Care allegations at under-staffed home made seven weeks ago

Last week Trevor Millar, Director of Adult Mental Health and Disability Services, at the Western Trust, revealed a number of staff at the home have been suspended as a precautionary measure following the allegations centred on the state-of-the-art facility for adults with learning difficulties at Gransha Park.

Now Health Minister Edwin Poots has revealed that as well as sparking a PSNI investigation into the mistreatment allegations the anonymous letter of July 24 also prompted a series of inspections of the facility last month that uncovered a number of failings.

Amongst these were the finding that a manager had complained to the Trust about inadequate staffing levels but that the required staff complement had not been achieved.

The inspections also found that the unit’s managers were working too long hours; that there was an excessive use of agency staff and that there was a failure to report injuries and incidents involving residents.

One of the inspections on August 9 found that one mother had complained that when she asked for her son to be taken swimming there was no evidence that this request had been actioned. Neither was there evidence of residents participating in any social activities.

The same inspection found that there was “excessive use of agency staff” and that nineteen temporary staff were used for two of the four houses (serving 16 residents) at the complex.

The Regulation and Quality Improvement Authority (RQIA) found that although the over-worked manager had made “repeated representations to the Trust regarding the inadequacy of staffing levels” the required staffing levels had not been achieved.

A second inspection on August 16 found a resident at the complex “with both hands bandaged.”

Staff claimed that the “restraint was applied to prevent introducing infection into a wound” but RQIA inspectors were concerned the Trust “failed to demonstrate that the restraint employed was the only practicable means of securing the welfare of the identified resident.”

On Monday Mr Poots revealed that the allegations of mistreatment at the complex, which are now under PSNI investigation, first came to light on July 24.

Mr Poots told the Stormont Assembly: “Following the receipt of the first anonymous allegation of abuse on July 24, the key agencies involved have all taken appropriate steps to safeguard the residents of Ralphs Close.

“In the intervening period to date, that has included the precautionary suspension of some members of staff pending PSNI investigations and the inspection of Ralphs Close, both announced and unannounced, by the RQIA during August 2012, which resulted in a number of recommendations for improvement.”

The Health Minister also revealed that the Western Trust has instigated a series of unannounced visits by senior staff and that this would continue.

Key workers have also been briefed to inform and liaise with families whilst independent monitors from other Trust facilities for people with learning disabilities have been placed in Ralphs Close on a 24/7 basis.

Two advocates have also been made available for residents and a manager has been put in charge to replace the staff who are under precautionary suspension.

“That manager is supported by experienced staff from other trust facilities. The Trust has now achieved compliance with two of the RQIA failure-to-comply (FTC) notices and has developed an improvement plan to meet the recommendations of the three remaining notices and those of the reports of the reviews that were carried out by the HSC Board and the RQIA. Implementation of that improvement plan will be overseen by a project board that will be made up of senior managers in the Trust,” the Minister said.

He outlined a range of issues the RQIA had raised “including its view that the unit’s managers were working too long hours and that the trust’s protection plan had not been actioned as committed and its concerns about the seniority of the monitoring officer’s brief for the role, the capacity to fulfill the role in two houses at one time, a lack of daily activity plans and meaningful activities for residents, excessive use of agency staff, and staff supervision, appraisal and training.”

He added: “It also identified a failure to report injuries and incidents involving residents, as required under the regulations, and the use of restraint without appropriate consultation, record-keeping or notification to RQIA. Those are the sorts of things that RQIA identified.

“They are certainly things that need to be taken very seriously in conjunction with the efforts of the whistle-blowers in bringing the matter to our attention.”