Watchdogs criticise care homes
Two care homes for disabled people have been criticised over the use of sleeping pills to control residents at night and unexplained bruising.
Watchdogs inspected Aras Attracta in Swinford, Co Mayo, in January after secret filming by RTE revealed graphic episodes of people being manhandled and shouted at.
The Health Information and Quality Authority (Hiqa) found evidence that drugs classed as "chemical restraints" or "hypnotics" were used in the home to manage residents' behaviour.
"One resident was prescribed a hypnotic on a regular basis," inspectors found.
A separate inspection, of St Peter's Centre in Castlepollard, Co Westmeath, found incidences of unexplained bruising on some residents.
Hiqa said the marks had been documented but there was no evidence that an official in charge of the protection of vulnerable adults had been informed.
On Aras Attracta, Hiqa said its officials saw a report by a healthcare professional who found sleeping pills were being administered to some residents earlier than recommended to mitigate for the lack of staff in November last year.
It is understood Hiqa regards the overuse of drugs for people with disabilities as a major concern in residential care centres.
The Health Service Executive, which runs both centres, has already apologised unreservedly for the "unacceptable" standards in Aras Attracta and suspended eight staff.
The drugs issue was made in an unannounced inspection following RTE's expose on the home in December and it also raised concerns that reviews of disabled people on psychotropic drugs were insufficient.
"There was no documentary evidence that the reviews evaluated the risk to physical, psychological or emotional well-being," the Hiqa report found.
The inspectors did not detail the specific drugs being used in order to protect the identity of people in the care home.
It also warned about unsafe medication practices at Aras Attracta including unnecessary injections of fluids to one person over concerns of dehydration and one resident given too many laxatives and anti-diarrhoeal medication.
An inspector reported one "near-miss" and stepping in on one occasion when drugs were being wrongly administered.
Twenty-eight people were being cared for in a series of bungalows at the home when the inspections took place over four days.
Inspectors found management procedures for residents with challenging behaviour were not specific to an individual and some notes showed one resident's name was scribbled out and another resident's name hand written over.
Bathroom facilities in some bungalows were not private, one bungalow smelt of urine and there was a risk of slipping on wet floors.
There was also a risk of unauthorised access to the homes.
A Garda investigation was launched into the allegations of abuse at the centre.
A series of reports on standards of care in centres for people with disabilities are expected in the coming weeks and months.
Disability Federation of Ireland said the report showed continued lack of appropriate care and support for the residents of Aras Attractra.
Allen Dunne, deputy chief executive, said: "It is apparent from the reports that in addition to core health and safety issues the residents are continuing to be treated with a lack of basic respect and dignity."
Mr Dunne said the HSE was trying to improve conditions but a huge immediate effort is needed to ensure an acceptable standard of safety and care.
The federation added that failures in care homes are symptomatic of a wider lack to commitment to the rights of people with disabilities in Government policy.
The HSE said a series of corrective steps have been taken since the Hiqa inspections three months ago.
An additional 27 staff were hired for Aras Attracta, which has increased social activities on site and in the community, and new therapies are being developed and provided including multi-sensory, hand massage, music therapy, beautician, imagination gym, art therapy and swimming pool.
Staff have been retrained on medication standards and a psychiatry review of prescriptions has been carried out.
Other training has also taken place for safeguarding vulnerable adults and supervisors are now only tasked to oversee other staff rather than on full-time rosters.
The HSE said it is also establishing a residents' council chaired by a family member to focus solely on the welfare of residents and protecting their rights.
"The new council will be involved with local management in shaping the future of the centre in response to the needs of the residents and will be empowered to raise any concerns with local management, HSE national management, HIQA or the confidential recipient," the HSE said.