‘Rigorous investigation’ into Ralphs Close abuse allegations balances ‘concerns’ against ‘significant improvements’

On July 24, 2012, an anonymous letter prompted a series of critical inspections at the state-of-the-art Ralphs Close facility for vulnerable adults at Gransha Park.

The revelations prompted a PSNI investigation, whilst some staff at the home were suspended as a precautionary measure.Initial inspections in August 2012 first highlighted concerns about inadequate staffing levels and mentioned complaints that the unit’s managers were working too long hours.

In October 2012 Health Minister Edwin Poots said a huge amount of supervision was taking place at the home in a bid to transform the culture of care there.

Today (Wednesday, February 26) a Western Trust Adult Safeguarding Team has published its own report on the situation.

According to the report the team found “cultural and professional practice concerns across the service” but also pointed to significant improvements to the service over the past year-and-a-half.

Amongst its recommendations (18) the team notes that: “The findings evidence cultural and professional practice concerns across the service provided in Ralphs Close.

“It is recommended that professional nursing in conjunction with the Learning Disability service should review individual practice, conduct and record-keeping in line with Trust Policy and Professional Codes of Practice.

“The Trust should determine from this if any Human Resource or Professional processes are required.”

And in its ultimate recommendation (19) the team states: “It is noted that there has been significant service improvement in Ralphs Close since the disclosure of the initial allegations.

“However, it is recommended that there is further development by the service division to consolidate the values and principles that underpin a social care philopsophy and environment.

“Such service improvements should be evidence based and measurable through Key Performance Indicators (KPI) of Quality Care Standards.

“The service division should ensure that the learning from such service improvement is shared across other service areas.”

The Trust says it continues to meet the families concerned and apologises to them for any distress caused to residents in the home.

It also points to an unannounced inspection of the facility by the Regulation and Quality Improvement Authority (RQIA) on February 12, 2014, which issued an overwhelmingly positive report.

In addition to the proposals above the safeguarding team also recommends that 1: Learning Disability services should review supervision arrangements; 2, information on Whistleblowing Policy should be made available to staff; 3, Learning Disability services should review the role of care management; and 4; KPI should be considered for inclusion in the Quality Improvement Plan (QIP).

It also recommends that: 5, the RQIA considers systems to ensure expedient reports; 6, the WHSCT reviews governance arrangements; 7, staff and management are aware of who to inform in the case of an incident; and 8, Learning Disability services should review Vulnerable Adult training.

The team recommends that: 9, all unexplained injuries and allegations are reported; 10, the Learning Disability service should develop assurance systems to ensure adherence to Trust policy; 11, record-keeping and communication processes should be revised; 12, staff should be trained on Trust policy on the Use of Restrictive interventions; and 13, Learning Disability services should review training for managing challenging behaviours.

Finally, the team says: 14, Learning Disability should review training on communication strategies; 15, assessment and care planning is reviewed at Ralphs Close; 16, moving and handling risk assessments be reviewed; and 17, residents nutritional care plans be updated.