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Regulator critical of care at Galway centres for adults with intellectual disabilities

The lack of staff hampered the safe evacuation of residents in the event of a fire at two centres for adults with intellectual disabilities in Galway.

Macotar Lodge Services in Kilkerrin and St Dominic’s in Tuam, both run by Ability West, were found to have serious regulation breaches when inspected by the Health Information and Quality Authority (HIQA) in the last two months.

Inspectors carried out unannounced visits following concerns reported to the regulator over their management by the charity.

Macotar was found to have breached six regulations, two of them posing the highest level of risk, both related to poor staffing levels.

At full capacity with six adults who had all lived together for a number of years, some residents in this centre required two staff to help with their incontinence care at night. But the inspector found only one staff member was on duty.

One incident had led to a resident being seriously injured but no review had been carried out to ensure it did not reoccur. The manager had to regularly provide direct care to residents as there was nobody else on duty to do it.

The aging residents required additional support with their mobility, incontinence care, personal care and neurological care needs due to their age.

“These issues were escalated to Ability West by local and senior management, however, at the time of the inspection, the provider had not made any improvement to staffing resources. This resulted in the continued limitations of this centre’s ability to provide a safe and good quality of service for these residents.”

Ability West carried out its own inspection two months before HIQA but failed to address the risks identified.

In response to the initial report, Ability West it had updated an assessment of need for all residents and a minimum of three staff were now rostered on duty when residents were awake and two when they were asleep, with an extra staffer brought in if needed to help getting them out of bed.

A night fire drill was carried out with two staff on duty and all residents were safely evacuated quickly.

Six residents were living at St Dominic’s, which had capacity for an additional respite resident.

The centre was reported to be “warm, cosy and it had a real sense of home” and staff on duty had “a kind approach to care and residents seemed at ease”.

Of the ten standards assessed, the centre fell badly down in four.

There were severe staffing shortages also at this centre: “A review of the rota indicated that the centre had operated below the assessed staffing requirement on numerous occasions.”

The manager had to fill in on the roster six times in the two weeks before the inspection last December. Yet this manager had been appointed to manage three residential centres.

Some residents required bed and wheelchair evacuation and one needed to be supervised at all times as they were at risk of wandering onto a nearby road. Yet there was just one night duty worker.

“Ability West was unable to produce a fire drill record where all residents had been evacuated by one staff member in a prompt manner. The most recent drill supported just five residents to leave the centre.”

Ability West said the respite service had been suspended until it could ensure safe evacuation of residents. It was working to address the staff shortages to ensure a full complement of workers.

In a statement issued following the publication of the HIQA reports, Ability West stated that there had been 25 inspections between July 2022 to February 2023.

These had identified a non-compliance rate of 24.8% and a full compliance or substantial compliance at 75.2%.

“It is a reality that services have been impacted significantly from a staffing perspective over recent years. Whilst every effort has been made to address the ongoing difficulty with recruitment and retention of staff, the issue of pay parity for Ability West as a section 39 service provider within the disability sector continues to be a barrier to attracting and retaining talent in their services.”

For more, read this week’s Connacht Tribune:

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