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'High-risk' physical and chemical restraint still in use at Limerick care centre

Hiqa said that the procedures at a daughters of Charity care centre continued to present “a risk to residents’ health and safety”.

A HIQA REPORT has found a Limerick centre for adults with disabilities non-compliant over issues to do with residents’ privacy and restraint procedures.

In a report published yesterday, the healthcare watchdog said that the use of “a high-risk physical restraint” at St Vincent’s Residential Services in Limerick had decreased, but was still approved and continued to present “a risk to residents’ health and safety”.

The report noted that:

A review of physical restraint indicated an incremental decrease in high-risk restraint techniques over the previous two years with a particularly high risk technique (prone or face-down restraint) being used once so far this year (once in a seven month period).

“This was a significant decrease from previous years,” the report said.

There were however well-documented difficulties with carrying out a health examination of any individual resident involved following any such episodes with only visual monitoring being possible.

It said that as a result, “despite the safeguards in place, the on-going use of such a high-risk technique coupled with the difficulties examining residents following any such episode remains a cause for concern for Hiqa in terms of residents’ health and safety”.

It added that a previous recommendation of how to use a chemical restraints had not been followed by the centre.

In a previous inspection, the centre was advised to improve its record keeping of the administration of PRN medicine usage (medication only taken as the need arises).

The centre was found to not have adequately documented any adverse effects of the medicines, or the efficacy of the medication.

In addition, improvement was required to ensure that the reasons for administering chemical restraint were recorded clearly and consistently as general terms such as ’agitation’ were being recorded as the rationale.

In another case, the consultant psychiatrist had indicated that the use of the chemical restraint in one particular circumstance was inappropriate, but the practice had not changed.

This was discussed with the person in charge and representative of the provider, who after the inspection arranged for a clinical meeting to take place to review their practices in the centre.

The administration of chemical restraint usage at the centre was reviewed on a weekly basis by a psychiatrist and service-wide oversight was taken by a drugs and therapeutics committee.

The Daughters of Charity-owned centre provides support and accommodation for adults with intellectual disabilities. Currently, the centre has seven residents.

Between two Hiqa inspections of the centre in May and July of this year, a report of an alleged breach of one resident’s human rights, in relation to their right to liberty, had been reported.

In response, a “safeguarding plan” was implemented at the Limerick centre, which included reducing restrictions and support from a speech and language therapist in communicating options and choices to residents.

The inspection report also found that the environment in which patients lived was unacceptable:

The failings identified at previous inspections found that “adequate private accommodation was not provided for all residents”.

The privacy and dignity of four residents was compromised due to the fact that partitions between sleeping areas were taller than head height but did not extend the full height of the room.
There was a gap between the top of the partitions and the ceiling of the room. As a result, bedroom areas were not fully private. Inspectors observed that windows in five bedrooms were above head height with limited natural light. Curtains were also at ceiling height

These had since been solved, the report acknowledged:

The staff team had made further efforts to decorate and personalise the centre with pictures, photographs, soft furnishings and other homely touches. Bedrooms were personalised and some residents chose to show inspectors their rooms, which they said they liked.

It was acknowledged that some positive actions had been taken at the centre. The centre arranged for two external reviews of the service of one part of the centre, and showed that they were implementing recommendations from those reviews.

The Hiqa inspector also found that “the building was not provided with construction capable of containing a fire where required” and that “a funded plan was not yet in place to address the failing that the environment” at the centre which was having an impact on residents.

Read: Children ‘subjected to atmosphere of fear’ due to issues at residential centre

Read: How many HSE doctors does Navan hospital’s emergency department have? None

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    Mute Misanthrope
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    Dec 21st 2017, 5:15 PM

    Inside job

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    Mute Dáithí Ó Raghallaigh
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    Dec 21st 2017, 5:18 PM

    @Misanthrope: definition someone with more knowledge than they should have had..

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    Mute Jimbo Jones
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    Dec 21st 2017, 5:19 PM

    Nice that he wore a hi-vis. Good to see that health and safety is being taken seriously.

    366
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    Mute Ciarán McPhillips
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    Dec 21st 2017, 5:19 PM

    Who withdraws €55,000 in cash for any legitimate reason nowadays? Seriously??!!

    420
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    Mute Casper
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    Dec 21st 2017, 5:22 PM

    @Ciarán McPhillips:

    Are you trying to say the business was using the 55000 euro for illegitimate reasons

    50
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    Mute Ciarán McPhillips
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    Dec 21st 2017, 5:27 PM

    @Casper: what business? There is no mention of any business in the article above.

    144
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    Mute Casper
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    Dec 21st 2017, 5:31 PM

    @Ciarán McPhillips:

    Just because it’s not mentioned doesn’t mean it’s not a business

    19
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    Mute Ciarán McPhillips
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    Dec 21st 2017, 5:35 PM

    @Casper: well unfortunately I just read the facts outlined in the article. It must be much more interesting reading the news when you don’t allow the facts to get in the way. Maybe extra terrestrials appeared and abducted them and stole the money. I mean using your logic- just because it doesn’t say it…..

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    Mute Dave Murray
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    Dec 21st 2017, 5:40 PM

    @Casper: Excellent retort there.

    20
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    Mute Casper
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    Dec 21st 2017, 5:41 PM

    @Ciarán McPhillips:

    Happy Xmas Ciaran

    7
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    Mute David Conroy
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    Dec 21st 2017, 6:28 PM

    @Ciarán McPhillips: Agree, I smell a large hairy rat, who carries that amount of cash for either personal or business use nowadays ?
    It just does not add up or make sense, why did bells not ring in the Bank either ?

    47
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    Mute Father Hody Commody
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    Dec 21st 2017, 6:46 PM

    @Casper: Well, if you happen to have that kind of cash on you boarding an aircraft, god help you.

    16
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    Mute Martin Morris
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    Dec 21st 2017, 7:00 PM

    @Ciarán McPhillips: hahahahahahaha just so good. I was saying boooourns.

    4
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    Mute Jack O'neill
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    Dec 21st 2017, 9:17 PM

    @Ciarán McPhillips: The robbery happened outside Rialto credit union.

    5
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    Mute Mick Jordan
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    Dec 21st 2017, 5:23 PM

    Who other than Cash in Transit Security withdraws €55,000 in cash from a Bank? 20-30 years ago understandable as possibly payroll. But today very very rare. One would have to ask questions as to what it was for.

    156
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    Mute Casper
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    Dec 21st 2017, 5:25 PM

    @Mick Jordan:

    Isn’t that the work of the Garda, like I am pretty sure this is all the stuff they will be looking into

    27
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    Mute Niall Sullivan
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    Dec 21st 2017, 5:39 PM

    @Mick Jordan: Paying a large sum of cash is not at all unusual. Many business sale deals are two thirds through the books, one third cash. Used to be fairly common. Same for selling commercial property. About 30% under the counter is common.

    The questions would need to be asked of the person receiving it on such a transaction, rather than the person paying it over, assuming the person paying it over got it legitimately. If they took it from a bank, it’s very likely declared and legitimate income. Revenue know about deposits.

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    Mute Aidan Molyneux
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    Dec 21st 2017, 7:19 PM

    @Casper: my question is why did the Garda wait from the 7th to 21st before asking for witnesses

    16
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    Mute Rónán O'Suilleabháin
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    Dec 21st 2017, 8:35 PM

    might be what I’ve heard called the ‘manage’ in cork. A couple of people collect money from colleagues all year, bank it, then give it back at Christmas time.

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    Mute Mark Heehee
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    Dec 22nd 2017, 8:01 AM

    @Aidan Molyneux: that’s my question too. I’ve been in the area many times,but was I there exactly 2 weeks ago at lunch? Why the delay in looking for witnesses?

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    Mute Ciarán McPhillips
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    Dec 21st 2017, 5:24 PM

    The more I read this the more peculiar it becomes

    No description other an average height
    No mention of any age profile
    No mantion of any sort of accent
    He approached on foot
    Left on a bicycle
    Having (presumably) followed them by car?

    Tia less fishy in Leo Burdocks

    114
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    Mute Casper
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    Dec 21st 2017, 5:26 PM

    @Ciarán McPhillips:

    Keep reading you might come up with more

    22
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    Mute David Dickson
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    Dec 21st 2017, 5:25 PM

    Why did the guards wait two weeks to make an appeal for dash camera video? How could anyone remember two weeks ago

    79
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    Mute Casper
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    Dec 21st 2017, 5:28 PM

    @David Dickson:

    Well if they look at the dash camera on that day the camera will jog their memories

    20
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    Mute John Barnes
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    Dec 21st 2017, 5:58 PM

    @Casper: cams override constantly no storage

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    Mute Father Hody Commody
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    Dec 21st 2017, 6:47 PM

    @David Dickson: Plus dash cams overwrite themselves.

    13
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    Mute Sean Whelan
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    Dec 21st 2017, 7:26 PM

    I don’t think you can walk into a bank and just withdraw large amounts of cash on demand anymore, as far as I know it has to be ordered in advance.
    If I was hedging my bets I’d be looking at an inside job.
    Not very difficult to tip someone off to a large withdrawal, sure you even know the person’s name and address in advance.

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    Mute Liam
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    Dec 21st 2017, 5:20 PM

    An oddity amongst oddities

    32
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    Mute Brian O Reilly
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    Dec 21st 2017, 5:40 PM

    It was Santa ,

    19
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    Mute Casper
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    Dec 21st 2017, 5:20 PM

    It’s the season for a bit of silliness and this inside job is pure silliness

    37
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    Mute Dave Murray
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    Dec 21st 2017, 5:42 PM

    @Casper: taking €55,000 out of a bank in cash is pretty silly too, I would say.

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    Mute Casper
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    Dec 21st 2017, 6:21 PM

    @Dave Murray:

    Not if they have 55 members of family that they wanted to give a Xmas pressie of €1000 each

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    Mute Fiona deFreyne
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    Dec 21st 2017, 6:19 PM

    An amazing coincidence. Santa was early.

    11
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    Mute Joe Dobias
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    Dec 21st 2017, 8:21 PM

    Sounds like a inside job.

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    Mute Sarah Murphy
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    Dec 22nd 2017, 9:26 AM

    Pedal Cycle; why use one word when you can use two

    5
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    Mute Terry Burns
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    Dec 22nd 2017, 3:43 AM

    It sounds like a bloke year’s ago in a bank in Talbot st.someone lodged it .?

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    Mute brian oconnell
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    Dec 29th 2017, 1:06 PM

    Probably an “inside family” job!

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