1. Brothers of Charity Services Ireland – Galway Human Rights Committee
Presentation at Inclusion Ireland National Learning and Sharing Event 15th June 2017
Breda Golden

2. Background and Laying the Foundation
First meeting July 2007 – 10 years in operation
Idea from organization as part of the accreditation process with the Council for Quality & Leadership (CQL) - importance of external representation and due process
Human rights seminars for staff, service users and family members in partnership with Amnesty and the BOC Training and Development Department
Policies and procedures developed by Committee (with senior management support) and put on website
Referrals from June 2008

3. Brothers of Charity Services Ireland – Galway Policies and Procedures
Policy on Human Rights and the Human Rights Committee
Procedures for the Operation of the Human Rights Committee
Brothers of Charity Services Charter of Rights
Policy and Procedural Guidelines on Moving Towards a Restriction Free Service
Closed Circuit Television (CCTV) Policy and Guidelines
Human Rights Referral Form
Individual Rights Assessment Form (as part of each service user’s Individual Plan)

5. Composition 2 Service Users from the Service Users’ Council
4 external (NUIG Centre for Disability law & Policy, retired consultant Paediatrician, Social Worker from local Service Provider) 1 vacancy due to recent retirement
6 internal (2 Social Work, Quality and Development, Psychology, Speech and Language, Service Co-ordinator)
Role of Chairperson is allocated to an external member

6. Referral Process
Informal contact about referrals – clearly stated in policies that there is a requirement to submit any rights restriction to HRC
Referrals welcomed from family members, service users and staff
Human Rights Restriction Form and supporting documentation submitted
Screening prior to HRC meeting to establish if case should be heard, or if more information required
Formal notification to person who submitted form regarding status of referral
inviting service user, family, staff and any other relevant persons to the HRC
Screening did exist before, but now has external representation. For practical purposes done internally.
Moving towards formal notification system – written record of submission. This is currently being developed.

7. Procedure at Meetings External representative chairs the meeting
Present who the person is, their quality of life and lifestyle preferences
Present reasons for right being restricted
Person subject to rights restriction (and support person(s)/advocate(s)) given opportunity to speak
HRC ask questions about facts and alternative approaches, what has been done to reduce or remove restriction
HRC reach decision and formally notify parties in writing of their recommendations
Director of Services and Sector Managers receive a copy of recommendations
HRC encourage broad representation of those involved and broad representation of opinions.
The CEO is also notified of decisions of HRC.

8. Types of restrictions Rights restriction Examples Freedom of movement
Locked doors, restricted access to garden/kitchen/road, stairgate, harness, bedrails, wheelchair
Privacy
CCTV, monitors, alarms, supervised access to the community
Choice of where and with whom to live
Inappropriate/unsuitable living conditions, incompatibility issues
Making decisions
Cigarettes, matches, access to money, refusing medication, locked wardrobe/cupboard, restricted access to family, restricted access to food/water
Bodily integrity
Psychotropic medication, covert medication, blood protocol, protective headgear
Appropriate support
Appropriate housing, limited community access
Locked doors (1 in 2009 (access to outdoors), 3 in 2010), Access to kitchen (2 in 2010), seclusion (2 in 2010), alarm (1 in 2010), harness (2 in 2011). Seclusion – person placed in room during day programme for 5 minutes when displayed aggressive behaviour. Partition between two day programmes.
Cameras (1 in 2009, 1 in 2010 – more cameras needed for changing behaviour? Raised in 2011), supervision for user (1 sexual abuse, 1 road safety – 2009)
Inappropriate housing 2 in 2010), dispute among service users (1) – but environmental/housing issues often raised as part of presentation of other issues to HRC. Choice of living alone?
Cigarettes (1 in 2009, 1 in 2010 – possibly inappropriate referral) Eating (1 in 2009, same in 2010), Refusing medication (1 in 2009, same in 2010) Helmet (1 in 2010) Risks (2 suicide risks, 1 sexual risks)
Psychotropic med (2 in 2010), covert medication (1 in 2009), Blood protocol (1), washing (1 in 2011)
Appropriate support (1 respite 2010), appropriate housing (2 in 2011), feeding (1)

9. Key figures Human Rights Committee meet 11 times per year for 3 hours
June 2008 – June 2009 = 18 referrals
January – December 2014 = 39 hearings
January – December 2016 = 93 hearings (Committee divided into 2 groups on 4 occasions and 1 day long meeting)
Referrals from Adult and Children’s services (residential, day, home sharing)
Currently 105 open to HRC including 21 on waiting list
Reviews 6 months – 2 years
Future issue: reporting – September to July? Don’t meet in August – stats should reflect this.
Would accept children’s referrals but would ask parents to be present.

10. Positive outcomes HRC seen as a support for staff, not a threat
High attendance of service users
Staff often come to HRC with solutions or issues resolved before meeting
Annual report to Services Management Team
Cultural change in organisation (e.g. cameras, skills building, use of technological aids)
HRC visiting places where people live
Impact on organisational decisions (e.g. when and where to move people)
Reduction in levels of restrictions for significant number
Comprehensive Human Rights database accessible to managers and relevant staff
e.g. HRC provide support to psychiatrist re issue of covert medication and generally in her work.

11. Learning Composition of Committee – recruit a parent representative
Reflective Practice
Commitment of Committee members
Clear leadership and Support of Director of Services and Managers
Definition and understanding of what is a rights restriction
Understanding the purpose of the HRC – not to resolve internal disputes which are not related to rights restrictions
Supporting documentation with referral (risk assessments and protocols, behavior support plans)
Process is viewed positively by HIQA

12. Challenges Lack of clarity on legal positions e.g. re capacity
Increase in the number of referrals and waiting times
Participation of family in HRC meetings
Resource issues and timeframes related to rights restrictions (housing, staff shortages)
Balancing rights (e.g. right to health v. right to make decisions, rights of service users v. staff/families, risk v. safety)
Refer back to internal disputes issue in balancing rights – need to hear opinions of wider group involved, not just views of one or two staff. Challenge: because we are welcoming referrals from as wide a range of people as possible.

13. Future issues Scheduling presentations and reviews in a timely manner
Sharing the learning (within and outside organisation)
Regular awareness raising with staff
Reviewing and follow up on recommendations, requests for further information
Children’s sector – East and West? Adult sector? Issues for Database records.
Staff have made the HRC work. Have been comfortable in making referrals.