HIQA highlights strengths and areas for improvement at Louth disability service

A recent unannounced inspection by HIQA (Health Information and Quality Authority) has identified both strong safeguarding measures and key areas needing improvement at My Life-Chara, a designated centre for adults with disabilities in Louth.

The inspection, which took place over two days in June, reviewed eight regulations at the centre, which is operated by MyLife by Estrela Hall Limited. The service comprises four community houses located within walking distance of local amenities, providing full-time residential and respite care for up to 19 residents over the age of 18.

The inspector found that five of the eight regulations examined were fully compliant, including staffing levels, staff training, protection, positive behavioural support, and individual assessments. One regulation was found non-compliant, and two were substantially compliant.

The report revealed that in advance of this inspection, the Office of the Chief Inspector received unsolicited information that raised concerns in areas related to poor management practices, residents' finances, residents' rights, and restricted activities for some residents. This information guided some of the lines of inquiry during the inspection.

HIQA commended the centre’s safeguarding systems, staff training in areas such as fire safety, infection control, safeguarding, and manual handling was also found to be up to date.

The inspector observed respectful interactions between residents and staff, describing the houses as “welcoming and homely.” 

“Throughout the inspection, adequate staffing levels were noted to support the residents, with some residents receiving one-on-one support. Staff members demonstrated appropriate knowledge of the care and support needs of the residents. They were observed interacting respectfully and jovially with the residents, and all were observed to enjoy these interactions.”

The inspection also highlighted the effective implementation of positive behavioral support by the provider, “demonstrating a commitment to resident care through the involvement of a qualified multidisciplinary team.” 

The report comments that: “The well-developed support plans reflected a strong understanding of the residents' needs, promoting positive interactions and outcomes. Additionally, the restrictive practices in place were found to be necessary for safety and were regularly reviewed, ensuring they remained appropriate and proportionate to the risks involved.”

However, the inspection also revealed notable inconsistencies in how residents were supported to engage in activities and express their communication needs.

Firstly, the inspector found limited oversight in certain areas, including residents' engagement in activities outside their homes. 

For two residents who communicated through non-verbal means, there was a lack of evidence demonstrating that their communication skills and needs had been assessed.

It was also noted that the staff members supporting these residents had not been provided with adequate information on how best to promote and support their communication. 

“Additionally, in one of the houses, there was limited written evidence to suggest that residents were being offered opportunities to engage in activities, raising concerns that they were not participating in meaningful activities outside of their homes,” the report noted.

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The report also commented that while some residents were supported in pursuing activities or achieving personal goals, there was a lack of evidence of others being offered or participating in activities outside their homes or doing things they enjoyed. 

In response to the findings, MyLife by Estrela Hall has committed to a compliance plan. This includes:

• Communication assessments for residents who need them.
• Improved activity planning and recording across all houses.
• Monthly reviews of key performance indicators relating to resident engagement.
• Regular meetings to ensure residents’ wishes shape their daily activities.

Overall, HIQA found My Life-Chara to be fully compliant in five areas, substantially compliant in two, and not compliant in one, with strong results in staffing, training, protection, and positive behavioural support, and improvement plans underway in governance, communication, and residents’ rights.