What happened to Ralph Close inquiries?

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Whatever happened to the investigation into claims of maltreatment of adults with learning difficulties at Ralph’s Close care home?

Separate inquiries by the PSNI and the Western Health and Social Care Trust (WHSCT) were ordered last September into allegations made in a letter from a whistleblower. A number of staff at the facility at Gransha Park were suspended pending the outcome of the inquiries.

The police inquiry has been completed. No criminal charges have been brought. The WHSCT investigation has also now been completed. But there is no sign of its findings being made public.

This isn’t good enough. The residents, their families, Trust employees and the public at large have a right to know what was unearthed in the investigation, where responsibility has been found to lie and what action has been taken to set matters to right.

All of the employees suspended were frontline staff. No member of management or any Trust official was stood down. It was observed here at the time that, “No investigation appears to have been undertaken into the possibility that the collapse in standards of care at Ralph’s Close had as much, or more, to do with management failure as with staff behaviour.”

The basis for this observation lay in the detail of five “failure to comply” notices which had earlier been issued by the Regulation and Quality Improvement Authority (RQIA) following unannounced visits to Ralph’s Close. The RQIA had identified 26 “specific failings”, all of which appeared to be wholly or partly failures of management.

One front-line worker was quoted here: “Most of the issues…are to do with structures, staffing, staff appraisal, training, supervision, reliance on the use of agency nurses and so on. If those issues aren’t at the heart of any investigation, we won’t find out what went wrong. But that means looking at policy decisions at the highest level and targeting management as well as people on the ground.”

The RQIA had reported on an unannounced visit in July 2012: “At the time of the commencement of the inspection (10am), the manager of the unit had been on duty from 12 midnight. The manager remained on duty throughout the inspection until 3.15pm and appeared physically unfit to effectively manage the home.”

The “manager” involved was, in fact, not a manager at all, but a “Band 5” worker who had been slotted into a managerial “Band 7” position. In other words, the Trust had been getting managerial work done at non-managerial rates, resulting in arguably inappropriate staffing of a challenging, sensitive and highly responsible position.

The RQIA noted: “The manager reported that the required staffing complements had not been achieved despite his repeated representations to the Trust regarding the inadequacy of staffing levels.”

I understand that the findings of the WHSCT investigation cast a harsh light on the way the facility have been managed. Front-line workers now say that they suspect that this - the fact that management comes out poorly - is the main reason the report has not seen the light of day.

The point of the Trust’s inquiry was presumably to find out what went wrong at Ralph’s Close and what needed to be done to put it right. So, what went wrong? What practices, procedures, performances have been found wanting? What changes have been made or are now to be made to ensure it doesn’t happen again?

Has any individual or group of individuals been identified as bearing or sharing responsibility for what appears to have been grave failure at senior level?

Why hasn’t the report been published, and when will it be published?