A DOSSIER DETAILING a series of allegations at a major charity for people with intellectual disabilities is to be handed over to the health watchdog.
The file, sent to the Health Information and Quality Authority (Hiqa) by Sinn Féin TD Rose Conway-Walsh, contains claims that staff have witnessed “verbal and emotional abuse” of vulnerable service users.
The claims centre around Western Care, a registered charity based in Mayo, which has 850 service users and employs over 1,000 staff in the region.
The concerns are specific to one section of the organisation covering over 50 service users who are spread across the county in their own accommodation with one-to-one care.
In the file, which The Journal has seen extracts of, staff members and family members of service users recounted alleged incidents, including one person who “witnessed verbal abuse… emotional abuse to service users”.
This person added: “Staff were afraid to report for fear of losing their jobs.”
Asked about the specifics of the allegations, Western Care Association told The Journal it “is not in a position to verify or investigate these complaints as we have not been provided with any detailed information on the allegations mentioned”.
“Western Care Association always thoroughly investigates cases brought to its attention by members of staff,” it added before saying it takes any allegations seriously and encourages staff to speak to the charity.
“Their concerns will be taken extremely seriously,” it said.
The charity was founded in 1966 and provides a range of services including one-to-one care for people with complex needs who are supported in their own accommodation across Mayo. It is a community and voluntary organisation in receipt of public funding.
But concern has been raised in recent years around a section of Western Care called Individualised Services which supports more than 50 service users in their own accommodation.
A report (the Wolfe Report) commissioned by the charity in 2020 – but which was only published in recent weeks – found that the service was in “significant crisis” with staff and management at risk of burnout and some staff at “high risk” of being injured on the job.
While it found that the “person-centred” care was giving many residents a life they may not have enjoyed without the charity’s work, it raised several concerns.
It listed a number of incidents including the “attempted choking” of staff and “continuous assaults”, and further questioned whether the charity can “safely sustain” the service, as reported in the Mayo News newspaper in its ongoing coverage of the controversy.
Staff who have spoken to this website believe they have been discouraged from reporting events of concern, and further expressed allegations that some vulnerable service users have suffered the “withholding of care” while living in “squalor”.
Western Care said its interim chief executive had visited many sites in her role and “would not recognise the descriptions provided” from what she has seen during that time.
“At Western Care Association, we ensure we comply with any of our legal obligations, including any of our services which fall under the Health Act 2007. The care of the people we support is under constant review so that the organisation can respond to changes in need as they arise,” it said.
“Western Care Association is confident that the standard of care we provide to the 850 people we support meets the appropriate standards.”
It added that it was now moving several service users to new accommodation as part of its restructuring.
Staff and a local Sinn Féin TD are now calling for an independent investigation into Western Care.
Rose Conway-Walsh, a Sinn Féin TD based in Mayo, told The Journal that the Wolfe Report was an important document but that an independent review into its services was needed.
Conway-Walsh said she has contacted the Health Information and Quality Authority (Hiqa) with the document of allegations following contact by a number of people involved with Western Care’s services.
I am very conscious that there are many dedicated workers working within Western Care and not all service users experience the negative things described to me in many of the calls, however all the calls and emails I received called for an independent external investigation.
Hiqa confirmed to The Journal that it has already received “information of concern relating to individualised services being operated by Western Care Association” and is currently engaging with the charity.
“We can confirm that we have received information of concern relating to individualised services being operated by Western Care Association and are currently engaging with the provider in this regard,” Hiqa said.
“The chief inspector in HIQA regulates designated centres which are residential services that meet the criteria set out in the Health Act 2007. Not all residential services meet this criteria.
“However, providers are legally responsible for notifying the chief inspector and applying to register centres that meet the criteria. The chief inspector has a number of regulatory actions that can be taken should a provider fail to fulfil their legal responsibility.”
Responding to the claims, the charity said a “number of changes” have been made to its management structure and to the “supervision of a number of services” since concerns were first highlighted.
Regarding allegations around the treatment of its service users, it said it is “not in a position to verify or investigate these complaints as we have not been provided with any detailed information on the allegations”, adding that it “always thoroughly investigates cases” brought to its attention by members of staff.
“There are a range of options available to members of staff to raise issues. The organisation welcomes feedback from staff as it is an important source of information for improving services,” it said.
It said its complaints policy is “clear” and added that “all staff have a duty of care to protect the people supported by Western Care Association” requiring them to report any issues that affect the safety and welfare of service users.
“No employee should ever be afraid to make a complaint,” the charity’s statement said.
A spokesperson, acting for the charity, also added that allegations of issues within the organisation are “historic” and that the charity is engaging with a number of statutory bodies.
“Western Care Association takes any concerns raised by team members, the people it supports, their carers or family members extremely seriously. The wellbeing of the people it supports and the wellbeing of its staff are the organisation’s utmost priority,” said the spokesperson.
“Western Care would encourage any staff, present or past with any concerns of any aspect of care or welfare to speak to the management team.”
The section which has raised concern – Individualised Services – seeks to support people with disabilities living in inappropriate conditions by providing staff to work with them in their home and giving them autonomy over their care. It has been in place since 2006.
The 2020 Wolfe Report found that Individualised Services had quickly expanded after 2012 but in a “reactive rather than planned” manner. Although it had almost a 2:1 staffing to patient ratio, the report said that a large number of workers were part-time or worked in sessions.
It added that 36 positions were vacant at the time.
The report noted that Individualised Services were spread across Mayo often in “isolated” locations.
As part of its restructuring of the organisation, the charity has recently sought to move the Individualised Services section to “two new support structures” based on geographical location.
One staff member, according to Conway-Walsh’s document, said their experience in Western Care has left them “traumatised”, but this person also expressed fears for the service users in the care of the charity.
They claimed: “…the residents living in these conditions have no escape, no support, no multidisciplinary team working for their best interests, left to live a life with no quality”.
Several comments in the document, from staff and family members of users, refer to a “culture of intimidation and fear” and express regret over their time with the charity.
“Our experience with [Western Care] is one of anger, disappointment, neglect and being constantly let down. It needs a complete overhaul and less people sitting behind desks and more people providing services to our children,” one said.
Another said their time with Western Care saw “what could only be described as an inadequate service with little to no management”, which they said resulted in poorly trained staff working with the most vulnerable service users in “non-professional ‘Care’ settings”.
When there was a risk of families complaining, staff were allegedly “told not to speak to families”, with one saying they “witnessed how they managed families who don’t toe the line”.
When speaking to The Journal, the charity said it has commissioned two separate reviews into the organisation to ensure it meets the “highest standards of governance and accountability” at the organisation.
One review is focusing on how Western Care carries out its work across its various care teams, while the other is examining its management structures.
“Western Care Association provides the necessary training to its team members and promotes a culture of professional development with staff provided with opportunities to upskill,” it said.
Additionally, the moving of the Individualised Services section to “two new support structures” under new area managers will help staff across Western Care Association to provide the best possible care to the people it supports, the charity said.
Regarding allegations that staff feel uncomfortable highlighting issues, the charity said its interim chief executive Dr Aoife O’Donohue has been “engaging extensively with staff and organisational groups within Western Care”, visiting its locations across Co Mayo.
It said Western Care has committed to “improving internal communications” so issues can be brought to senior management’s attention much faster.
“In the meantime, work is continuing to transition a number of people supported by the organisation into new and bespoke designated services. Western Care Association continues to engage with all relevant statutory bodies, including HSE, Hiqa and The Safeguarding Team.”
The document also contained a claim that the charity has been beset by legal cases in recent years. According to a search of High Court filings, 15 cases have been taken which named Western Care as defendants since 2019.
Western Care said that it cannot comment on individual cases or legal proceedings regarding the people it supports or its employees.
“It is conscious at all times of protecting the privacy of the people it supports and its employees as well as the confidentiality of any information relating to them.”
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