TWO RESIDENTIAL CARE centres for people with disabilities operated by Stewarts Care Limited in west Dublin have again failed to provide adequate social, health and safety needs for residents, despite being threatened with closure.

The Health Quality and Information Authority (Hiqa) has ordered Stewarts Care Limited to submit a governance improvement plan in relation to all of its centres and said it will closely monitor the safety and quality of life of residents.

Hiqa conducted two unannounced inspections on Centres 1 and 5 on the Palmerstown campus on 19 October 2017. A total of 48 adults with disabilities were living in the centres at the time of the inspections.

Both centres had been previously inspected in July 2017 and poor levels of compliance were identified across all areas examined. In August 2017, Stewarts Care Limited was issued with a notice of proposal to cancel the registration of the centres. In turn, the company had to submit a plan of action to Hiqa.

Despite this, both centres failed all nine areas inspected by Hiqa during the inspection in October.

Centre 1

In the reports published today, Hiqa inspectors said they saw one resident being locked in an apartment in Centre 1. When questioned, staff and management said this was “the practice”.

In this centre, inspectors found that residents’ privacy and dignity was not consistently maintained. They witnessed a resident in a state of undress on a number of occasions, in the presence of other residents in the centre.

In addition, the report criticises some staff members who did not speak about residents with dignity and respect when discussing the provision of care and describing the residents and their care.

In one area, the main living space for residents was found to be dark, unhomely, with little or no personalisation of the environment. The seating was found to be in an unhygienic state and food debris was found on a number of chairs in the sitting room.

Centre 5

In Centre 5, inspectors found that six incidents of abuse had not been appropriately followed up on in line with policy.

Three of these incidents related to peer-to-peer physical abuse, two incidents related to unexplained bruising found on residents, and one related to a peer-to-peer verbal abuse incident.

When a senior member of staff was asked about the appropriate response to unexplained bruising, they stated that addressing incidents of that nature did not always involve safeguarding considerations.

A review of staff training records at the centre found that only 13.3% of staff members employed at the centre had completed the mandatory safeguarding training.

The outcome of Hiqa’s new monitoring will determine a final decision on the registration of the centres.

Stewarts Care statement

In a statement issued on behalf of Stewarts Care, the company said that these reports were difficult to read.

“We accept fully that the conditions they describe are unacceptable and that governance and management systems were not effective,” the statement said.

The inspection reports also confirm that Stewarts Care was given notice last year of a proposal to cancel/refuse registration of two of its centres. The conditions and circumstances that gave rise to those notices are the subjects of a detailed and multifaceted response action plan that began last summer and is ongoing.

That work is accelerating the previously planned break-up of the congregated residential setting in which its services had historically been provided and transitioning all residents into community settings*.

“The scale of change required is extraordinary and unprecedented. It involves providing new physical infrastructure as well as significant changes in structure and human resources. Critically the change prescribed requires investment beyond the resources ordinarily on hand to Stewarts Care.

The board and its senior management are fully aware of those challenges and are committed to taking the steps required to secure the capital and human resource investment required to overcome them. They cannot do so alone and will continue to work with Hiqa, the HSE, and other relevant stakeholders in that regard.

This story was updated on 17 April 2018.