Shock new whistleblower allegations have been made about the abuse of vulnerable care home residents in the wake of the Áras Attracta scandal.
Records seen by the Irish Independent detail how the mistreatment of intellectually disabled residents is continuing - despite promises of a clampdown on rogue staff by the Government and the HSE.
Physical and emotional abuse, shouting, force feeding, and injuries occurring due to a lack of supervision are just some of the problems highlighted by current and former care workers.
One care professional who raised concerns with their employers said they had experienced intimidation and had their hours cut, while others alleged Health Information and Quality Authority (HIQA) inspectors were being duped into believing care centres were well run, when the opposite was the truth.
The allegations were made in the aftermath of the exposure last December of the scandalous treatment meted out to three intellectually disabled female residents at Aras Attracta, a HSE-run facility in Swinford, Co Mayo.
Details of the complaints were released under freedom of information rules to Fine Gael TD Fergus O'Dowd.
One of the whistleblowers found working in a care centre "disturbing", while another told HIQA they had resigned out of frustration out of "mismanagement" of care units.
It is unclear to what extent the allegations have been investigated. While HIQA is able to trigger immediate inspections on the back of such complaints, it lacks the power to investigate specific allegations.
HIQA said that while it couldn't comment on individual cases, if the information provided indicated an immediate and serious risk to care home residents, it would undertake a triggered inspection.
All allegations are immediately "risk assessed" and can also be referred to the HSE and to gardaí.
Some of the complainants who contacted HIQA in recent months were advised to complain to the Ombudsman, who can investigate HSE-run homes, but not private ones.
Mr O'Dowd said that while the majority of care homes were well run, it was clear Aras Attracta was not just an isolated case.
"These reports show that the neglect of vulnerable people with intellectual disabilities is continuing behind closed doors," he said.
"These allegations about low standards and downright abuse cannot be ignored. This must be rooted out. It is incumbent on everyone, be they health providers or politicians, to step up to the mark."
In the aftermath of the Aras Attracta revelations, the HSE put in place a six-point plan in a bid to safeguard resident safety, dignity and respect.
A confidential recipient, Leigh Gath, was also appointed to examine disclosures of abuse of vulnerable people in HSE-funded services.
However, suggestions that the HIQA's powers could be expanded to allow it to conduct specific investigations do not appear to have gained traction.
Other proposals, including the use of undercover staff and hidden cameras have also not been implemented.
The HSE said these potential measures were still under consideration.
"This would be a new measure, never undertaken before, and the HSE is very conscious of the potential difficulties in relation to privacy and data protection," the HSE said in a statement.