The HSE has been called on to address its ‘poor oversight and governance’ of disability services at a local, regional and national level.
HIQA has made the recommendation following inspections at 18 HSE-run centres for people with disabilities in Donegal.
The Chief Inspector also required the HSE to improve mechanisms to ensure safeguarding arrangements were effective, in order to protect residents from the risk of harm.
You can read the full report here
Meanwhile, the HSE has issued a statement regarding the HIQA inspections:
The HSE operates 30 designated residential centres for persons with disabilities in County Donegal. In January 2022 over a two week period, 18 of these centres were inspected by the Health Information and Quality Authority (HIQA).
Three regulations were inspected:
- Positive behavioral support – found to be substantially compliant
- Governance and Management – found to be not compliant
- Protection – found to be not compliant.
HIQA inspectors did not identify any known safeguarding issues affecting residents in centres that had not been appropriately responded to.
A detailed compliance plan has been submitted to HIQA and is being implemented in Donegal Intellectual Disability Services to address the non-compliances.
Positive Behavioral Support
- Additional Multidisciplinary Team supports such as Psychology, Social Work and Speech and Language have been approved and are being progressed for recruitment.
- A review of training requirements has been undertaken so as to ensure all staff have up-to-date knowledge, skills and the identified training to support residents with behaviors of concern.
- Sexuality Awareness in Supported Settings (SASS) training commenced in November 2021 and is currently being delivered to all staff working in centres across Donegal Disability Services. To date 217 staff have undertaken this programme.
Governance & Management
- Management structures across Donegal Intellectual Disabilities Services have been reviewed and are being strengthened.
- Donegal Disability Management has governance meetings in place for the service at County, Local Network Area and Centre levels.
- A Human Rights Committee for Donegal meets to support and provide oversight to the Service.
Protection
- Donegal Disability Services have undertaken a review of the safeguarding & incident management process to ensure there are comprehensive safeguarding and protective arrangements in place.
- A ‘Policy on Provision of Safe Wi-Fi Usage’ is currently being developed in Donegal Disability Services.
- Safeguarding review meetings and audit processes are in place with regards to oversight of appropriate safeguarding processes across the service.
- Enhanced safeguarding training is currently being implemented.
HIQA inspectors reported a number of positive findings arising from the January 2022 inspections:
- “Inspectors found that current safeguarding concerns were being responded to appropriately by the HSE. However safeguarding arrangements need to be strengthened.”
- “Staff were seen to be respectful of residents and to support them in a kind and caring manner.”
- “Residents had pleasant, homely environments that were personalised and comfortable”.
- “Persons in charge were suitably experienced, qualified and knowledgeable about their centres, and were working towards ensuring a good quality and safe service for residents.”
- “Overall residents said that they were happy in their homes, were happy with staff and with the service that they received. Most residents said that they liked their homes and they felt safe”
Community Healthcare Cavan, Donegal, Leitrim, Monaghan, Sligo Disability Services continues to work to deliver on service improvement requirements in designated centres ensuring compliance with standards is achieved. Recent HIQA inspections of the seven designated centres in Ard Greine Court, Stranorlar, on various dates in February and March 2022 identified areas where improvement was identified and included the development of clear governance structures and increased input and access to multi-disciplinary professionals for residents.
Community Healthcare Cavan, Donegal, Leitrim, Monaghan, Sligo Disability Services continues to ensure that safeguarding practices and supports are implemented in line with national policy. Current and historical matters of concern are actively followed up which includes the File Review undertaken in relation to Ard Greine Court services. The findings of the File Review have been externally validated and actions from the validation are now being progressed for implementation.
Additionally Community Healthcare Cavan, Donegal, Leitrim, Monaghan, Sligo Disability Services remains firmly committed to the development of a community based model of living and support for people with disabilities and will continue to work towards implementing this model through supporting people with disabilities to live in homes in the community rather than in congregated settings – decongregation.
The decongregation of 112 residents from the Cregg campus in Sligo has been completed. A number of residents from other congregated settings such as Cloonamahon, Sligo and James Connolly Memorial Unit, Donegal have also moved to new homes in the community. Plans are underway to support residents from a range of other congregated settings to move to community group homes and Disability Services are engaged with HSE Estates, Local Authorities and Approved Housing Bodies to develop suitable residential properties. A number of developments are also being supported by Parents & Friends Groups. Other community accommodation is also being developed to ensure that appropriate housing is provided to people in residential services.
The purchase/lease and renovation of several new properties is being progressed in Donegal to provide appropriate residential accommodation to people living in congregated settings such as the James Connolly Memorial Unit, Carndonagh, Ard Greine Court, Stranorlar, Ballytrim, Raphoe and Piermount, Dungloe. Two new community group homes were recently completed in Donegal Town. Active planning for a number of residents to move in 2022 and 2023 is under way with properties being procured and renovated to the necessary regulatory standards and based on the preferences of the residents moving in.
Head of Service for Disability Services, Community Healthcare Cavan, Donegal, Leitrim, Monaghan, Sligo, Edel Quinn, stated “The HSE will continue to work to ensure that robust governance, quality and safety arrangements are in place and that these systems are working effectively to ensure that person centred, safe, high quality services are provided. We will continue to advocate for the further development of services for people with disabilities ensuring that accommodation and supports that best meets residents’ needs are in place.”
