HIQA releases reports on six services for people with disabilities in Donegal

HIQA has published reports from 29 inspections of designated centres for people with disabilities, six of which are in Donegal. 

On the whole, a  generally good level of compliance was noted. 

The six facilities in Donegal are all operated by the HSE. The inspections which took place between August and October followed on from a targeted inspection programme which took place over two weeks in January 2022. 

The January programme was, according to HIQA: “due to concerns about the management of safeguarding concerns and overall governance and oversight of HSE centres in County Donegal.”

It focused on regulations relating to positive behaviour support, and governance and management. The overview report of this review has been published on hiqa.ie 

The HSE subsequently submitted a compliance plan describing all actions to be undertaken to strengthen these arrangements and ensure sustained compliance with the regulations. 

HIQA Inspectors are now carrying out a programme of inspections to verify whether these actions have been implemented as set out by the HSE. They are also assessing whether the actions of the HSE have been effective in improving governance, oversight and safeguarding in centres for people with disabilities in Donegal.

Overall, the reports have been positive with some areas for improvement. 

All centres have prepared Compliance Plans with a view to attaining full compliance in all areas of service quality and governance. 

The full reports can be found at hiqa.ie

Riverwalk Respite House

An unannounced inspection was carried out at Riverwalk Respite House on August 24. 

The centre provides accommodation for up to three residents and was established as a respite service to provide both day and overnight residential respite care to children and adults with a disability, Children and adults avail of the centre at separate times. 

In addition to their own bedrooms, residents have access to communal facilities which include a kitchen-diner, two sitting rooms,a laundry room and bathroom facilities. 

On the day of inspection, the centre provided a full time service to two residents and was not offering respite services. 

According to the inspector: “The person in charge reported that efforts were underway to identify alternative accommodation for the residents.

“When this accommodation was sourced, it was intended that the respite services in

the centre would recommence.”

Overall, the inspector found that the service in this centre was of a good quality and

that residents’ choices were respected. 

Both residents told the inspector that they were happy in the centre and were looking forward to moving into their new homes. 

They spoke about the activities that they enjoyed, upcoming plans for outings, and projects in which they had engaged.

Overall the inspector found that while the centre was clean, homely and personalised with the residents’ belongings, it required some repair and refurbishment. The person in charge reported that this had been identified and that extensive work was scheduled.

Outside, one resident with a particular interest in gardening  had planted flower beds and potted plants, making for a very pleasant display of colour. 

Hens were kept in a hen house beside the centre and residents enjoyed being involved in their care. 

Quotes had been obtained for a new garden shed, new wheelchair accessible picnic tables, a new bench for sitting out, and repairs to a water feature. 

A handrail was also due to be repaired. 

Staff interaction with residents was noted as being carried out in a friendly, caring and respectful manner. 

The inspector found Riverview Respite House to be ‘Compliant’ in areas of Communication, General Welfare and Development, Food and Nutrition, Individual Assessment and Personal Plan, Healthcare, Residents’ Rights.

It was found to be ‘Substantially Compliant in the areas of Staffing, Training and Staff Development, Governance and Management, Risk Management Procedures, Positive Behavioural Support, Protection.

Railway View

An unannounced inspection took place on October 18 at Railway View, a facility which provides 24 hour full-time residential support to male and female residents, some of whom have complex support requirements. 

There were three residents present at the centre which can accommodate four adults. It comprises one detached bungalow on a small campus based setting. 

There is a centralised kitchen on the campus from which meals are provided to the residents. There is also a day service where residents can attend external to the campus. 

Each resident has their own bedroom, while the bungalow has considerable collective space and spacious gardens. 

The centre is staffed on a 24/7 basis with a full-time clinical nurse manager II in charge, and a team of staff nurses and a team of health care assistants.

The inspector met with all three residents, who appeared relaxed with the care and support they received. 

Staff were knowledgeable about residents’ needs and provided support as and when required in line with residents’ non-verbal communication and observed behaviours.

Staff members spoke about the range of activities residents enjoyed at the centre, which included attending an activity hub in the local town. The hub provided a range of activities such as reflexology and arts and crafts. 

The inspector observed that Railway View was homely in appearance, clean, spacious and in a good state of repair. 

Residents' bedrooms and these were personalised with photographs and ornaments and clearly showed the interests and likes of the individuals. Personal items were also observed in communal areas.

The inspector reported: “Residents also had access to the centre’s kitchenette to prepare simple meals, get snacks and make beverages, the main meals being provided by the campus’ centralised kitchen. 

“Although some residents were able to access the kitchenette, due to its size this opportunity was limited to residents with mobility needs. Staff members spoke about how they currently negotiated this obstacle through bringing cooking equipment for activities like baking into the nearby dining room so residents could be as involved as possible.”

Plans are in place to reconfigure the kitchenette in order to give greater accessibility. 

In summary, the inspector found residents’ needs were supported at the centre and care and support was provided to a good standard, although further improvements were required to build upon and sustain compliance.

The facility was found to be Compliant in areas of Person In Charge, Notification of Incidents, Risk Management Procedures, Fire Precautions, Individual Assessment and Personal Plan, Positive Behavioural Support, 

It was deemed Substantially Compliant in Staffing, Governance and Management, Premises, Protection, 

Railway View was found to be Non Compliant in one area, Training and Staff Development. 

Finnside

The unannounced inspection of Finnside took place on October 18 and 19. 

Finnside is a designated centre within a small campus setting which contains six other designated centres operated by the provider. It can provide full-time residential care and support for up to four residents, both male and female. 

The facility consists of two sitting rooms, one of which has patio doors with access to the garden, a dining-room, a visitor’s room, kitchen, Jacuzzi bathroom, three shower rooms, two en-suite bedrooms and four single bedrooms. 

A laundry room is available where each resident, if they choose, can participate in their laundry. 

Residents are supported by a staff team of nurses and healthcare assistants who provide 24 hour support, with two waking night staff in place each night.

There were three residents present on the date of inspection, all of whom were met by the inspector. 

Residents interacted with the inspector on their own terms and with the support of staff. They were observed to be relaxed in their home. 

According to the report: “The house was spacious to meet the needs of the three residents. 

“The centre had experienced the death of three residents over the previous two years and it was observed that there was a ‘memory table’ set up in the hallway for the deceased residents. 

“Since the last inspection, three trees had been planted in the garden in memory of the deceased residents.”

The inspector was informed that the centre held a memorial service during the summer, with residents actively involved in the planning.

The garden also contained garden furniture, garden ornaments and some potted herbs and shrubs.

The house was observed to be clean, bright and well ventilated. Each resident had their own bedroom which were personalised to their individual tastes. 

Staff were observed to be supporting residents in line with their assessed needs, care plans and communication preferences throughout the inspection.

Staff described how the death of peers had affected some residents. 

The inspector reported: “It was evident in documentation that residents were supported to try to understand this loss and were actively involved in creating memories and having open discussions about the loss.”

In general, the inspector found that the service strived to provide a good quality and person-centred service to residents. 

However, some improvements were required which would enhance the good care provided. 

Finnside was deemed Compliant in terms of Persons In Charge, Notification of Incidents, Risk Management Procedures, Individual Assessment and Personal Plan, Healthcare, Positive Behaviour and Support, and Residents’ Rights. 

It was found to be Substantially Complaint in areas of Staffing, Training and Staff Development, Governance and Management, Quality and Safety, Communication, Fire Precautions, and Protection. 

Eden Crest and Cloghan Flat

An unannounced inspection took place on October 10 at Edencrest and Cloghan flat which provides full-time residential care and support to adults with a disability. 

The designated centre comprises a six bedded bungalow and a one bedroom flat located within a campus setting. 

Residents in the bungalow have their own bedroom and have access to a small kitchenette, dining room, two sitting rooms, clinic/visitors room and bathroom facilities. 

Cloghan flat provides self contained accommodation with a bedroom, bathroom, kitchen and living room. Meals are prepared and cooked in a centralised kitchen on the grounds of the campus and delivered at specific times throughout the day. 

Residents are supported on a 24/7 basis by a staff team of both nurses and health care assistants.

There were six residents present when the inspection took place. The inspector was only able to meet with the residents at Edencrest due to an outbreak of Covid-19 in the other part of the centre. 

Only one resident was able to tell the inspector about their life at the centre. They said they were happy with the care and support provided to them and liked living there. 

Throughout the day, the inspector observed that residents were both relaxed and happy with the care provided to them by staff, and were facilitated to enjoy a range of activities both at the centre and in the local community. 

Staff were positive about staffing arrangements and recent changes at the centre, and how these had positively effected residents’ care since the last inspection in March 2022. 

The inspector observed that Edencrest was homely in appearance and was clean and spacious and suitably adapted to the needs of the residents.

However, some improvements to the condition of the building were required, although these did not pose a risk to the welfare of residents. 

The inspector observed that residents had been supported to personalise their bedrooms through the use of items such as county flags, photographs, posters and personal ornaments.

Residents also had access to a large rear fenced garden, which had access to garden furniture and was well maintained.

In summary, the inspector found residents’ needs were supported in a dignified and respectful manner at the centre and care and support was provided to a good standards although further improvements were required to build upon previous improvements and sustain compliance with the regulations.

The facility was found to be Compliant in areas of Persons In Charge, Notification of Incidents, Communication, Risk Management Procedures,  Individual Assessment and Personal Plan, Positive Behavioural Support, 

It was deemed Substantially Compliant in terms of Staffing, Governance and Management, Premises, Protection

One area of Non Compliance was noted, that of Training and Staff Development. 

Dreenan Ard Greine Court

An unannounced inspection took place on September 27 and 28 at Dreenan, a facility which provides full-time residential care and support for up to six adults with an intellectual disability. 

Dreenan comprises a six bedroom bungalow and residents have access to communal facilities at the centre which include two sitting rooms, a dining room, a kitchenette, a laundry room and bathroom facilities. Each resident has their own bedroom. 

The centre is located within a campus setting which contains six other designated centres operated by the provider.

During the day, residents are supported with their assessed needs by four staff members with one nurse being on duty at all times. At night-time, residents are supported by two staff, a nurse and health care assistant.

There were four residents living in Dreenan at the time of inspection, with two vacancies. The inspector was informed that there were no plans for anyone to move into the centre at this time. 

The inspector got the opportunity to meet briefly with three residents over the course of the inspection. Residents interacted with the inspector on their own terms and with the support of staff and were observed to be relaxed in their home. 

The inspector reported: “Through a review of documentation, photographs and discussions with staff and the management team, it was evident that residents enjoyed a variety of activities and outings in line with their wishes, stages of life and developmental needs.”

Residents were reported to have good communication and contact with their families, and visitors were welcome to Dreenan. 

Staff were observed to be caring and respectful in their interactions with residents and responsive to their needs. Residents were supported by staff in line with their assessed needs and staffing requirements throughout the inspection. 

However, at times the regular staff working in Dreenan were moved to respond to staffing issues in other centres and this impacted the continuity of care for residents in Dreenan. 

Residents were dependent on staff for most of their care needs. Consistent and familiar staff were noted to be important in ensuring residents’ support needs were met.

 Staff appeared knowledgeable about residents’ specific care needs and about how to support them with health issues and anxiety behaviours. 

The house appeared homely, clean and spacious for the needs and numbers of residents. There were framed photographs on display throughout the home, which included residents and their friends. 

The back garden area was spacious and well maintained. It contained garden furniture, a swing bench, a basketball hoop and some garden ornaments. The front of the house was decorated with a variety of garden ornaments and potted plants and flowers. 

Bedrooms that the inspector observed were found to be clean, personalised and comfortable. 

The kitchen area in the house was small and not fully accessible for wheelchair users. There were plans in place to alter this, and this had been an action on previous inspections by the Health Information and Quality Authority (HIQA). 

There had been some safeguarding concerns and incompatibilities between residents living in Dreenan. Environmental measures, staffing numbers and the implementation of care plans to support residents and guide staff helped to reduce and minimise potential safeguarding risks. 

However, it was recognised in various documentation and care plans that the safeguarding risks will remain until such a time that some residents did not live together. 

In general, the inspector found that the service strived to provide a good quality and person-centred service to residents. However, improvements in staffing arrangements and protection would further enhance the safety and quality of care provided. 

Dreenan was found to be compliant in areas of Complaints Procedure, Risk Management Procedures, Individual Assessment and Personal Plan, Healthcar, Positive Behavioural Support, and Residents’s Rights.

It was Substantially Compliant in Staffing, Training and Staff Development, Governance and Management. Premises, and Protection.

It was noted to be Non Compliant in terms of Notification of Incidents, 

Cloghan

The unannounced inspection took place on September 27 and 28. 

Cloghan provides full-time residential care and support to three residents within a small campus setting which contains three other designated centres.

It comprises a four bedded bungalow where its three residents are supported by a staff team of both nurses and care assistants. 

The inspector met briefly with all residents over the course of the inspection. The residents were supported in their social interactions as per their individual wishes and needs. 

During this inspection improvements were found in the premises provided since the last inspection.  

According to the inspector: “The centre appeared cleaner than previously found. The radiators had the rust removed and were painted.”
Further work was due to be completed in the near future. 

The kitchen was observed to be neat and tidy and there was a plan in place to replace the microwave. The residents at Cloghan had their breakfast at their home, but lunch and dinner was delivered from a campus based kitchen. 

Each resident had their own bedroom and the inspector met with one resident at the entrance to their room. It appeared comfortable and personally decorated with a television displayed on the wall. 

The inspector noted that it was evident that there were issues regarding compatibility of residents at this centre. 

“This impacted on residents’ feelings of safety and their quiet enjoyment of their home,” reported the inspector. 

“Furthermore, difficulties in relation to the provision of an experienced and consistent staff team at Cloghan further impacted on the lived experience of the residents living at this designated centre and this required review.”

Overall, the inspector found improvements in the systems and processes in place since the last inspection and work was ongoing. 

However, further advances in the governance, management and oversight of the service, along with a review of the systems used to submit notifications would enhance the quality of the service provided.

Cloghan was deemed Compliant in areas of Training and Staff Development, Risk Management Procedures, and Individual Assessment and Personal Plan. 

It was Substantially Compliant in Staffing, Statement of Purpose, Complaints Procedure, Premises, POsitive Behavioural Support, and Protection

The facility was found to be Not Compliant in Governance and Management, and Notification of Incidents.