A resident in a Galway facility for adults with intellectual disabilities was behind 14 violent incidents which left the other men living there in fear and often confined to their bedrooms.

An inspection by the Health Information and Quality Authority (HIQA) found that Ability West had identified 13 “safeguarding incidents” had taken place last year and a further incident had taken place in February 2023 at Devon Lodge in Salthill.

There had been a recent escalation in “behaviour of concern” by this resident which was having a negative impact on the other four men there.

Staff described residents as “living in fear”, “living on edge”, “unable to relax” and “walking on eggshells”.

“Staff advised that despite safeguarding plans in place being implemented and good supports being available from the designated officer and psychologist, they were unable to prevent behaviour of concern such as shouting and threats of aggression,” the inspector stated.

One of the sitting rooms was allocated for use solely by this resident.

“Residents were not always able to enjoy living in the house in a relaxed environment, could not always choose to spend time in the rooms of their choice and could not always choose to use various facilities in the house for fear of negative peer interaction,” the inspector stated.

“Some residents had restricted access to parts of the house at times. For example, some residents had to go directly to their bedrooms on return from day service to allow staff time to determine how another resident was presenting. Some residents were restricted regarding the times they got up, from using parts of the house and using facilities in the house due to fear of verbal abuse and negative interactions with another resident.”

Because of the challenging behaviour, the other men could not have visitors.

Staff were also negatively impacted by the man’s challenging behaviour and spoke to the inspector about enduring “aggression and violence”, bullying and workplace stress.

The situation at the house was compounded by recent staffing shortages when just one staff member was on duty for the morning shift instead of two. Just one worker was on duty at night. One staff member was on long term sick leave, another on maternity leave and another was due to retire shortly. Relief staff were not always available at short notice as they also worked in other designated centres.

Ability West had previously agreed to provide alternative living accommodation for the man, but the inspector said progress was slow and there was no definitive date about when the proposed property would be ready for occupation.

“The provider had completed the purchase of alternative accommodation for one resident who wished to have their own apartment and that a planning application was currently under consideration. They advised that a planning decision was due by the end of March and that an architect was currently drafting plans for the project.”

Following the report, Ability West agreed to move the “incompatible” resident to another vacant centre between 4pm and 8pm during the week and 10am to 6pm at weekends until the permanent home was ready for the welfare of the residents and staff.

At a second residential facility for adults with intellectual disabilities run by Ability West, HIQA praised the improved staffing since the previous inspection.

But the inspector criticised the plan at Ocean Wave Services to bring in another resident to live with the other four, even though the centre was licensed to accommodate five adults.

“Although there was vacancy in this centre, the provider had not given consideration to the potential implications to the quality and safety of care delivered to the four residents already living there,” the report states.

Ability West had also not outlined a “no robust action plan” to carry out improvements required to the building in Salthill to meet the changing needs of residents.

Ability West said it acknowledges that there are “a number of non-compliance issues” relating to residential centres in Galway following the HIQA inspections.

“The response to the inspections was treated as an immediate priority by the senior management team and the Ability West Board of Directors,” said a spokesperson.

“Ability West has had positive engagement with HIQA regarding a regulatory plan over an agreed period of six months, to address non-compliances. They are also working with their primary funders, the HSE, in this regard.

“Ability West is committed to the safety and wellbeing of the adults and children that they support, and a compliance plan was implemented as a matter of urgency.”

The charity said it had been in contact with its employees, people they support, families and carers to brief them on the HIQA engagement.

“The organisation will continue to work closely with HIQA and the HSE to ensure that all services provided across its residential and day services are of the standard required by HIQA.”