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A CARE home for people with learning and physical disabilities has paid back over £7,400 to its residents after a financial abuse investigation.
Twenty five residents were reimbursed after the Southern Health and Social Care Trust identified concerns about a charging scheme which ran for seven years at The Haven Nursing Home in Dungannon.
A trust investigation identified “significant issues” regarding a 10% levy imposed on purchases made on behalf of residents at the private nursing home.
This included a charge for services and activities provided in the care home by external contractors such as therapists and hairdressing services.
In May 2015 money was paid back to residents, with individual payments ranging from £20 to £850.
We contacted Haven Private Nursing Home but it declined to comment.
However Northern Ireland's care home watchdog, the Regulation Quality and Improvement Authority (RQIA), confirmed it had received assurances that the charging scheme has ceased and residents have been reimbursed.
In a further development new figures obtained by The Detail show that almost 20% of enforcement action taken by RQIA across Northern Ireland since 2012 has related to breaches in financial regulations.
In Northern Ireland RQIA conducts a programme of annual inspections at nursing homes on a minimum of two occasions per year.
In 2012 concerns were raised by RQIA inspectors about financial practices at Haven when they found that there was an “inconsistent approach to charging service users the additional levy” and it referred the matter to the Southern Trust.
The trust intervened and carried out its own investigation after the RQIA raised “significant issues” regarding the 10% levy.
The Detail obtained a copy of the trust’s investigation report from June 2014 through a Freedom of Information request. It concluded that there was evidence of financial abuse in respect of a 10% administration charge and application of mileage and supervision charges.
The report stated: "Financial abuse is upheld in relation to the 10% administration charge on the basis that the Trust does not accept the reasonableness or necessity for this charge."
In November 2014 RQIA threatened to impose sanctions on the care home but in February this year it received “assurances from the provider that it would refund in full - all patients charged this levy.”
A spokesperson for the RQIA said: “During the year ahead, RQIA will conduct an unannounced inspection to assess the compliance in this area.”
ENFORCEMENT ACTION
Inspections of care homes here may be announced or unannounced in the areas of care, medicines management, estates and finances.
Since April 2012, RQIA has taken enforcement action in relation to breaches in regulation associated with financial issues on 25 occasions. The table below provides a breakdown by service type. This accounts for almost one fifth of all enforcement action taken during this period.
*2015-16 figures are from April 2015 to September 2015
When concerns are identified, RQIA can issue a failure to comply notice. In serious cases this means they can: enforce a closure of a premises by cancelling registration; pursue a prosecution; or impose conditions on registration, such as halting new admissions to a service for a period of time.
“FINANCIAL ABUSE WAS UPHELD”
The Haven in Dungannon is a registered nursing home for people with a learning or physical disability.
During finance inspections of Haven in May 2012, April 2013 and February 2014 RQIA raised issues regarding a 10% levy imposed on purchases made on behalf of service users.
The RQIA eventually referred the matter onto the Southern Health and Social Care Trust (SHSCT) and in June 2014 the trust undertook a safeguarding investigation report into the potential financial abuse of two service users.
In Northern Ireland the Department of Health set a regional rate for care costs that is reviewed annually.
The trust’s investigating officer found that on top of the regional physical disability rate of £609 per week, residents in the Haven nursing home were also charged a 10% administrative fee since 2007 for goods purchased in respect of their care.
This covered a range a of products and services including providing rooms to patients for hairdressing, staff escorting patients to rooms to receive hairdressing services and staff time involved in making trips to the bank to withdraw patients’ monies to pay for additional services.
Haven had previously told the regulator that the services by external contractors such as therapists and hairdressing were subject to a 10% levy on cost for use of premises. This also included fees for transport and arrangements for purchasing toiletries.
The investigating officer for the trust raised concerns about this practice and the report stated that the trust did not accept “any explanations offered by the Haven Private Nursing Home to be a reasonable justification for 10% being charged to residents”.
The investigating officer stated: “The contract fee for the Haven Private Nursing Home should include all services for the residents and the home can arrange services e.g. hairdressing for the resident but should not be entitled to charge an extra 10% for this.”
The report concluded that the allegation of financial abuse was upheld in relation to the 10% administration charge on the basis that the trust did not accept “the reasonableness or necessity for this charge.”
Following the trust's investigation the RQIA wrote to Haven to inform it of its intention to a serve a failure to comply notice on the nursing home.
RQIA confirmed that it did not enforce the failure to comply notice after assurances it received in February 2015 that Haven would refund in full all patients charged the 10% levy.
In a statement to The Detail the Southern Trust confirmed that in May this year 25 residents placed there by the trust, both past and present, received reimbursements from Haven ranging from £20 to £850.
The overall total figure for trust placed resident reimbursements came to over £7,400.
To view The Detail's previous coverage on care home regulation, click here.