100% compliance in two mental health centres17 February 2023
The Mental Health Commission (MHC) has this morning published inspection reports for three approved centres in Waterford and Dublin which have identified one critical-risk rating, one high-risk rating, two moderate-risk ratings for non-compliance with regulations, and one low-risk rating level of non-compliance with regulations relating to the code of practice on admission, transfer, and discharge.
Two centres in Waterford have retained 100% overall compliance with rules, regulations and codes of practice. It is the second year in-a-row that Grangemore Ward has achieved a 100% compliance rating, while it is the third consecutive year for Aidan’s Residential Healthcare Unit.
The critical risk was identified in a Dublin centre and related to the regulation on staffing. The inspection found the numbers and skill mix of staffing in the centre were not sufficient to meet residents’ needs. Not all staff were registered psychiatric nurses, which meant that the centre did not always have a registered psychiatric nurse on duty.
The Inspector of Mental Health Services, Dr Susan Finnerty, said: “Appropriate staffing is critical in providing care to patients as well as maintaining a safe environment for all those attending an approved centre. The Mental Health Commission continues to engage with the service to monitor compliance with staffing.”
The Chief Executive of the Mental Health Commission, Mr John Farrelly, referred to the positive trend of increasing compliance ratings being retained by approved centres. “Maintaining high levels in overall compliance provides clear evidence that regulation works by ensuring an increase in standards and quality of care for patients.”
Grangemore Ward is located on the grounds of St. Otteran’s Hospital in Waterford City. This approved centre is a large two-storey house comprised of 14 single bedrooms. At the time of the inspection, construction work was being carried out for an extension to one of the downstairs bedrooms. Since the last inspection, an upgrade to the interior had been undertaken in the centre, which included new wardrobes and lockers, as well as decorative work of bedrooms. The residents also have access to two well-maintained gardens.
At the time of inspection, 11 residents were present in the centre. Overall, compliance remained at 100% for the second year in-a-row. The centre had no conditions attached and was compliant with all regulations.
Aidan’s Residential Healthcare Unit is situated in Waterford Residential Care Centre in Waterford City. It provides psychiatry of later life and rehabilitation services. This approved centre is a purpose-built modern facility with 20 registered beds, and at the time of inspection there were 16 residents present, which included 13 residents accommodated for longer than six months.
Overall, compliance at the centre remained at 100% for the third consecutive year. The centre had no conditions attached and was compliant with all regulations.
The National Eating Disorder Recovery Centre is an independent service specialising in the treatment of eating disorders and is located on Merrion Road, Ballsbridge, Dublin. It is a large two-storey semi-detached house that had been renovated and refurbished for the purpose of providing both an inpatient and outpatient facility. The inpatient treatment facility is registered for the care and treatment of adults with an eating disorder.
At the time of the inspection, there were no conditions attached to the registration of the centre. However, the MHC had issued an ‘Immediate Action Notice’ which required the centre to take immediate steps to address non-compliance with the regulation on staffing. The MHC continues to engage with the service to monitor compliance on this matter.
Overall, compliance fell from 100% in 2021 to 83% in 2022. The inspection identified critical risk levels of non-compliance with regulations relating to staff; high levels of risk relating to the administration of medicines; moderate levels of non-compliance with regulations relating to individual care plans and complaints procedures; as well as low levels of non-compliance with regulations relating to the code of practice on admission, transfer, and discharge.
In relation to the critical risk, the numbers and skill mix of staffing in the centre was not sufficient to meet residents’ needs. The inspection found that an appropriately qualified staff member was not always on duty and in charge, as not all nursing staff were registered psychiatric nurses. This was the case particularly on Saturday and Sunday nights, as there was only one nurse on duty during those times. Following the raising of this issue during inspection, the centre adopted a policy of having two staff members (one nurse and health care assistant) on duty on weekend nights.
Link to reports
Aidan's Residential Healthcare Unit Report 2022