hse health service executive ‘grace’ care adults
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The Health Service Executive (HSE) has repeated earlier apologies for failings in the care of vulnerable adults in foster care in the south-east.
The apology was made at the formal launch of two reports into the alleged sexual and physical abuse suffered by an intellectually disabled woman known as ‘Grace’ at a southeast foster home.
She remained in the care of the foster family for more than 20 years despite allegations of serious sexual abuse.
Dr Cathal Morgan, head of operations, at HSE disability services said he wanted to offer a “heartfelt and unreserved” apology for the failings in care that occurred and the failure to keep people safe.
Dr Morgan said the HSE had wanted to publish the reports, which date from 2012 and 2015, for “quite some time” but had been prevented from doing so for “specific legal reasons”. The service had not waited for this to happen to make improvements.
“I’m not going to excuse what happened. However, it is important to draw attention of the public and to point out there have been improvements made.”
These include new organisational structures, a national foster care audit and an audit of child protection services, he told the press conference in Kilkenny. An office of independent confidential recipient for whistleblowing allegations had also been established.
Aileen Colley, chief officer of the HSE community healthcare organisation in the south-east, said funding for disability services in the area had increased by 21 per cent since 2011.
A new senior management team for disability has been put in place, and a disability services manager and principal social worker appointed.
A focus on training has led to increased responsiveness and there has been a growth in advocacy services for people with disabilities.
Ms Colley also apologised for the failings in care that had occurred and said the HSE welcomed the commission of investigation due to begin shortly into the controversy.
Four other cases
The inquiries have recommended the cases of four others who were cared for in the same home be examined.
These include the case of a man who alleges he was locked in a cupboard by the family.
The reports included an investigation by independent management consultant Conal Devine, which was completed in 2012, and an investigation by Resilience Ireland, an independent provider of social services, which was concluded in 2015.
Both reports were commissioned by the HSE.
The investigations found 47 children with profound intellectual disabilities aged between four and 17 were placed in the care of this family from 1985 to 2013.
However, the family did not make health services aware of its decision to care for a number of children in a private capacity, meaning there may be a number of other unidentified cases of children being cared for by them.
It is known nonetheless that nine of the 47 children were among those privately cared for at the home, including a woman called Ann, who resided there until 2013 and has alleged sexual abuse.
Both reports stress the cases of four other “service users” require further investigation including one report of sexual molestation, claims of physical abuse and an allegation from one man that he was locked in a cupboard by the family.
Minister of State at the Department of Health Finian McGrath will bring a memo to Cabinet on Tuesday outlining the content of the reports.
He will also confirm his intention to bring forward terms of reference for a commission of investigation next week.
The family was not given permission to care for adults or to care for more than two children at any one time.
However, this was “breached on a number of occasions” and complaints of overcrowding were consistently made to both inquiry teams.
In 1985 the foster family provided placements to at least 14 children for an average of one week per child. In 1986 it cared for at least 19 children.
In 1987 it provided placements for at least 20 children, with one child staying for 10 months.
The Resilience Ireland report found the health services in the area did not check who was living in the house, their gender and ages, the sleeping arrangements or their living conditions.
Both reports centre on the case of “Grace” who was placed there in 1989, when she was 11, and stayed there for 20 years – until she was 31, despite allegations of sexual and physical abuse.
A Garda investigation into allegations she was sexually abused is ongoing.
The report by Conal Devine found that reviews, which are supposed to take place every six months, did not occur.
In 1995, Grace, who was 17, began visiting a day service. Staff noticed distress and bruises on her body.
A year later the mother of a different service user said that her daughter had been abused while in the care of the same foster family.
It was agreed at that point that Grace should be removed from the care home. However, she remained there for a further 13 years.
In August 1996 the foster family wrote to the then minister for health Michael Noonan asking him to reverse the decision of the local health services to remove Grace.
Health board staff wrote back saying the case was under review by them and a month later it was agreed Grace would remain in the home.
That same year another health board case review was carried out and it was agreed that no other child should be placed there.
However, staff did not follow up on these recommendations and Grace remained in the care of the foster family.
The daycare centre continued to complain of injuries the young woman had suffered including bruising to her breast and once a black eye.
On one occasion in 2009 bruises were found on Grace’s thighs and breasts and she was sent to hospital.
There were no places in any other residential facility available for her to stay when she left hospital so she was returned to the family.
Four months later she was removed from their care and placed in a residential facility.
Mr Devine found a litany of failures including no clear record of key decisions taken at meetings about the young woman’s care, new staff not being informed and no follow-up to concerns raised by day service staff.