to such activities and their quality of life was impacted by the lack of reliable transport, and the lack of adequate clinical advice and behavioural supportive interventions to guide their care. 

Inspectors were also concerned that there were detailed behavioural support plans available but no system for assessing their effectiveness, or if they were being adhered to.

“Staff were not aware of a significant change which had been made in one resident’s plan. Given the complexity of some residents’ needs and in some instances the environment they lived in, there was also insufficient access and review by mental health and psychology specialists,” the report states. 

One resident’s circumstances had not been clinically reviewed since 2017, despite “significant concerns evident”. 

The inspection also concluded that the overall state of the premises and decor remained poor in two of the houses.  It did find that “significant improvement” had been made in the gardens of one of the houses since Hiqa’s last inspection. 

A new bathroom had been fitted into one of the campus based houses, but on the day of the inspection, it was locked and not in use. It was reported by staff that there was a leak in this room.

The full inspection report can be read here.