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HIQA move in on Western Care services


Five Western Care services must now be scrutinised by HIQA with 51 more under review

Edwin McGreal

HIQA will take over the monitoring of five more Western Care services with immediate effect while a further 51 unregulated services are subject to internal and external reviews.
The Mayo News has learned that this greater oversight by the independent healthcare and social care watchdog was communicated to senior management in Western Care last week. It comes in the same week that the association confirmed the ‘principal element’ of their ‘review of management structures’ will consist of ‘an external review of the 104 individualised services’ in Western Care.
In a letter to staff and families of service users, Interim CEO Dr Aoife O’Donohue said this external review is to ‘assess the standard of care provided, and to ensure best practice and good governance’.
“Two external independent consultants have been appointed and their review will begin in January 2023,” she wrote.
The latest news comes after weeks of turmoil at the Mayo-based charity which provides services and supports for over 850 services users with intellectual disabilities and/or autism in Mayo and employs approximately 1,000 staff.
An investigation into the Individualised Services section in Western Care was ordered by then CEO Donal McCarthy in October and three senior staff were placed on leave.
However, Mr McCarthy had his employment terminated by the Board of Western Care in mid- November and he was subsequently replaced by an interim CEO Dr Aoife O’Donohue.
Issues at Western Care were first broken by this newspaper and have been raised with the Taoiseach in the Dáil.  
Internal correspondence from last week seen by The Mayo News confirms that five services under the management of the Head of Individualised Services reviewed on December 7 last must now be registered with the Health Information and Quality Authority (HIQA).
A further 28 services under the Head of Individualised Services will be subject to ‘an internal and external review to identify the model of support’.
The internal figures clarify the precise number of individualised services in Western Care.
There are a total of 104, of which 33 operate under the management of the Head of Individualised Services (IS). This IS section of Western Care has been central to recent turmoil.
There are other individualised services managed outside of the IS section. Twenty four are under the management of regional service managers (RSMs), 44 are termed merely as ‘home supports’ with three termed as ‘home sharing’.
All the services under RSMs are subject to ‘internal review’, save for one where HIQA registration is in process.
Many current and former staff who have expressed concerns that many unregulated settings under the Head of Individualised Services should be regulated by HIQA. While HIQA is statutorily required to monitor several Western Care services, concerns have been raised about a ‘legislative loophole’ where Western Care effectively self-assess if individualised services, where people receive support in their own owned or rented accommodation, require HIQA oversight.
“Western Care have not been upfront with HIQA about some of the Individualised Services which ought to be under the scrutiny of HIQA but which Western Care have not registered,” said one former Western Care employee, who worked in the Individualised Services section this year.
‘Significant crisis situation’
The Individualised Services section was criticised in an damning independent report commissioned by Western Care in 2020.
The Wolfe Report described the Individualised Services section as being ‘very much in a significant crisis situation’ with concerns for staff safety and the quality of supports received by service users highlighted in the report.
Mayo Sinn Féin TD Rose Conway-Walsh has called for an independent investigation into concerns at Western Care, saying the testimonies she has received are ‘troubling and traumatic’.
In her letter to staff and families of service users, Dr Aoife O’Donohue said the external review of individualised services is the ‘principal element’ of ‘three strands’ of the overall review.
The other strands, she wrote, include ‘an appreciative inquiry – looking at leadership, governance, our teams and management roles’; and ‘a service improvement framework in collaboration with the HSE’.
“We will be working in collaboration with the HSE on all aspects of the review.
“Our job and our mission statement remains the same – to provide the most appropriate care to the people we support, in the most appropriate setting,” she added.
In response to a series of questions from The Mayo News about recent developments, Western Care issued the following statement:
“Western Care Association continues to actively engage with all State agencies and is regularly engaging with HIQA and the HSE. The external review will look at all aspects of individualised services across Western Care Association. It is being carried out by independent experts with long-standing experience and a proven track record in the sector,” they stated.