Pat Casey (Wicklow, Fianna Fail)
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Sunbeam House Services provides vital services to adults with intellectual disabilities in Wicklow with full-time residential, day services and respite care. There are hundreds of service users and their families requiring the services of Sunbeam House Services throughout Wicklow but particularly in facilities in Bray, Wicklow and Arklow. Needless to say, any organisation providing such services needs to be fully transparent and provide a service that has the full confidence of the service users, their families, the front-line staff and the State agencies that act on behalf of the taxpayer who fund these services.

Recent and routine HIQA inspections have found failings in the operations at Sunbeam House Services which, along with family and staff complaints, have led to a recent assurance review by the HSE that again has found failings in the operations of Sunbeam House Services. The report refers to 284 separate complaints being registered against Sunbeam House Services between January 2013 and September 2016. Concerned family members have been in contact with me since July 2016 about their serious complaints and concerns. I have attempted to get answers to very serious allegations including the mistreatment of service users and serious failings in management at Sunbeam House Services. I have been attempting to do this without increasing further the anxiety to the family members of service users and to the service users of other Wicklow based organisations that may be involved in a proposed merger with Sunbeam House Services. Information supplied to me by concerned families suggests that long-serving social workers and a senior medical doctor involved with Sunbeam House Services have serious concerns about the procedures, care services and management at Sunbeam.

The removal of the assurance report from the HSE website has convinced me that I needed to bring these issues directly to the Minister for Health, Deputy Harris, and for a publicly accountable response on the floor of the Dáil. I am also concerned about the apparent lack of a protected disclosures policy at Sunbeam House Services. Given the responsibility of care given to any organisation providing services to adults with intellectual disabilities, the absence of such a policy is, quite simply, disgraceful. The families need to know if protected disclosures have been made to the HSE or to Sunbeam House Services, the number and gravity of such disclosures and the response to such disclosures, including reporting to the Garda where required.

Transparency and accountability in the provision of care services should be front and centre in every organisation providing such services to the most vulnerable members of our community. I am shocked about what is contained in the reports and how the reports have been removed from the website. From my contact with some families I know they have been very reluctant to go public because of a deep seated fear that their loved ones' level of service may be affected. The fact that family members of service users are living in fear is enough of a disgrace to warrant a serious, rapid and public response from the HSE and from the Minister.

Simon Harris (Wicklow, Fine Gael)
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I wish to thank Deputy Casey sincerely for raising this important issue. I know it is of great concern to the families affected, many of whom I have had an opportunity to meet, correspond and talk with - as the Deputy has.

I would like to begin by reiterating that the Government's ongoing priority is the safeguarding of vulnerable people who are in the care of the health service, and I appreciate that the Deputy has outlined this also as his ongoing priority. This includes those people who avail of services provided by voluntary organisations such as the service provider in question.

As the Deputy will be aware from his work in Wicklow, Sunbeam House Services is a voluntary organisation providing a wide range of services across east Wicklow and south County Dublin to adults with intellectual disabilities. It is supported financially by the Health Service Executive and received core funding of €24.1 million in 2016. I am very aware of the broad range of supports that Sunbeam House Services has been providing to date for people who have a disability. These services include residential places to those with intellectual disabilities, rehabilitation training places, day services to over 300 clients and home support services to a cohort of 42 adults. It also supports nine respite beds, providing more than 800 places to 51 service users each quarter of each year.

Unfortunately I am also aware that a number of serious issues of concern have been raised by families of service users attending Sunbeam House Services. On foot of these concerns, an externaI assurance review of the systems of governance and management in Sunbeam House Services was recently commissioned by the chief officer of the HSE community health care organisation, CHO 6. I very much welcome that this was an external review because this was important for providing reassurance to families that this would be an external review; someone from outside to look at these issues. The review focused on Sunbeam House Services governance and management structures in respect of the management of complaints, the management of incidents, the management of protected disclosures and the implementation of the HSE’s national safeguarding of vulnerable adults policy.

As part of this process, a review was undertaken of the independent regulator HIQA’s inspection reports on Sunbeam House Services disability residential centres. I understand that in addition the review process involved interviews with families who had raised complaints and concerns. There was also a consultation with service users, because it is important that the voice of the service user is heard in this process, and meetings with staff focus groups.

The review team has now finalised its formal written report in line with its terms of reference. I wish to be clear that I consider the issues to be extremely serious and I have engaged closely with senior management of the HSE regarding the review report. I have stressed the need to ensure that an appropriate implementation plan is put in place as a matter of priority and I understand this is currently being finalised. I will be meeting with HSE management to focus specifically on this issue and I intend to meet tomorrow with representatives of families who have raised concerns. I have been, and will continue to be, very clear that I want to see all recommendations of the report acted upon quickly and any further actions that may be required to be followed up without delay.

In conclusion I wish to assure Deputy Casey that I and my Department will continue to maintain close contact with the HSE with a view to ensuring that all necessary service improvements across the range of services provided by Sunbeam House Services are instigated as soon as possible. I also want to thank the families for coming forward and highlighting these very important issues. If it was not for the families then we would not have the body of knowledge which merited the external review. My assurance to them today on the floor of the Dáil is that each and every one of the recommendations in the report must be implemented by the HSE and by Sunbeam House Services. I expect the HSE to get on with ensuring the implementation plan is in place as a matter of urgency.

Pat Casey (Wicklow, Fianna Fail)
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I thank the Minister for coming to the House to answer the question himself. I thank him for his response and for his confirmation that he is meeting immediately with the HSE on this matter. I am also delighted to see that he is meeting formally with the families tomorrow. This is what is needed. Now that action is being taken a public response is needed that all service users, the families of service users and front-line staff can take confidence in. There needs to be a rapid, time-bound approach to every single recommendation contained within the reports into Sunbeam House Services. I accept that due process is important but these concerns have been investigated for a long time now. Families have stressed to me how the vanishing of reports from the website has further contributed to the concerns of families.

Reports appeared on the website and were taken down the next minute.

The Minister will be aware of the proposed merger involving Sunbeam House Services, KARE and St. Catherine's, which would, in effect, bring the entire service offered to those with intellectual disabilities in Wicklow under one managing entity. It is my information that the insurance report recommends this merger be put on hold until such time as the issue in respect of Sunbeam House Services has been resolved. If the Minister is not aware of that, I would ask that he come back to me on it. I also ask that he ensure that, at a minimum, this recommendation is followed.

Simon Harris (Wicklow, Fine Gael)
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I fully agree with everything Deputy Casey said. I have been involved with advocating for people with disabilities in County Wicklow since my teenage years. I have absolutely no intention of allowing a report that has been commissioned and that has made very clear and stark recommendations to sit on a shelf. It is my absolute determination that the HSE will deliver what Deputy Casey rightfully calls for, namely, a very public response in terms of an implementation plan that shows exactly how we are going to deliver on all of the improvements the report seeks in respect of Sunbeam House Services.

For quite a period, parents have been highlighting concerns about a number of issues at Sunbeam House Services. It is my absolute view that the report vindicates those concerns. I understand the HSE published the report online and that it was subsequently taken down, and that there is some legal or administrative reason for this. The main comfort I take is that the parents have the report. It has been circulated because many parents got it from the website and they have seen it. I am sure Deputy Casey has seen it. I have seen it. There is no doubt about the body of work that needs to be done. I agree with the Deputy about the need to hold off on any merger until all of these issues have been fully resolved.

Many of the staff in Sunbeam House Services have been doing Trojan work at different levels and in a variety of roles. There is a clear need for improvement and things have gone wrong. The report leaves us in no doubt of that. However, for the people who work in Sunbeam House Services and do their very best to provide a good service, for the parents who advocate on behalf of their service users and for the families, I really believe that by working together we can make this an organisation that delivers the type of service we want to see in Wicklow and south Dublin, and one of which everybody can be proud. The report is the beginning of that process and stands as an important roadmap for the improvements we need to see. Now the HSE and Sunbeam need to get on with delivering it.