Some gains at Sunrise, more to do

(CNS): While there have been some improvements to the health and safety concerns at Cayman’s only facility for disabled adults, many of Complaints Commissioner Dr John Epp’s recommendations, made following an Own Motion Investigation completed in June 2008, including the delivery of programmes to clients, overcrowding, and a long range plan for the facility, have not been met.

After a site visit to the Sunrise Adult Training Centre on Thursday 8 January, the Office of the Complaints Commissioner (OCC) found that in the wake of its report on the Centre, which was tabled in the Legislative Assembly on 6 October, 2008, the Ministry of Education, Training, Employment, Youth, Sports and Culture had implemented some of Epp’s eleven recommendations.

The OCC reported in a press release that there have been significant improvements to the health and safety concerns of the current facility that the Centre occupies in West Bay. These include additional emergency exits from the building, fully fitted out with wheelchair accessible ramps. Fire exits are now clearly identified and paths to exits are easily accessible. One of the bathrooms has been renovated to allow for better access and use by the disabled and wheelchair bound. Improvements to outdoor porches and ramps have proven to be excellent additions for use in ambulatory programs.

The Centre has obtained written permission from the landlord to make any changes required to the facility, both inside and out, in the interest of making the current facility as safe and functional as possible. In addition, the Director of Sunrise confirmed that the Centre now meets the required standards as set out in the Cayman Islands Building Code and that they had received their official Certificate of Occupancy.

“While it is extremely encouraging that the Ministry has taken these steps to improve the facility, we are awaiting compliance with the remaining recommendations which, as stated in the October report, should be implemented as a matter of urgency,” said Dr Epp.
One of the recommendations in the report was for the Ministry to revisit a decision to reject an offer by a corporate donor for a modular classroom, which would provide some immediate relief to the issue of overcrowding. Among the health and safety issues that the report said the Ministry and Sunrise must tackle was to take steps to arrange better access to medical emergency services.
The report also found that when new clients were introduced into the Centre, little if any background information or preparation was given to the staff, which had the potential to cause problems if a client reacted violently to a situation that the staff should have been aware of. The overcrowding also affected instructors’ ability to teach because they were preoccupied with keeping clients safe and might lack the energy to do more than the minimum in the lesson.
The Commissioner further recommended that the Ministry and Sunrise take steps to continue to improve management systems and procedures, and that the delivery of training programmes be regularly monitored by the Ministry until it is satisfied, by an objective standard, that the quality of the programmes is satisfactory.
This reflects the findings that some disabled adults might be capable of independent living by the time they are 25 to 35 years old, which was very important to ageing caregiver parents and to the community as a whole. However, while occupational therapy andjob placement appeared to be areas of strength at Sunrise, the OCC found that clients were not assessed for skill levels and their progress was not assessed regularly, and that clients spent too much time watching television.
Dr Epp recommended that client assessments be completed at regular intervals, and that communication with parents and guardians about clients occur regularly and be documented.
The final recommendation of the report was that the Ministry and Sunrise should provide a plan for the way forward which addressed the shortfalls in the provision of education for disabled adults.
The report noted that, while the need to move to a larger central location was acknowledged by the Ministry, the Chief Officer believed that new construction should not be undertaken until major reforms in the approach to assisting disabled persons were implemented. Plans for the better use of facilities or resources had not been discussed between the Ministry and the Director of the Sunrise Centre by the Spring of 2008, and no plans had been made for making available services for disabled adults who live in the Sister Islands.
“The Ministry’s effort to engage in a comprehensive review is commendable. However, as the Chief Officer has warned, major change – a paradigm shift – takes a significant amount of time to plan. Thereafter a lot of time will elapse between when the implementation of change begins and its completion. This leaves the question of what will be done now and in the intervening years before the major reform is in place.”
The report concludes, “It remains, then, to move forward with improvements in assessing clients needs, settling on appropriate programmes and support services such as case management software, and offering these services in buildings that are safe for both clients and staff.”
Dr Epp said, “The conclusions of the report remain pertinent and there is still an urgent need to act on the remaining recommendations as quickly as possible in order to improve the quality of life of the clients of the Sunrise Centre and their caregivers.”
The OCC is located on the 2nd floor, 202 Piccadilly Centre, Georgetown, Grand Cayman, phone number (345) 943 2220. The website is www.occ.gov.ky.