Poor HIQA checks leave residents at risk, report claims
Inspectors are failing to properly investigate homes for people with a disability - leaving many vulnerable residents at potential risk, a report has warned.
The heavy criticism of the Health Information and Quality Authority (HIQA), which sends inspectors to visit the homes, is contained in a major new analysis.
It comes in the wake of the scandal over áras Attracta in Mayo, now under investigation following under-cover television footage showing residents being slapped, kicked, verbally abused and force-fed.
The analysis, commissioned by advocacy organisation Inclusion Ireland, was carried out by independent researchers and examined 50 HIQA inspection reports.
The reports covered 123 units which served over 700 people with disabilities across the country in 2014.
It revealed that more than half the centres involved residents living in separate homes such as bungalows in congregated settings - but it was not clear which sections were visited or bypassed.
Paddy Connolly, head of Inclusion Ireland, said he is extremely concerned at the finding.
He warned that the method of inspection, whereby not all units in one setting are inspected, could mean abusive care practices could go undiscovered.
The analysis revealed:
In one HIQA report, a centre had separate housing for 44 residents in different homes. But it was only inspected for services to 13 people and the three homes visited were not specified.
It said that inspectors appear challenged when tasked to compile a single report to reflect equally on separate groups of residents, in different locations, undermining the process.
Inspectors should investigate a home under 18 key headings but this is not always done.
A key weakness throughout is that the "voice of the resident is extremely faint or silent".
There were few if any quotes from residents and scant references to comments by families. Questionnaires were not always completed. "There are no first-hand accounts. No direct quotations." It means there is little insight into residents' quality of life. They may be safe but they could be "lonely and bored".
The majority of inspections are announced.
This undermines the robustness of the process and means managers can give a false impression during the inspectors' visit.
The reports reveal a picture of extensive breaches of regulations in a areas such as health and safety, independent advocacy, restrictive practices and checking of medicines.
There is a lack of consistency in the scores given to breaches - the same fault can be judged moderate in one report and major in another.
Residents did not have a choice about who they wanted to live with in community residents and these kind of living arrangements could be "bordering on the abusive".
Mr Connolly said that HIQA needs to follow the UK which involves "people with a disability on the inspection team and in the training of inspectors.
"The HSE should conduct its own review of HIQA reports and ensure failings are addressed across all services," he said.