Ability West only provided incontinence wear to a resident at night after an inspection by the health regulator.

The six residents with an intellectual disability who lived at Fairview Services in Galway City told inspectors they liked living there and considered it their home, having good access to the local community and supported by a staff team which had their best interests to the forefront of care.

They went out shopping, bowling and to the cinema and had nights away to a hotel planned with spa treatments booked.

The centre had a very pleasant and homely atmosphere and staff who were on duty had a warm and considerate approach to care, an inspection report by the Health Information and Quality Authority (HIQA) stated.

“It was clear the residents enjoyed living in this centre and the measures and actions of the staff team ensure that residents were active in their local community and enjoyed a good range of activities.

However, the centre had failed to adapt to the changing needs of one resident who had spent a number of weeks in hospital and had returned with a “rapid decline in their cognition”.

They were at a much greater risk of falling and suffered from incontinence most nights.

Ability West – a non-profit organisation which provides supports and accommodation for children and adults with intellectual disabilities – had not ensured that an incontinence assessment was carried out and incontinence pads were provided at nighttime.

“The inspector found that this lack of response by the provider had breached the dignity of this resident and an urgent action was issued to the provider to bring about a prompt and suitable change to the care provided to this resident.”

Ability West had also failed to have the resident undergo occupational therapy to lessen their risk of falling.

Despite adopting “additional oversight measures” in response to recommendations from the Chief Inspector, this latest inspection found the centre “had actually regressed in terms of the quality and safety of care”.

HIQA found that the centre breached three out of eight of the regulations, a key one regarding governance and management, with deficits uncovered in the multidisciplinary support provided.

In its response to the breaches, Ability West said it had applied for incontinence wear for the resident with the HSE and would fund the cost until the application was approved.

“The medical practitioner review concluded that the resident requires support for incontinence and an application has been submitted to HSE. As an interim measure, Ability West has sourced the necessary incontinence wear and will incur the cost of the incontinence wear until the application submitted to the HSE has been approved. The service user is now using incontinence wear.”

Meanwhile the situation at Macotar Lodge Services in Kilkerrin had turned around after the Chief Inspector of HIQA cancelled the registration for Ability West to run the centre where five residents were living following serious breaches highlighted in four inspections, as previously reported by the Connacht Tribune.

The areas of concern included the use of a chemical restraint, fire safety measures, inadequate staff, and safeguarding of residents’ finances. There were also breaches in the management of medication, and little oversight of their social activities.

Ability West did not appeal the decision and it was taken over the HSE, with the latest inspection the first since the government agency took over.

The same staff had remained but changes to the way the centre was being managed had resulted in a much improved service being provided with “enhanced oversight and monitoring of quality and safety of care” with a reduction in medication errors occurring.

Weekly meetings now meant that the residents’ activities were planned and taking place.

“Some residents had recently attended a local ploughing event, others enjoyed going out for a drink, got out for walks and to local GAA matches, others visited friends and family, some regularly went shopping, to the cinema and many often headed out for a meal.”

Staff spoke with the inspector about the improvements made by the HSE which had a positive impact for staff and residents.

“They each spoke very highly of the new management structure, and of how they were receiving ongoing guidance and support, which had improved their way of working and overall improved staff morale.”

The new management was given the green light when assessed for 11 regulations, its most positive performance in years.

Separately Abbeytrinity Services, which is a residential home for four people with intellectual disabilities in Tuam run by Ability West, was still in trouble with the regulator with infection prevention and control, fire safety and how it dealt with risks.

The inspection found it had fully complied with just two of nine regulations assessed.

There was a lack of a “prompt and robust” response from Ability West when the manager raised concerns which they had rated as high risk.

The manager was in charge of three centres, which result in adequate oversight.

In its response, Ability West said it had since appointed a team leader due to start last November who would have six hours dedicated to administration. A new manager had also been recruited, who would have responsibility for two centres rather than three from late November.