An unannounced health watchdog inspection of a centre for adults with disabilities in Co Wexford has found punishment of residents was prevalent.

This involved the removal of personal items, restriction of food items and fining of residents.

The Health Information and Quality Authority inspection of Highwater Lodge, run by Stepping Stones Residential Care Limited, also found "a significant level and frequency of aggressive behaviour in the centre that required residents to be moved from their living areas in order to protect them from injury."

An action plan states management at the care centre have acted on all of HIQA's recommendations.

This report followed an unannounced inspection after HIQA was notified of an incident in which one resident struck another, causing a head injury.

An earlier inspection in July 2016 had raised concerns in relation to the mix of residents living together and the safety of residents in relation to behaviours that challenge.

The centre, described as a large spacious house in a rural setting, was available to both adult men and women but the report found the mix was not appropriate at the time of the inspection on 3 November 2016.

Inspectors found that residents had very little opportunity for making choices, and that there were various structures and rules in place, with very little evidence that some of them were in the best interest of residents.

"Punishment regimes including the removal of personal property and the withholding of edible treats in place throughout the centre," inspectors said.

"There was frequent reference to residents being obliged to 'comply', family visits were described as 'access', and the prescribed consequences for some residents' behaviour was clearly identified as 'punishment'."

Staff were advised that in situations where items were damaged by the behaviour of residents, the resident was to "pay for the item, and that the staff on duty were to apply this charge immediately."

"The rights of residents were not upheld in relation to the application of punishment, and in the terminology used throughout the centre."

The provider was required to immediately ensure that all staff were informed that punishment was no longer to be used, and the threat of withholding snacks was to be removed from all guidance.

The report also found management systems were not in place to ensure that the service provided was monitored, or that it was appropriate to the needs of residents.

HIQA found the provider had not put adequate arrangements in place to safeguard residents, including from the risk of fire, and ordered immediate action relating to the fire concerns.

These fire risks included candles in residents' and staff bedrooms, poor management of cigarette smoking and extinguishing of cigarettes and no fire risk assessments in place.

Residents and staff were also sharing bathroom facilities, but there were no privacy locks on the doors of bathrooms or toilets.

21 other HIQA inspection reports published

HIQA has today published 21 other reports on residential services for people with disabilities.

Inspections in 19 centres found a good level of compliance with the requirements of the regulations and standards.

A lack of effective governance and management systems was identified in Vevay Close in Wicklow run by Sunbeam House.

HSE-run Teach Solas/Oaklands in Westmeath also required attention to ensure compliance with regulations but overall the centre was well managed and the HSE was providing a good quality service to the residents.