Employees in a center for adults with severe disabilities were repeatedly told that they had to leave a resident during evacuations of the fire brigade, "and rely on the presence of fire doors to protect them", the health watchdog has established.
Fire safety problems identified in previous reports on the Drombanna Center, conducted by RehabCare in Limerick, were not adequately addressed by March of this year, the Health Information and Quality Authority (Hiqa) discovered.
Hiqa published 29 inspection reports on centers for people with disabilities on Wednesday, with the vast majority of them finding a high level of compliance with the regulations.
The Drombanna center, where five residents live, was previously inspected in September 2014, May 2016, June 2017 and November 2017. This last report is from an announced inspection on March 13, 2018.
In November 2017, this report says: "The inspector reviewed the records of simulated drills that had been called since the last inspection, and the staff had failed to evacuate one occupant at any time." The personal emergency evacuation plans (PEEP & # 39; had been revised, but did not guarantee that all reasonable efforts would be made to evacuate residents in the event of a fire.
"Personnel were still advised to leave the resident in the center and rely on the presence of fire doors to protect the resident."
RehabCare had given a "satisfactory" confirmation in November 2017 that there was a plan to ensure that all residents would be evacuated in a fire. However, during the more recent inspection, the evacuation arrangements remained inadequate and "there was no agreed corrective plan".
In addition: "It was unclear what supervision and accountability was for the practice of drug management." The inspector was worried about finding eight separate drug labels issued by the pharmacy in the medicine cabinet. & # 39;
The inspection of November 2017 had established: "Residents did not live in compatible with each other, which had an impact on the safety and quality of life of residents in the center."
Although there was "some improvement" since a previous inspection in June, "peer-to-peer physical interaction incidents continued in the center".
While RehabCare had to address shortcomings, "this last inspection" again found unsatisfactory progress ".
"Residents did not receive a consistently safe quality service."
RehabCare, however, says the report, articulated a "commitment to improve service" and to reduce capacity utilization and the plan was "on target".
"In spite of the provider's plan, the assessed risk of the impact of peer-to-peer behaviors is currently being assessed … from moderate risk A high level of peer-to-peer physical interaction incidents continued in the center. "
There was also concern that the level of threat posed by some "core risks" and the actions needed to contain them were not adequately identified.
Personnel issues persisted, with RehabCare saying "There were challenges for recruiting staff and these challenges were not specific to this center."
The center turned out to be non-compliant under six headings, including & # 39; risk management procedures & # 39 ;, & # 39; positive behavioral support & # 39; and & # 39; fire precautions & # 39 ;; Substantially compliant & # 39; under two cups & # 39; – & # 39; records & # 39; & # 39; Staffing & # 39; and, in accordance with three rules, including 'general welfare and development & # 39; and & # 39; responsible persons & # 39 ;.
RehabCare on Wednesday said: "With regard to the fire evacuation problem, RehabCare followed the standard hospital and nursing home practice for the care of residents in case of fire and strongly rejects any suggestion that a resident was at any time in danger.
"From the most recent Hiqa report on the Drombanna Center in March 2017, it is clear that the vast majority of Drombanna issues have been resolved and RehabCare continues to work to ensure that Hiqa requirements are fully complied with."