Some of the most vulnerable people in Northern Ireland are being forced to live in inhumane conditions without privacy and dignity, a health watchdog has found.
A series of startling failures at mental health and learning disability hospitals across Northern Ireland have been uncovered by the Regulation and Quality Improvement Authority (RQIA).
Lack of privacy, potentially lethal fire hazards, overstretched and undertrained staff and patients concerned about their personal safety were all identified as issues to be addressed by health trusts.
An inspection of one ward at Muckamore Abbey – Moylena – in June last year highlighted some particularly distressing failings in basic care for patients.
The ward provides accommodation for 18 adult male patients – many of whom have been receiving inpatient care on the hospital site for up to 50 years.
The team found that on occasions one patient was being restrained by four members of staff to allow them to take blood from him.
The patient's family said they had never been informed this was happening to their loved one.
"There were no apparent safeguards for this patient in relation to their rights and in the absence of such safeguards, this aspect of their care and treatment was significantly compromising the patient's dignity," the report stated.
Patients living at Moylena also had no time away from other patients, except when escorted to the bathroom by staff.
Some were found performing sex acts in public areas as a result of having no access to "any real privacy at any time of the day or night", the RQIA found.
The inspection team also raised concerns that previous recommendations to improve the experience of patients had not been implemented.
The report stated: "While assurances were given verbally and in writing that these concerns would be addressed in a timely manner, it would appear that patients in Moylena continue to have their rights to privacy and dignity overlooked.
"It would not be routinely acceptable for patients or service users in any other healthcare setting to have their right to privacy and dignity denied.
"RQIA remain very concerned that the human rights of these patients have not been safeguarded and that the patients' experience could be perceived as degrading."
Patients in the ward were also found to have nowhere to store personal belongings.
The team noted: "Senior nursing staff were unable to provide any assurances that these concerns, having been raised for a second time by inspectors, would be addressed.
"This was very concerning."
Both the chair and deputy chair of the Stormont health committee have expressed alarm at the findings.
Sue Ramsey, chair of the committee, said: "We need to ensure that people are being treated properly and the Health Minister needs to deal with these issues quickly."
Deputy chair Jim Wells said: "I am concerned about what has been discovered by these inspections and this is certainly something the committee will want to look at in detail. It is incumbent upon society to at least ensure that people in mental health and learning disabled facilities have a happy and fulfilling existence."
Releasing its findings, the RQIA said: "Although there was evidence that safeguarding was being promoted, a common theme across all trusts was that there were instances where procedures were not always being appropriately and consistently applied."