Some 1,812 alleged abuse cases submitted by disability and older persons services for review by a HSE safeguarding and protection team (SPT) had not been examined as of late 2020, due to persistent staffing deficits and the volume of referrals. Some of the unreviewed abuse concerns in Community Healthcare Organisation (CHO) 7 dated to June 2019.
The team also had received 1,626 safeguarding plans, dating to 2016, which it had been unable to examine. There was no waiting list for referrals from the community. The situation, raised repeatedly by the SPT internally, is putting service users at risk of harm, according to records released to the Medical Independent (MI) under Freedom of Information (FoI) law.
Inadequate response times to abuse and neglect “could result in abuses occurring, which could otherwise be prevented”, warned a CHO7 SPT/HSE National Safeguarding Office (NSO) business case in July 2019. It advised of “a significant risk that case or cases may not be monitored or highlighted from the waiting list and an adult experiences abuse which may be avoidable with oversight and advice”.
As of late 2020, however, the issue was not recorded on the CHO7 Chief Officer’s risk register released under FoI.
CHO7 (Dublin South, Kildare, and West Wicklow Community Healthcare) has the largest population of older persons and disability services nationally. The level of safeguarding training in the area has also contributed to greater referral rates, the HSE has previously stated.
However, while the CHO7 SPT receives 20 per cent of national referrals, it is funded and staffed equivalent to the CHO with one-fifth of its referrals, according to an internal paper.
SPTs in CHOs support services to assess and manage abuse concerns. HSE and HSE-funded disability and older persons’ services are required to submit preliminary screenings of abuse concerns to SPTs for review. Services must ensure the immediate safety of service users and provide appropriate supports.
However, the ability of services to effectively prevent, identify and manage abuse concerns is variable.
According to a draft summary of 2020 activity, prepared by the CHO7 SPT for management, there is “a significant risk of harm to service users due to [the SPT’s] inability to respond in a timely manner to concerns of abuse coupled with inability to identify patterns of abuse due to significant backlog…”.
This resulted in “lack of governance and oversight of HSE and HSE-funded older persons and disability services”.
A HSE spokesperson told MI it is “committed to protecting adults at risk of abuse who are in receipt of the health and social care services we provide and fund”.
The safeguarding operations in CHOs “have been monitored and we have learned that improvements are required. These include an adjustment of resource to areas with higher populations and rates of safeguarding referral per capita, eg, Dublin and Kildare, and more consistency across the services we provide and fund.”
See news investigation Major backlog of abuse concerns with HSE safeguarding team – Medical Independent