HIQA flags major issues at Leitrim group home

A Leitrim group home for adults with intellectual disabilities has been flagged as needing major improvements by a Health Information and Quality Authority (HIQA) inspector.

Sunbeam Lodge Community Group Home - run by North West Parents and Friends Association for Persons with Intellectual Disability - underwent a six and a half hour unannounced inspection on February 8, 2023.

The home - which consists of a bungalow situated in busy town close to community amenities - provides full-time accommodation to three male and female adults with moderate to profound intellectual disabilities and a range of high support needs.
According to a report published on June 8, 2023, the home, which is staffed by nurses and healthcare assistants, was deemed ‘Non-compliant’ in nine out of twelve categories, with compliance noted only in areas of staffing and healthcare.

The home also received a grade of ‘Substantially compliant’ for training and staff development.

During the inspection, the inspector found concerns regarding governance, management and oversight arrangements, and a deterioration in regulatory compliance, which impacted on the safety and wellbeing of residents.

Some of the issues highlighted in the report include limited access to facilities for residents’ occupation and recreation, insufficient space in the centre, non-current information in residents’ files, and safeguarding concerns.

The inspector noted that risks in relation to safeguarding, positive behaviour support and compatibility were not assessed or addressed, and safeguarding notifications were not submitted to the Chief Inspector.

The inspector noted the provider had not ensured residents were protected from abuse, and responsive measures had not been taken to address safeguarding issues in the centre.

This related to incident report forms that were completed by staff.

The inspector also noted a failure to recognise and act on occasions when there may be grounds for concerns in relation to their peer’s behaviours of concern.

Although the provider had some arrangements in place to assess, manage and respond to risk, the arrangements were not always effective.

In addition, not all risks identified had a risk assessment in place, including risks in relation to the oven in the kitchen, excessive seeking of food and the throwing of items at mealtimes.

However, the quality of care provided by staff and their knowledgeable interactions with residents was favourably noted.

Staff had access to training, including refresher training, as part of a continuous professional development programme, however not all training modules - such as moving and handling training, positive behaviour support and fire safety training - were up-to-date.

On the day of the inspection, the residents were found to have a range of different support needs and staff were required to continually adapt provided care.

Overall, staff at the home were praised for their work, with one resident’s family members informing the inspector they were “very happy” with the care and support provided and that they appreciated the work of the staff.

The provider also ensured that appropriate healthcare supports were provided for each resident.

This included support at times of illness, access to a general practitioner (GP) and to the supports of the multi-disciplinary team.

A comprehensive and holistic plan for end of life care was also in place for one resident.

However, residents were found to have very limited access to their community, and there was no plan in place to expand the residents’ day-to-day lived experience.

Space at the home was also highlighted as a concern.

Residents reportedly had a lack of secure outdoor space for independent use, and a lack of space for visitors was also noted.

This is reportedly due to the closure of a bedroom because of a heating leak, which resulted in a small sitting room formerly used for visitors being used as a bedroom.

Overall, a deterioration in compliance when compared to previous inspections was noted by the inspector.

Following receipt of the report, the provider pledged to replace the boiler to address the heat leak, to commission a landscape gardener to provide a quotation for modifications to the outside garden, and to provide training in record keeping to all staff.
It is currently unknown if these measures have been pursued.

When contacted by the Leitrim Observer, a representative of St Ciaran’s Services refused to offer comment on the content of the report.

However, adverse incident reporting training for staff has reportedly taken place, and a behaviour therapist has conducted a review of the service user plan.