The Health Information and Quality Authority (HIQA) has today published three reports on a Camphill Communities of Ireland residential centre for adults and children with disabilities. 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.

Today’s three reports relate to inspections carried out by HIQA in Camphill Community Ballytobin on 21 to 22 February 2017, 9 May 2017 and 23 May 2017. Due to ongoing and significant failings to ensure residents were adequately safeguarded from the risk of abuse, HIQA made the decision to cancel the registration of this centre. Overall, inspectors found increasing evidence that the provider did not have adequate oversight of the centre, that safeguarding arrangements were very poor and that the provider was incapable of taking effective action to manage the increased risk to residents.

Prior to these inspections, in April 2016, HIQA required the Chairman of the board of directors and senior managers to attend a regulatory meeting. This was because of poor findings in previous inspections in a number of centres operated by Camphill Communities of Ireland, particularly relating to the protection of residents from the risk of abuse. The provider was required to submit a governance plan to ensure improved safeguarding arrangements were put in place to protect residents from risk of abuse across their centres. The provider was required to attend a follow-up meeting in October 2016 to discuss poor progress on the implementation of that plan, and the provider was issued with a warning letter.

Since then, while inspectors found improvements in safeguarding arrangements in other centres operated by this provider, there continued to be a lack of adequate improvements in Camphill Community Ballytobin. In addition, further information was provided to HIQA which gave increased concern in relation to arrangements for keeping residents safe in this centre.

Inspectors undertook an announced registration inspection of this centre on 27 May 2016. Due to the level of concern in relation to poor arrangements to protect residents from the risk of abuse, the registration inspection was suspended and inspectors focused on safeguarding issues for the remainder of that inspection. The inspection report identified a large number of non-compliances with regulatory requirements and the provider was required to submit an action plan to HIQA, addressing 28 non-compliant areas.

Inspectors undertook a further inspection of this centre in October 2016 and found that the provider had taken action to improve the quality of service in the centre. However, while there had been some improvements, safeguarding arrangements in the centre were not sufficient. In addition, improvements were also required in relation to the supervision of staff, including voluntary co-workers.

Following the October 2016 inspection, HIQA received information of concern which described incidents of intimate care and physical restraint practices in the centre that could be considered abusive. Inspectors found that the practices had been sanctioned by a manager without any risk assessment or consideration of the safeguarding issues. In addition, when the incidents had been brought to the attention of the provider, the provider took action to stop the practices but did not undertake an appropriate investigation of the incidents.

Given the failure of the provider to respond adequately to these specific safeguarding issues and previous findings of poor management of safeguarding in the centre, HIQA issued a notice of proposal to cancel the registration of the centre on 14 December 2016. Inspectors required the provider to undertake a review of all allegations or incidents of abuse or staff misconduct.

HIQA was subsequently informed of a number of allegations of serious physical and sexual abuse of vulnerable people, some of whom could not speak for themselves.  Due to the serious nature of the alleged incidents, inspectors informed An Garda Síochána, the Child and Family Agency (Tusla) and the National Safeguarding Office of the Health Service Executive (HSE).

In addition, inspectors required the provider to take immediate action to ensure the safety of residents. The response by the provider to these concerns was deemed inadequate and inspectors required the provider to take further measures.

Given the seriousness of the incidents and the repeated failures of the provider to effectively safeguard residents from abuse, HIQA issued a final notice of decision to cancel the registration of Camphill Community Ballytobin on 22 May 2017. In accordance with the Health Act 2017, as amended, the provider was given the right to appeal the decision to the district court within 28 days.

The provider wrote to HIQA on 24 May 2017 to say that they accepted the decision and sought the immediate cancellation of the registration. The provider also wrote to the Health Service Executive (HSE), informing the HSE that the provider did not have the capacity to ensure residents were safe within the centre, and asking that the HSE take charge of the centre immediately.

The registration of the centre was cancelled on 6 June 2017.