HIQA flags ongoing serious concerns over Ballytrim House in Raphoe

Significant concerns remain over the suitability of a residential disability service in Raphoe.

A HIQA inspection at Ballytrim House found that the facility remains non-compliant in some key areas. 

The latest inspection, a follow-up to an earlier visit in April, found that while there had been improvements in governance, safeguarding and staff training, significant concerns remained regarding the suitability of the premises, risk management procedures and residents’ rights.

“Significant improvement was required to ensure that the premises were laid out and suited to the needs of residents,” a HIQA report said. “Residents were prevented from accessing communal rooms in the centre due to the lay-out of the building. This impacted on their rights to exercise choice and control in their daily lives.

“Significant refurbishment works had been identified by the provider. Though meetings between senior management had commenced, there was no definite plan in place on the day of inspection to address these issues.”

Since the previous inspection in April, three residents had moved to a new centre, but a change in lay-out meant that residents could not freely access rooms as they needed or wanted.

The inspector found that the kitchen was located in a section of the building that was only accessible to two residents. The other two residents would need to be let into that part of the building by staff. In addition, the sensory room was located in a section of the building that was only accessible by one resident.

Of particular concern was the failure to complete an urgent fire safety assessment, despite the issue being identified by the provider in May 2025. On the day of inspection, there was no clear plan in place to carry out the assessment, leading HIQA to require an urgent compliance plan from the HSE.

A report commissioned by the HSE earlier this year concluded that Ballytrim House “lacks suitability to meet the needs of all current residents” and highlighted issues including dampness, mould, damaged flooring, hot water problems and infection prevention and control risks.

The latest inspection highlighted the possibility of the presence of MICA in the building and a test is required. “This may impact the long-term viability of the building,” the report said.

Padding installed on walls in one section of the building to support a resident with complex needs was also criticised. While introduced for safety reasons, inspectors found it impacted the resident’s dignity and posed cleaning and infection control challenges.

The inspector found that the provider had implemented new strategies and systems to improve the governance and oversight of the quality of the service in this centre. Staff had received training in modules that were relevant to the care of residents.

“The change in the residents’ living arrangements had reduced the risk of safeguarding incidents and negative interactions between residents, but improvement is still required to ensure that the premises were suitable to meet the needs of resident and to ensure that their rights were respected. 

 Due to the level of non-compliance, the provider was required to attend a warning meeting where a warning letter was issued outlining that the provider was required to come into compliance. 

The purpose of the most recent inspection was to review the implementation and effectiveness of that compliance plan.

The inspection also found improvements in staff training, communication supports and safeguarding arrangements. Staff had received additional training in behaviour support, communication and human rights, while residents’ care plans were found to be largely comprehensive and regularly audited.

However, HIQA concluded that Ballytrim House was not compliant with regulations relating to premises, risk management and residents’ rights, warning that continued failure to address these issues could impact the centre’s registration.

In response, the HSE said it has taken some actions to ensure full compliance within the facility.

“The HSE Disability Services Management Team and the HSE maintenance department have completed a schedule of works for the centre to be completed on a phased basis,” a statement said.

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“Following engagement with the HSE Estates department, Disability Services Management updated the fire safety risk assessment and implemented additional fire safety controls.

“A formal action plan of works with agreed timeframes will be completed and monitored weekly through the centre’s quality improvement plan.”