THE DÁIL HAS heard that a culture of providers “marking their own homework” by “deciding whether or not to invite inspectors” to examine settings for vulnerable service users has existed at a Mayo charity.
Sinn Féin TD Rose Conway-Walsh said an independent investigation needs to be carried out “to know who made the decisions that these services did not need to be regulated” in her address to the Dáil.
She said that, following engagement with the health regulator, Western Care has now confirmed that dozens of its services doing focused one-to-one care were operating outside of regulation.
The deputy further alleged that the charity had “exploited” a loophole in the legislation and not registering Individualised Services for oversight.
Last month, The Journal reported that a dossier containing a series of allegations at the charity for people with intellectual disabilities is to be handed over to the health watchdog.
The file, sent by Conway-Walsh to the Health Information and Quality Authority (Hiqa), contains claims that staff have witnessed “verbal and emotional abuse” of vulnerable service users.
The registered charity is based in Mayo and has 850 service users. It employs over 1,000 staff in the region.
“The last number of months has seen a flood of people coming forward to discuss serious issues in relation to the care being provided at Western Care and the treatment of staff,” the deputy told the Dáil chamber.
She said that as the legislation currently stands, Hiqa does not have the authority to enter and inspect non-registered services without Western Care’s permission, “even though some people receiving care in this way are the most vulnerable people in our county”.
Western Care confirmed to The Journal that a total of 37 of its Individualised Services have been brought to the attention of the Health Information and Quality Authority (Hiqa). They will now be subject to oversight by the watchdog.
This is along with five other Individualised Services. The total number of the centres stands at 104.
“A holistic approach is necessary where HIQA has the powers and resources to inspect all the services delivered by providers,” Conway-Walsh told the Dáil, also saying that “many of the most alarming accounts centred” on care for individuals living alone in Individualised Services.
“A culture of providers marking their own homework and deciding whether or not to invite inspection cannot be tolerated.”
She alleged that attempts by Hiqa to regulate that part of the organisation had been unsuccessful as Western Care had “argued that no oversight was necessary”.
But Conway-Walsh added: “Late last year Western Care agreed to allow Hiqa to inspect a sample of five homes where care was being provided. Hiqa found that all five should have been registered. Operating unregistered in an offence under the 2007 Health Act.”
She said “contravention of the 2007 Health Act over such a long period of time is a very serious
Matter”, and called upon Minister of State for Disabilities Anne Rabbitte to ensure there is “accountability” and to outline the steps she is taking to “ensure this can never happen again either in Western Care or similar care services in the future”.
“It is very clear that the 2007 Health Act needs to be extended to incorporate all services provided to vulnerable users,” she said.
Sinn Féin’s spokesperson for disability Pauline Tully commended staff who allowed residents to “live the best life possible” through their work for Western Care, but said where that “support” or “living conditions are not satisfactory”, then it needs to be corrected.
She said people who are the country’s “most vulnerable citizens” suffer as a result.
Responding, Minister Rabbitte said “there was a lot of work ongoing” between Hiqa, the HSE, the board of Western Care and its management to ensure compliance with up-to-date standards.
She said Hiqa had assured her that it has been actively engaging with Western Care, and that “action has been taken to prioritise the safety and quality of care and support” for residents.
Rabbitte added that there has been an “escalated level of inspection activity” in Western Care and that the HSE is also engaging with Western Care to address any immediate concerns.
Conway-Walsh said there must also be “firm and frank assurances” that those who have come forward to “expose the non-compliance will not be ostracized” as a result.
Rabbitte said she wanted to “thank the people who have come forward” who have highlighted the issues around the charity.
She added: “I want to thank the staff that work within Western care and the continuous care that they give, but I also want to give reassurance to the families of the 700 who would have loved ones participating.
“We all know that Western Care is a fantastic service provider in Mayo, but we also need to bring that reassurance piece to it, that their loved ones are protected and minded to the highest possible standard.”
When contacted, Western Care said it continues to engage with Hiqa and the HSE on an ongoing basis to ensure services meet the required standards and to comply with its regulatory obligations.
“The support and care of the people it supports remain under constant review so that the organisation can respond to changes in need as appropriate, ” it said, adding that Hiqa guidance in relation to determining whether services are regulated was updated in June 2022.
“Five services have since been registered with HIQA. In keeping with the new guidance, Western Care has put forward an additional 37 centres for consideration by HIQA. Western Care is currently actively engaged in a process with HIQA in that regard.
“This is being undertaken to meet the evolving needs of the people we support, and to ensure we provide the most appropriate care in the most appropriate setting. This process is in line with the HIQA guidance issued in June 2022 on ‘What is a designated centre’”.
The charity added that any service that requires registration with HIQA will be registered. “Western Care’s aim is always to provide the most appropriate support and care in the most appropriate setting,” it said.
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