Confidential NHS investigation reveals whistleblower raised alarm about Muckamore abuse seven years ago
Two months after a detective revealed the scale of an abuse investigation at Northern Ireland's main hospital for adults with severe learning disabilities, a NHS whistleblower report into earlier allegations has emerged. It also gives an insight into the facility's culture. Health Correspondent Seanín Graham reports
A LEAKED high-level report has revealed allegations of horrific abuse at Muckamore Abbey Hospital were first reported by whistleblowers seven years ago.
The confidential document details a catalogue of appalling mistreatment of vulnerable patients with authors expressing concern that "alleged behaviours" were "happening openly in front of visiting staff" on a ward in November 2012 - five years before CCTV exposed almost identical allegations on a different ward.
Sources say the 2013 report, known as the 'Ennis Ward Adult Safeguarding Investigation', has re-surfaced within the top tiers of the trust over the past month, with questions being asked about its content and "how this could have happened again".
It has also emerged that a new team of directors have been appointed to manage the facility from this week.
Muckamore, which is based outside Antrim town and cares for adult patients with severe learning disabilities, is currently at the centre of the biggest PSNI safeguarding investigation of its kind after CCTV footage emerged of alleged abuse of patients in a Psychiatric Intensive Care Unit (PICU) in 2017.
To date, 1500 suspected crimes have been identified while 33 staff have been suspended. A fresh wave of further suspensions is expected while arrests are understood to be imminent.
Ennis, which was an all-female ward and cared for patients with severely complex needs, closed over five years ago.
One of the most disturbing incidents in the probe relates to a "very distressed" female patient witnessed leaving a bathroom naked with blood coming from her mouth, screaming: "I hate her (staff member) she hit me".
The safeguarding investigation into Ennis ward took 10 months to complete and also involved the PSNI.
Allegations only came to light after a care assistant from a private facility, Bohill Care Home in Coleraine, raised the alarm.
She and 11 of her colleagues worked shifts at Muckamore over the course of a month between October and November 2012 as part of an induction for Ennis patients being moved out of the regional hospital and into the home.
Multiple whistleblower allegations regarding physical and mental abuse as well as neglect of patients are made in the report, which has been seen by The Irish News. These include:
- Staff member "grabbing a patient by the jumper" and telling her to "get the f*** out of my face" and "she's f***ing doing my head in" before pushing the patient down onto a sofa
- The words "you are doing my head in" were "shouted at patients in general"
- Patient "pushed so hard" into a chair that she "hits her head of back of chair" while another is left "soaking wet" outside on the grass without appropriate clothing
- Patient left sitting naked and told she "wouldn't get her sweets and lemonade" if she "didn't put her nightdress on"
- Patient being pulled to the floor from a sofa by a staff member
- Staff "encouraging'" patient to hit fellow patient back
- "Belt tightening" to such an extreme that patient became uncomfortable
Muckamore employees linked to the allegations were also interviewed and strenuously denied the allegations.
The report’s authors concluded there was enough evidence to warrant disciplinary procedures against two employees, who were subsequently arrested.
In 2014, one of the Ennis staff, Karen Hayes (54) who was a care assistant, was convicted for an assault after she dragged a sleeping patient off a sofa onto the floor for no apparent reason. She received a suspended prison sentence. A second woman, Margaret Hill (71) was cleared of all charges.
Unlike the current police investigation into Muckamore, which is relying heavily on 300,000 hours of CCTV as evidence, the PSNI probe into Ennis had no CCTV footage as cameras had not been installed.
During police interview, the safeguarding report reveals that Ennis staff repeatedly denied the offences with one worker even saying she hadn't been on duty - despite staff rotas and "descriptions matching hers" confirming she had.
Some workers refused to take part in the investigation and resigned.
Others described the ward as "pleasant, warm and homely", stressing patient care "was good".
Patients with capacity were also interviewed as well as family members, with no major criticism flagged up.
However, one woman admitted she was left to supervise her mother when visiting the hospital due to staff shortages - a "concern" noted by the report,
The probe also identifies "significant staffing problems" in the months prior to the allegations and recommended that the hospital's senior management team review its response to "incident reports".
It further notes that a hospital manager during interview had quoted from a positive RQIA watchdog inspection, which had cited Ennis ward as an "example of good practice".
The report's authors also asked Muckamore bosses for earlier disciplinary records of Ennis ward staff to discover if there was "any evidence of trends or patterns of concern" about "staff behaviour".
They found an incident in which a "non-Ennis" employee had observed and reported an incident in which a ward patient had been "roughly handled and threatened" in 2011.
"It is potentially significant that this was another occasion when poor care practice by Ennis staff was reported by non-Ennis staff..." they note.
They conclude there was a vast difference between the evidence provided by the Bohill workers, who they said had "significant concerns about care practice" at Muckamore, and the hospital staff, who "had none".
"The investigating team gave weight to the amount of concerns raised by twelve members of Bohill staff, the consistency between accounts and the level of detail contained in their interviews. The team notes as potentially particularly concerning the reports that alleged behaviours happened openly in front of visiting staff," the authors wrote.
"The investigating team thought it unlikely that Bohill staff would have any motivations to falsify reports."
A raft of recommendations relating to staff management, safeguarding training and the care packages of specific patients was made.
When asked to respond to concerns raised in the report, who it had been shared with and if the trust is content that all recommendations had been acted on, a trust spokeswoman said it could not provide a response until Monday.