Care Home Concerns

It's being going on for years now, yet it still fills me with dread every time I see a report about a care home that has mistreated it's residents. 

The latest report is about the mistreatment of people with Intellectual Disabilities in a care home in Co Mayo, which was televised on RTE Prime Time on Tuesday night. By all accounts it made for some pretty horrific viewing.

I haven't watched it yet myself and have now decided that I won't . 

As the daughter of a parent who is a longtime resident of a care home it would be far too upsetting. And I can only imagine how the parent of a child with disabilities, who may ultimately need the facilities of a care home, must feel on watching these reports.

How many of these programmes do we have to watch before something is done?

I for one was glad when HIQA was set up in order to keep controls and to unearth unacceptable behaviours in our private and state run care homes. It is comforting to know that someone is calling unexpectedly - and sometimes by appointment - into these facilities to check them out. It is comforting to know that you are not your loved one's only advocate. I have studied recent reports on the care home we use and found them to be quite comprehensive, I actually feel that HIQA should have been harder on them over one particular and very serious issue. However, HIQA has been instrumental in instigating some helpful social activity changes and resident questionnaires, but it has also enforced what could be considered an administrative nightmare. One that has brought about an additional daily 'administrative charge' being passed on to residents in our case. HIQA has spent time analysing this cost, and the term used to apply it, and finds it unacceptable. They insist on it being changed and it would appear that an awful lot of paperwork has gone into ensuring that this happens.

Meanwhile there's a care home in Co Mayo where residents are being regularly and horrifically abused. What analysis was done in this home?

The decision to send your loved one - be they young, old, disabled or elderly - into a care home is one of the toughest decisions you'll ever have to make. It's one that, after nine long years, still doesn't sit easy with me. The fact is however, that it's not always possible for a family member to give 24/7 intensive care to one loved one while looking after everyone else in the family; and whilst also giving young children, who may have special needs of their own, their optimum chance in life.

Once you make the decision you then hope that they are always in good hands - especially when you can't visit. You make unexpected visits of your own, at differing times, and even stand outside their room if carers are in with them - secretly listening for any possible issues. You also listen to your loved ones concerns and complaints and investigate those that you can, while trying not to fling unsubstantiated accusations about. While it is very difficult if your loved one cannot verbally express themselves it is also difficult to deal with those who can. Mental Impairment can make distinguishing between fact and perception extremely difficult. 

The care home we use is very good, but it's not perfect. I've seen such loving care and gentle, yet quite firm, responses being administered in many different situations here over the years. I've even seen things I've not been happy with and was easily able to bring them to discussion. I've seen wonderful changes, particularly in the area of social activities, brought about by HIQA visits. I've also seen my own parent brought through diagnosed end-of-life stages, at least three times in as many years. It was excellent nursing care that made this happen, against the odds. And an indomitable fighting spirit and the incredible will to live of the patient herself, we must not forget that!  

However, no-one knows what happens behind closed doors when there no visitors, be they from HIQA or personal, around.

So, what can we do? 

There have been calls for imprisonment of the abusers. I do agree that these abusers must face investigations and be ultimately held accountable for their actions, but they must also face due process. This point is very well, and generously, made by a family member of one of the Aras Attracta residents .

However bringing the abusers to account is not going to completely solve this.

Closing down care homes because of abuse doesn't stop it from happening elsewhere either.  Although re-opened after some time, Leas Cross was closed down in 2005 and yet we're still hearing of  residential abuse today.

Personally speaking I think that maybe more consideration should also be given to the following:

Hiring: Qualifications, References and Training: It would seem that we need to pay more attention to these areas in our Private and State run facilities. We need to consider this very strongly for all nurses/carers in our system, no matter their nationality. Although the abusers in the Aras Attracta case were all Irish I would question if foreign qualifications are equal to our national ones? And indeed are our national ones sufficient? The same must apply to the hiring of management to run state facilities. Staff training for all should be regularly updated.

Owners and Management: Owners in private run facilities need to take a hands-on approach to running their own care homes. They must see their care home for the 'caring home-from-home' that it should be, and  not the tax relief investment they might prefer. The difference in the provisions of my mother's care home was very noticeable when the owners got fully on board. Police it yourself, don't wait for HIQA. Bring on board family members. Do night shifts. Unannounced.

The HSE must be very particular about whom they hire to run our state facilities. These managers should also do night shifts. Unannounced.

Staffing Levels: There should be no excuses or allowances made in any care home, private or state owned, for not employing the relevant, best practice, carer and nurse:resident ratio. Whatever the cost.

Camera Surveillance: There have been some suggestions of this online. We need to deal with any privacy issues and give this serious consideration,

HIQA: Personally speaking I'm impressed with the reports that I have read and the changes they have instigated; and I feel very re-assured that they continue to inspect. Any 'Administrative Nightmares' notwithstanding. However, perhaps we need to review how successful, or not, this authority has been in unearthing and tackling residential abuse; and in ensuring the delivery of 'Safer Better Care'? And then we need to make any necessary changes. Now.

Advocacy for Residents: All vulnerable residents in our care homes need to be given a voice and their voices need to be heard. Whatever the nature of their disability, or reason for needing such levels of care, their dignity and humanity must be preserved and respected.  Family members can only do so much. HIQA seem to attach a lot of importance to this area of care and inspect individual plans and their implementations with regard to resident's personal requirements and challenging behaviours, but clearly more needs to be done by some care homes themselves.

And finally we need to keep these stories in the limelight. 

Keep it fresh so that something is done and so that more assurances can be given to those who need these facilities - and to those who love them.



Since posting this last night I learned of a new care home abuse story in Stamullen, Co Meath .
I have also read this article contending that HIQA was 'deliberately misled by care homes'. This makes sense to me. As I've said above we need to know why they didn't unearth this abuse.... and then make any necessary changes.

Take care,


  1. Thank you so much for writing about this, and I wonder how on earth we are going to keep the public interested and engaged? Less than a week later and it seems that many people have moved on :( xx

  2. I just feel sick to my stomach over these issues. How another human being can abuse a vulnerable member of our society is completely beyond me. I really worry for my son's future when I am not around to care for him.

  3. @looking for Blue Sky: And two weeks on and there's even less about it. we have to keep annoying people I think....

    @Bright Side of Life: It is dreadful, and a worldwide issue.

    Thanks for your comments :-) xx

  4. I really hope it is the beginning of the end of this undocumented abuse of some of our most vulnerable. As someone who was abused as a child, I have seen what happens when we speak up. It was not easy to do but now here in Ireland child abuse is now well documented and awareness is high. It can happen and it has to begin somewhere I really hope this is that somewhere.

    1. @mythoughtsonapage: I am so sorry to hear of your experience. You;re right though, we need to speak up. These vulnerable residents don't have a voice. We need to give them one and make sure that it's heard. We need to keep talking about this and raise awareness to stop this abuse... now.xx


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