By Kathy Chaffin
kchaffin@salisburypost.com
A report based on the state inspection of a Rowan County Group Home reveals behavioral problems jeopardizing residents’ privacy and safety along with discrepancies in documentation.
Three deficiencies were cited at the Liberty Home at 3425 Cauble Road on May 19, according to the report from the Mental Health Licensure and Certification Section of the N.C. Division of Health Service Regulation. Two were recitations of deficiencies found during a Feb. 11 inspection of the group home operated by One Love Developmental Services of Salisbury.
The report did not cite any unsanitary conditions as alleged by former Liberty Home employee Pierre Smith in a story in Wednesday’s Post.
One Love Developmental Services was notified in June 11 letters of the Mental Health Licensure and Certification Section’s intent to revoke the Liberty Home license and suspension of admissions effective immediately. The state also imposed a $1,000 fine against the group home.
Attorneys William R. Forstner and Patricia A. Markus filed a petition July 1 on behalf of One Love for a contested case hearing challenging the state’s decision. Officials at the company’s Klumac Road headquarters had no comment when contacted by the Post about the matter.
One deficiency found in the inspection violates the state requirement that residential treatment staff ensure safety for children or adolescents. The report states, based on record reviews and interviews, that Liberty Home staff failed to do that in an incident April 29, affecting two of three residents.
The first resident involved was a 14-year-old with a conduct disorder diagnosis, while the second was a 12-year-old with diagnoses of oppositional defiant disorder, intermittent explosive disorder and attention deficit hyperactivity disorder.
According to the report, the second resident was in his bedroom jumping from his dresser onto his bed when the first resident entered the bedroom and jumped on top of him on the bed. The first resident weighed 230 pounds, 100 pounds more than the resident he jumped on.
The second resident was injured and taken to the Rowan Regional Medical Center Emergency Department, the report says, where X-rays showed two fractures in his forearm.
The resident was referred to an orthopedic surgeon, underwent surgery on May 6 and wore a cast for six to eight weeks afterward.
In interviews with state officials, the two residents said they were playing and that staff had told them to stop. Staff interviewed as part of the inspection also said they told the two residents to stop, but did not physically intervene.
One staff member stated “there was frequent difficulty with getting clients to go to bed and that clients had run out of their rooms,” the report says.
The plan of correction submitted by One Love Developmental Services states that Liberty Home staff have developed a safety plan to reduce the risk of resident injuries. The safety plan requires staff to accompany residents going into their bedrooms and to stand in the doorways blocking entrance to the rooms while facing the hallway so they can continue to provide supervision of the hallway and other residents.
The plan further states that any resident going into someone else’s bedroom will be physically escorted out “ASAP (if necessary) using therapeutic walk.” That means the staff member would physically lead the resident without causing bodily harm. The resident would also be placed on restrictions for 48 hours.
Record reviews revealed additional incidents between the two residents on May 9 between 3 p.m. and midnight and May 10 between midnight and 8 a.m.
Notes in the residents’ records were identical for both days. On May 9, records state: “Client hit peer. Client disrespected staff. Client said he did not care and can say what he wants. Client continues to stay on the phone and computer.
“Client said he did not care about rules or his goals. Client did not complete chores. Client continued to go in the van. Client did not go to bed and said he can do what he wants.”
On May 10, records for both residents state: “Client was not in his room. Client was outside. Client did not reply to staff’s request. Client said he did not care about danger to himself or others.
“Client continued to use profanity towards staff. Client threatened to hurt staff.”
One Love’s plan of correction calls for residents’ bedtimes to be staggered and for one staff member to monitor the hallway for an hour after residents fall asleep. If for any reason the staff member has to leave the hallway, another staff member must cover.
If staff aren’t in this position, the plan states, termination will occur immediately.
The second deficiency had to do with residents’ plans, which should be developed within 30 days of admission based on assessments and include goals and strategies for implementation.
Record reviews and interviews during the inspection found that Liberty Home staff failed to implement strategies to address behaviors and ensure the safety of two of three residents, the report states.
In its plan of correction, One Love Developmental Services, which operates seven other group homes in seven different counties, agreed to review all residents’ plans with qualified professional staff, focusing on the goals and strategies for implementation. All plans are to be reviewed monthly by group home staff and qualified professional staff for changes in plans.
The third deficiency cited was noncompliance with the Liberty Home’s licensed capacity. The report states the group home exceeded its licensed capacity of three by serving five residents between Jan. 25 and Feb. 11 of this year, thereby affecting the three current and two discharged residents.
In the plan of correction, One Love officials said Liberty Home staff will ensure that a new resident is not admitted until an existing resident is discharged, with the appropriate paperwork completed.
The plan also states that the director will ensure the correct number of beds prior to admission.