A disability charity is refusing to cooperate with a HSE review into allegations that a non-verbal female resident may have been assaulted in one of the charity's care homes, RTÉ Investigates has learned.
According to HSE records, this refusal prevents the review from being completed.
The HSE funds the charity, which operates care homes for adults with intellectual disabilities in the south of the country.
In February 2023, the parents of the woman complained to the HSE when it found unexplained, extensive bruising on her buttocks and thigh area.
It also complained about two earlier incidents where a male care home resident was discovered in her bedroom at night.
Under its incident management policy, the HSE appointed a review team in June 2023 to examine the allegations.
However, the review was "officially paused" in January this year because the charity's management refused to cooperate with the review team.
Due to the case's sensitive nature, RTÉ Investigates cannot disclose the charity's name.
Over the past decade, the HSE has provided the charity with several million euro in funding.
RTÉ Investigates has reviewed extensive documentation relating to the case— including correspondence between the family and the HSE, and internal HSE records.
The woman was placed in the care home in 2020 and initially, her parents were happy with the care provided.
However, difficulties emerged in 2022 when a male resident was also placed in the care home.
The woman's father said that around this time, he noticed his daughter – a non-verbal adult with an intellectual disability and medical complications – became increasingly agitated.
"She was becoming more nervous and there were a lot of screaming episodes," he said.
'Assurances'
In November 2022, one of the charity staff members told the woman's parents about an incident involving their daughter and the male resident, according to correspondence sent by the parents to the charity that month.
The correspondence referred to a meeting between the charity and the parents, who were told that the male resident had entered her bedroom on two occasions, one night in early November. The parents complained that they were only told about this incident five days after the night in question.
At the meeting with the charity, according to this correspondence, the parents asked how long the male had been in the bedroom and were told, "It was not possible to say."
"We asked for absolute assurances that the male resident had not assaulted [our daughter] or touched her inappropriately or put her in fear of her own safety," the parents said in the correspondence.
The parents also said that they were told that a report had been prepared on the incident. However, they said that they were refused a copy of this report and were told by the charity that this was their daughter's information and not theirs.
'Not a safe place'
Over the course of around three weeks in late January and early February 2023, while their daughter was visiting the family home, her parents noticed bruises on her body.
There were three separate incidents. The first, in late January, was not initially overly worrying. They thought this could be explained by something mundane, such as a simple fall.
However, the second discovery – deep purple bruising on her upper thigh – caused immediate alarm. The family reported this to the charity.
"We were completely stumped," the father said. "We assumed that they [the charity] were going to tell us what had happened."
In early February, a senior manager at the charity emailed the father, acknowledging his complaint.
"We are taking your allegation of abuse very seriously," the manager said.
"All mandatory obligations are being met with notifications to both HIQA and the HSE."
Around two weeks later, the family found more bruises. The father emailed an official at the HSE, stating that his daughter "came home this week with a third selection of bruises on her leg, which are unexplained to us."
He also said he did not believe the care home "is a safe place for her to be."
Around mid-February, the parents decided to take their daughter out of the care home, to reside with them in the family home.
Concerns
The family had a phone call with an HSE official in February and a meeting with HSE officials the following month. RTÉ Investigates has seen HSE memoranda of both conversations.
"The family… are strongly of the view that something happened to [their daughter] in her residential service causing the bruising, which was evident on three separate occasions," a HSE memorandum states.
The mother and father also explained that they had learned that a male service user had been found in their daughter's bedroom.
They advised the HSE that they remained "fearful for [their daughter's] safety due to this resident's known assaultive behaviour" and queried whether this resident had assaulted her.
They also explained that their daughter had no history of self-harm and that it was not possible for her injuries to have been self-inflicted.
Review
That June, the HSE told the family that it had appointed a review team, consisting of a senior social worker and a senior nurse, to examine the allegations. The review's terms of reference stated that it would engage individual residents, staff, and family members.
It also said that the review should be completed within 120 days. However, the October 2023 deadline soon passed with no sign of a completed report from the review team.
In January this year – some seven months after the review began – the HSE informed the family it could not complete the review.
In a letter to the family, the HSE said that the review was "now officially paused" because of the "non-engagement of the Service Provider Management Team with the review process."
The review team also wrote to a senior HSE official that month to explain that under the terms of reference, its review could not be accomplished "without the engagement" of the charity.
It also claimed that the parents had concerns about the terms of reference of the review and proposed that the terms of reference be revised "in consultation with the parents and the [charity] management when the issue of non-engagement has been resolved."
However, the father told RTÉ Investigates that while he asked that the review look at broader issues related to the charity, he also clarified to the HSE that "we in no way wanted the review to be stopped and insisted that it must carry on."
The parents say they are at a loss to understand how the charity, which the HSE funds, could not be compelled to engage with the review.
"It was a complete disappointment that the management should be allowed just to have our review paused," the father said.
"I have written to them as well saying that I think that it's disgraceful that these people's wages and salaries are still being paid by a HSE grant," he added.
Last month, in response to a Freedom of Information request to the HSE for records relating to its review, the father was told that while the review is "paused," it is also "ongoing." The HSE said that it could not release certain records relating to the review because it has not concluded.
'Matter has been addressed’
RTÉ Investigates submitted detailed queries to the HSE and the charity.
The charity said that it could not comment on matters related to individual service users.
It also stated that it "has always and will always fully cooperate with any external review of its activities."
RTÉ Investigates asked the charity to clarify its statement that it always fully cooperates with "any external review," given that the HSE had cited the charity management's non-engagement as the reason for its review being "officially paused."
However, the charity replied that it could not make any further comment on the matter.
The HSE also told RTÉ Investigates that it could not comment on individual cases, but added, "the matter referred to in your query, which concerned a particular resident, has been addressed in a thorough manner in line with HSE safeguarding policy and procedure."
But when specifically asked about the status of the review, the HSE said, "Separately, a broader review taking into account wider matters and which is not focussed on any single circumstance has not been completed."
However, the family has disputed the HSE’s claim that the matter "has been addressed," saying they have yet to be given a satisfactory explanation as to how their non-verbal daughter came home on several occasions with deep bruising on her body, having been in the charity’s care.
"I think of all the other people who are out there that don't have anybody to speak for them," the mother told RTÉ Investigates.
"I mean, in a way, my daughter is lucky. She has a family. There's a lot of people in these situations that don't. And that's what keeps me awake at night."
