A Monaghan residential centre has been found to be non-compliant in almost half of the areas inspected by HIQA this year.
Inspectors visited the Tonyglassion Group Home in January and found issues with staffing, management and a number of others areas.
The centre, which is operated by the HSE, was inspected at the end of January when five residents were present.
It was found to be non-complaint in five of the 12 areas examined - residents' rights, positive behavioural support, premises, governance and management and staffing.
Inspectors found not enough staff members were employed at the centre and it was "not adequately resourced to ensure the effective delivery of care and support to residents in accordance with the statement of purpose".
It was also found the group home was not fully accessible to all residents and there was a need for improvement in the upkeep and maintenance of parts of it.
The use of restrictive practices, including the locking of some doors and all kitchen cabinets, as well as restricted access to running water, were not in line with national policy.
HIQA said it was not clear if residents were receiving the maximum amount of water they should as medically prescribed, with some receiving as little as 500ml in a 24 hour period. However, the report states that there was the possibility of "poor recording practices" in the centre.
In response, management said additional staff have been allocated to Tonyglassion, there would be ongoing monitoring of the centre's plans and works would be undertaken to improve the appearance.
A "systematic review of all restrictive practices" has also been conducted.
STATEMENT FROM THE HSE
This HIQA report was the result of a short notice inspection which took place on the 28th January 2021
This centre is managed by the Health Service Executive and is located close to Castleblayney in Co. Monaghan . The centre is made up of one unit providing residential services to people with an intellectual disability, who have been identified as having complex needs and as requiring high levels of support. The service accommodates male residents from the age of 18 years and upwards.
The report states that overall the residents were happy living in this centre. Staff were found to be knowledgeable of residents' needs and wishes and were fully compliant in their training and development. The person in charge had implemented an effective system to monitor and oversee the management of complaints.
Of the 12 regulations inspected 6 were deemed compliant, 1 substantially compliant, and 5 were not compliant.
With regards to the regulations found not to be compliant, actions taken to address these areas included the following:
Staffing
Due to the temporary closure of Day Services because of COVID-19 public health requirements, an additional staff has been allocated to the centre to ensure activity levels for residents and opportunities for 1:1 engagement are provided.
Premises
Painting of the interior and the exterior of the building will be completed in May 2021
A temporary ramp has been installed
Floor covering in one bedroom has been replaced
Governance & Management
Management systems in place in the centre have been reviewed to ensure the needs of residents are appropriately met and are monitored on a regular basis.
Weekly monitoring of incidents and restrictive practices by the Clinical Nurse Specialist in Behavioural Management.
Positive Behavioural Support
All restrictive practices will be reviewed and monitored by the Person In Charge with the Clinical Nurse Specialist. The Senior Management Team is informed on a weekly basis as to what restrictive practices are being used and review ensures that such practices where required for the protection of residents are only used for the shortest duration necessary and that the least restrictive alternative has been considered
Resident's Rights
Systematic review of all restrictive practices has been conducted and alternative measures have been implemented.
The Registered Provider has assessed the compatibility of residents who share accommodation in the centre. Plans have been developed for a new extension to provide accommodation for one resident which has the potential to further decrease the use of restrictive practices within the centre. This is due to be completed in October 2021.
The HSE will continue to work to ensure that robust governance, quality and safety arrangements are in place and that these systems are working effectively to ensure that person centred, safe, high quality services are provided to all service users and residents.
