‘Significant risks to human rights of residents’ at Raphoe disability care home

A resident in a disability care home in Raphoe had to be moved to a new room after HIQA found ‘significant risks’ in their living arrangements.

This is one of the findings at Ballytrim House, which was found to be non-compliant with HIQA standards on almost all grounds.

The report published is based on an unannounced visit by the HSE to Ballytrim House in April.

The report found “significant failings in relation to the governance and management of this service were identified on inspection. This created significant risks to residents, impacting their quality of life and their human rights.

“Inspectors were not assured that residents were kept safe in this centre. Inspectors found significant risk to one resident in relation to their living arrangements. This resulted in the issuing of an urgent compliance plan the day after the inspection.

“This required the provider to respond to the Chief Inspector of Social Services with a time-bound plan for the resident to move to the part of the centre that was suited to their needs. The provider responded that the resident would move to their new bedroom by 10 May 2025.”

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Ballytrim comprises a seven-bedded one-storey building located in a residential housing estate. On the day of inspection, seven residents were living there.

Overall, Ballytrim House was only found to be compliant in one of 10 grounds, which was staffing.

Non-compliance was found in training and staff development, governance and management, communication, premises, risk management procedures, individual assessment and personal plan, positive behavioural support, protection and residents' rights.

A plan for three residents to move from Ballytrim House to a new centre had been delayed on several occasions. On the day of inspection, the new centre was registered.

One resident resided in a section of the building that was separated from the rest by a magnetically locked door.

Damage to the walls, broken radiator covers and damage to sensory equipment were found in rooms.

While staff had up-to-date training in safeguarding and received training in a human rights-based approach to care, they had not received training in all areas.

One resident’s speech and language therapy report had recommended that all staff complete training on ‘intensive interactions’. On the day of inspection, the person in charge reported that this training had not been completed by any staff member and that there were no plans in place to complete that training.

In addition, six of 24 staff required refresher training in supporting residents to manage challenging behaviour. Despite this, on the day of inspection, there was no plan in place for staff to receive refresher training in this area.

Neither the annual report nor unannounced audits had adequately identified the significant risks in the centre in relation to the inappropriate living arrangements for two of the residents. This was despite the fact that these issues had been highlighted at the time in resident risk assessments, behaviour support plans and safeguarding plans. There were no actions listed in the annual report or unannounced audits to address these known risks.

Where guidance was provided to staff on how to support residents, this was not always kept up to date. It was not clear that residents were supported in communicating their needs and wishes. The restrictions placed on residents in the centre were not adequately reviewed to ensure that they were the least restrictive options.

The padding needed by one resident was not available to them. Another resident was living in that area who did not require the padding.

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One resident’s risk assessment identified that they were at high risk of severe injury due to their behaviour. Despite the control measures outlined, the risk remained at a very high level as identified by the provider on their assessment. There was no information provided to staff on the mitigating actions that should be taken in the absence of padding should the resident engage in self-injurious behaviour.

Inspectors were not assured that the health, social and personal needs of residents had been adequately assessed. The designated centre did not meet the needs of each resident. Significant improvement was required in relation to the supports offered to residents in relation to their behaviour and in the review of restrictive practices in the centre.

The provider had not implemented all measures to ensure that residents were protected from abuse.

HIQA gave a date of July 1, 2025, for Ballytrim House to comply with the regulation that had been risk rated red (high risk).

This was in regards to Regulation 05(3), “The person in charge shall ensure that the designated centre is suitable for the purposes of meeting the needs of each resident, as assessed in accordance with paragraph (1).”

Ballytrim House was required to give dates of compliance for regulations that had been risk rated yellow (low risk) or orange (moderate risk).