ALLEGATIONS HAVE BEEN made regarding physically and verbally abusive staff, unexplained bruising and poor hygiene standards in disability services in Ireland, according to documents released to TheJournal.ie under the Freedom of Information Act. 

The documents show that since January of this year, specific concerns were raised about staff shortages, residents falling, accommodation issues and abusive staff. 

In one piece of correspondence sent to health watchdog Hiqa, it is alleged that one resident in a disability centre is “suffering verbal abuse from a staff member” and that they are “feeling upset as it is ongoing with threats that the resident will be forced to leave the centre”. 

The documents contain what is described as “unsolicited information received by Hiqa in relation to older persons’ services” from 1 January to 4 June 2019. 

The documents detail issues recorded by the agency’s staff. In some cases, the complaints are summarised by an employee and refer to the person raising the issue as a CP (concerned person).

Hiqa is responsible for the monitoring, inspection and registration of designated centres for people with disabilities.

The information can come from anyone concerned about something in a disability centre.

The concerns are heavily redacted in places and are undated. All identifying material of the centres and the people involved are removed, in order to respect their privacy.

Despite this, they give a clear indication of some of the primary issues affecting disability services across the country.

On 27 August, Hiqa published 25 reports on designated centres for people with disabilities. Evidence of good practice and compliance with the regulation and standards was found in 16 centres. However, evidence of non-compliance was found in nine centres.

Injuries and assaults

Last month, TheJournal.ie reported allegations made about nursing homes since January. In these documents, multiple instances of injuries and assaults were detailed. 

Similar allegations were made regarding residents at disability centres. 

In one instance, a concerned person (CP) claimed that a person at a disability centre was “injured in a peer-to-peer incident that took place”. 

In another instance in the documents, it is claimed that a resident was “assaulted by a staff member”. 

Another person claimed that a resident was “at risk” and that there were “no safeguarding measures in place” at the facility. 

“There is another resident with challenging behaviour who is liable to assault the resident,” the allegation continued. 

Another piece of information by a concerned person outlined an allegation that a resident had “suffered physical and verbal abuse”. 

“CP brought these issues to the attention of the management and had a meeting to further discuss. However, the resident is still at risk. Management was dismissive of CP’s concerns and fears,” it said. 

Numerous instances of residents allegedly falling and sustaining injuries were also outlined in the pages of documents.

In one instance, a concerned person claimed they were not notified after a resident “suffered a fall” and added that “there were different accounts on how the accident happened”. 

Another concerned person alleged that a resident received “no assistance” when they used the bathroom. 

“Resident fell and sustained injuries. No record made relating to fall,” the complaint claimed. 

Another complaint was raised which claimed that a resident who has “limited communication” had “unexplained bruising”.

Other complaints

Other common issues raised within the documents include staffing worries, accommodation concerns, disruptive residents and hygiene issues. 

In one instance, a person brought up “the severe reduction in care staff” which they claimed “will put their relative at risk”. 

Another writer claimed that a resident left a centre “for over two hours unattended” and that the resident’s siblings were not issued with a “notification of incident”. 

The documents outline two claims of staff members being under the influence of alcohol while on duty. 

“Staff member inebriated while on duty,” one complaint alleged. 

The other complaint claimed: “Staff member was drinking while on duty.” 

In relation to residents’ wellbeing and hygiene, Hiqa received numerous complaints. 

One complainant claimed that it was “advised that a programme would be in place to progress the resident’s lifestyle and behaviour”. However, they also said that “there is no programme in place and the resident’s behaviour and appearance has deteriorated”. 

The document continued: “The resident’s [feet] are in deplorable condition with the nails curling around the toes and the big toes are infected. 

There is no encouragement given to the resident and personal hygiene is ignored. 

Numerous people raised concerns regarding the standard of accommodation in some centres. 

For example, one person alleged that a centre was “not wheelchair accessible”. 

Another person claimed that there was “limited space” in one house. 

Finally, concerns were also raised by a person regarding alleged “breaches of confidentiality and data protection”.

Hiqa’s role

Hiqa does not have a remit to investigate individual complaints. However, all unsolicited information, which can be received from anyone concerned about the centre, is used to inform the authority’s monitoring of each residential centre.

Noting this fact while speaking to TheJournal.ie last month, Fine Gael TD Fergus O’Dowd said: 

“I’d be very concerned that [the complaints] never trigger, as far as I understand, an immediate investigation of the individual. 

[Hiqa] can go in … but they can’t as for the file of the individual which doesn’t make sense and you need a lot more accountability from Hiqa as to what they are actually doing. 

As noted above, the concerns are heavily redacted in places and are undated. All identifying material of the centres and people involved are removed, in order to respect their privacy. 

“I think that the [identity] of the individual should never be disclosed but I don’t see why there shouldn’t be as little redaction as possible because you need to know the full detail of what culpability or what are the responses of the actual institution to the complaints that are made,” O’Dowd said. 

Where there are risks to the safety of residents or where the provider has failed to address areas of concern repeatedly, Hiqa can take escalated action, up to and including court action to cancel the registration of a centre.

“The aim of the Health Information and Quality Authority is to advance high-quality and safe care for people accessing health and social care services in Ireland,” a spokesperson for Hiqa said previously.

“Where Hiqa has concerns related to the safety of residents and the quality of care that they are receiving, providers are required to take immediate action to address this.

Hiqa inspectors follow up with providers to ensure that the actions are being implemented and are resulting in improving for residents.