HIQA finds good care at Louth centre for disabilities but flags delays in plans

An unannounced inspection by the Health Information and Quality Authority (HIQA) has found that residents at Ladywell Lodge in Louth are well cared for and supported to make their own choices, but that improvements are required in personal planning, communication supports and the timely progression of a planned community move.

The inspection of Ladywell Lodge, operated by St John of God Community Services CLG, took place over two days in October 2025 and focused specifically on safeguarding and supported decision-making.

According to the report, “overall, the inspectors found that there were adequate resources in place to provide person-centred care to the residents living here.” Inspectors said this meant that residents “got to choose what their day looked like and what activities they would like to do each day.”

At the time of inspection, five residents were living in the centre, which is registered to accommodate eight. The provider is not currently admitting new residents. The centre is nurse-led, with a nurse on duty 24 hours a day.

Inspectors described a relaxed atmosphere, noting that residents were seen making day-to-day decisions about their routines. “Residents could get up in the morning time whenever they chose to,” the report states, adding that some residents got up at night to watch television or have tea with staff.

On the day of inspection, residents had headed out on a variety of outings. One person travelled to a shopping village and enjoyed “sitting out having crepes and coffee”. The report noted that this resident “loved driving to different places and one of their goals was to visit every county in Ireland,” having already visited Galway, Dublin and Kildare.

Another group went out for food and “a ‘pint’ in the evening time,” while others planned Halloween celebrations, with one resident acting as “the ‘events manager’” for decorations.

Inspectors observed that staff supported residents “in a kind, patient and jovial manner, while respecting the residents’ rights to make their own decisions.”

Overall, inspectors found that residents “looked well cared for, were included in decisions about their lives and appeared happy living in their home.”

The inspection followed a number of safeguarding notifications made to HIQA in the previous year. Inspectors said they were assured that the provider had taken action. “Inspectors were assured from reviewing records that the registered provider had taken actions to address the safeguarding concerns reported.”

A business case has been submitted seeking funding for an individualised community placement for one resident. In the meantime, the resident has been moved to live alone in one unit of the centre, while the other four residents live in the adjoining unit.

HIQA noted that this “addressed the immediate safeguarding concerns, notwithstanding, this was a temporary solution, and this unit was not suitable as a long term home for the resident concerned.”

Under Regulation 23 (Governance and Management), the centre was found to be “substantially compliant.” While a clear management structure and regular audits were in place, inspectors found that some issues — particularly around equipment and the transition of one resident to a bespoke community setting — had not progressed in a timely way.

The report states that although the resident’s move to a community-based setting was identified in 2022, “this had not progressed at the time of this inspection as the provider was still awaiting approval from the funding agency to progress this.”

The most significant finding related to Regulation 5 (Individual Assessment and Personal Plan), which was judged “not compliant”.

While residents had up-to-date assessments and comprehensive support plans, inspectors identified several recommendations that had not been implemented promptly. These included:

• A sensory assessment report from 2021 not being available.
• Prescribed hand and arm splints that had been purchased but not yet fitted.
• Bedroom and bed assessments for residents who had experienced falls not yet completed.
• Delays in the delivery of a new wheelchair and a comfort chair.
• A resident “waiting to see a dentist for a prolonged period of time.”

The report stated that this was concerning given that “all of the residents had mobility needs in this centre and these recommendations needed to be implemented in a timely manner to safeguard the residents concerned.”

Communication supports for one resident also required improvement. While a communication plan was in place and the resident used four signs to express choices, inspectors found that “more detail was required in the residents communication plan” to ensure a consistent approach from staff.

HIQA found the centre to be compliant in staffing, training, risk management, positive behaviour support, protection and residents’ rights.

There were sufficient staff on duty during the inspection, including nurses, a social care worker and healthcare assistants. Staff had completed mandatory training, including safeguarding, human rights, assisted decision-making and the national consent policy.

Four staff members told inspectors they had no concerns about the quality of care and felt well supported by management.

In a compliance plan submitted following the inspection, the provider outlined steps taken to address the findings.

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It said a sensory assessment had been reviewed and completed in early November 2025, arm splints were fitted in October, bedroom assessments were carried out, and replacement chairs delivered. A dental appointment has been booked for December.

The regional director also raised the outstanding business case for the resident’s community placement with the HSE in November and requested an update.

HIQA rated the non-compliance under Regulation 5 as “orange” (moderate risk), with a compliance date of 20 December 2025. Other findings were rated “yellow” (low risk).

The overall report concludes that, while improvements are required in specific areas, residents at Ladywell Lodge are receiving a generally safe and person-centred service.