The Health Information and Quality Authority (HIQA) has published an overview report of monitoring activity undertaken between 2015 and 2017 in Áras Attracta, a large campus based residential setting for people with intellectual disabilities in Co. Mayo operated by the Health Service Executive (HSE).

Over the course of 14 inspections from July 2015 to May 2017, HIQA found that the HSE was consistently failing to appropriately address the institutional model of care, centralised care practices, safeguarding issues and lack of opportunities for residents’ personal development and growth on the campus. On 28 September 2017, the Office of Chief Inspector of Social Services issued the registered provider (the HSE) with notices of HIQA’s proposed decision to cancel the registration of all three Áras Attracta centres.

In October 2015, the HSE presented the Chief Inspector with a three-year improvement plan for Áras Attracta. HIQA informed the provider that the implementation of their three-year improvement programme would be monitored, and should the actions not result in an improvement for residents, further regulatory action would be taken. Throughout this period, regulatory activity has seen evidence of a range of actions being initiated and significant additional resources being allocated across the three centres. However, the Chief Inspector has found limited progress and improvement overall on the campus.

HIQA has found that the HSE has failed to show the effectiveness of the additional, allocated resources and the sustainability of the measures that were implemented. While there have been some improvements for a minority of residents, there is insufficient evidence to show that these improvements have been maintained. The provider failed to implement their own action plan and to ensure that any actions taken were effective in reducing risk to residents.

By May 2017, most residents continued to experience an institutional model of care, with centralised practices and limited or no opportunities for personal development and growth.

HIQA found that the provider of Áras Attracta had failed to: 

• improve the lives of all residents living on the campus,
• implement action plans within the required timelines,
• implement and adhere to the HSE’s own national safeguarding policy,
• respond to a significant number of occurrences and reports of alleged abuse between residents,
• progress the plan to transition residents to more appropriate, community-based accommodation,
• consult with residents before making decisions impacting on residents’ personal finances,
• appropriately investigate and respond to concerns,
• ensure governance arrangements and improvements were sustained.

As set out in the Health Act 2007, the registered provider was given 28 days from 28 September 2017 to make written representations to the Chief Inspector before a final decision to cancel the registration of all three Áras Attracta centres would be made. These representations, received on 31 October 2017, set out the actions that are now being taken by the provider to ensure that the care and support to residents in the Áras Attracta is improved.

The Chief Inspector has given consideration to these proposed actions and will schedule an unannounced inspection of the centres to verify whether these actions have been effective in making life better for residents who live in Áras Attracta. HIQA will use the findings from these inspections to inform a final decision on the registration of the centres by February 2018.

Notes to Editor:

• HIQA inspects against the Health Act 2007 (Care and Support of Residents in Designated Centres for Persons (Children and Adults) with Disabilities) Regulations 2013 and the National Standards for Residential Services for Children and Adults with Disabilities.
• Áras Attracta campus comprises three designated centres and, at the time of the most recent HIQA inspection, 86 people with disabilities were living there.
• The findings from all 14 inspections are detailed in 12 inspection reports published today, available on www.hiqa.ie.