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	The standards of care in some residential centres for people with a disability inspected in recent months are &quot;disturbing and chilling&quot;, the head of the health watchdog has warned.</p>
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	Phelim Quinn, chief executive of the Health Information and Quality Authority (HIQA) said some of the inspections uncovered poor care standards that should have been long been consigned to the past.</p>
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	Among the examples of poor practice found by inspectors were dangerous physical restraints, inattention to hydration and nutrition, extended periods without fresh air and restricted movement.</p>
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	The problems did not just exist in one or two centres but in a significant cluster of centres, mainly due to long-established congregated settings.</p>
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	He said: &quot;In a number of these instances, it appears that senior managers within provider organisations - 18 months after the commencement of regulation - appear not to be aware of the circumstances and cultures existing within their organisations.</p>
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	&quot;In a significant number of the circumstances that I have outlined, staff have practised and interacted with residents in these ways even in the presence of inspectors.</p>
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	&quot;This is indicative of a culture so engrained that some staff appear not to be able to distinguish between what is an acceptable and unacceptable standard of care.&quot;</p>
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	Speaking at the National Disability Summit in Dublin he told the gathering all of these issues have been seen in inspections carried out by HIQA since awareness arose of the circumstances in &Aacute;ras Attracta, the HSE-run home in Mayo at the centre of a television expose and now subject to investigation.</p>
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	&quot;How often as senior managers and accountable officers of your organisations do you look at reports on complaints, incidents and the outcomes of investigations and inspections to see how the findings and learning has been applied to improve your services at local level and in the instances of larger providers at national level?&quot; he asked.</p>
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	In some of the instances, he said it was evident senior managers of some of the services inspected had not &quot;had a presence in some of the centres&quot;.</p>
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	&quot;How often have you as service providers undertaken a leadership walk-around in your services - how aware are you of the leadership, culture and practices that exist,&quot; he asked those in the audience.</p>
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	<a href="http://www.independent.ie/irish-news/health/standards-in-some-care-homes-are-still-chilling-hiqa-chief-31130999.html">http://www.independent.ie/irish-news/health/standards-in-some-care-homes-are-still-chilling-hiqa-chief-31130999.html</a></p>
