HIQA finds healthcare and risk management failings at Louth disability service

The Health Information and Quality Authority (HIQA) has found failings in healthcare provision and risk management at a residential disability service in Co Louth, following an unannounced inspection carried out on October 1, 2025.

Inspectors found that the Coastguards designated centre, operated by the Health Service Executive, was “not compliant” with regulations relating to healthcare and risk management procedures.

The inspection was carried out after HIQA received both solicited and unsolicited information raising concerns about the service. According to the report, these concerns related to “staffing practices, incident reporting and response mechanisms, provision of healthcare supports, and governance and management arrangements”.

While HIQA noted that staffing levels and training were compliant, inspectors concluded that “systems in place to ensure that residents’ needs were appropriately identified, documented, and met were found to be inadequate”.

One of the most significant findings related to how falls and injuries were managed within the centre. Inspectors stated that “In some instances appropriate care and follow up actions had been taken to ensure the safety of residents. However, the management of unwitnessed falls, or in one instance, healthcare monitoring following a resident hitting their forehead, was not sufficiently comprehensive”.

The report noted that “neurological observations had not been completed for a resident, after banging their head, and falling a number of times without anyone witnessing the fall”, adding that “adequate measures had not been taken at the time to provide assurances on the wellbeing of the resident”.

Inspectors also raised serious concerns around manual handling practices. Despite a resident being assessed as high risk for falls, “there was no guidance in place to safely transfer the resident from the floor following a fall”. 

Healthcare provision was another area where the centre was found to be non-compliant. HIQA reported that “appropriate healthcare was not provided to a resident in line with their changing needs”, citing a failure to complete recommended assessments including physiotherapy, swallowing assessments and diagnostic testing.

The report also stated that “a holistic approach to care was not in place”, noting that known health issues, including a vitamin deficiency linked to bone health risks, were not adequately monitored or investigated.

Governance and management arrangements were judged to be “substantially compliant”, with inspectors finding that oversight systems “had not been effective in ensuring the timely identification and resolution of service delivery issues”. Records reviewed “did not accurately reflect current needs”, and gaps in auditing meant that problems went undetected for an extended period.

Despite these findings, HIQA noted some positive feedback from residents and families. One resident “spoke positively about the health class they had attended”, while a family member described “effective communication with the staff team” and said they felt their loved one was “well supported and cared for”.

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In response to the inspection, the HSE submitted a compliance plan outlining corrective actions, including new post-fall protocols, enhanced clinical monitoring and additional staff training. 

The provider has been given deadlines extending into early 2026 to address the identified non-compliances and bring the centre back into full compliance with national regulations.