Breach of condition on staffing at Sligo mental health centre28 February 2023
The Mental Health Commission (MHC) has this morning published inspection reports for approved inpatient mental health centres in Laois, Dublin, Sligo, Limerick and Monaghan.
One centre in Sligo was in breach of a condition relating to staffing, whereby the MHC had requested that the centre develop and implement a plan to ensure all healthcare professionals working there are up-to-date in mandatory training areas.
The MHC has the power to attach conditions to an approved centre’s registration. The most common reason to attach conditions is continued non-compliance with a regulation or a statutory rule. It is an offence to breach a condition of registration.
“As we have stated many times before, an appropriate skill-mix of staff who have completed all the mandatory training courses in areas such as basic life support, fire safety and management of aggression and violence, is essential for the successful running of an mental health centre to support resident needs,” said the Inspector of Mental Health Services, Dr Susan Finnerty.
Three of the centres - in Limerick, Dublin and Monaghan - each received a critical risk non-compliance with the regulation on premises, with another centre in Laois receiving a high-risk non-compliance for the same regulation.
“Unfortunately, until we see a targeted and proactive approach to maintaining and improving the physical environment, we will continue to find critical and high non-compliances with the regulation on premises,” said the Chief Executive of the Mental Health Commission, John Farrelly. “The current approach to structural improvements in a high number of our public mental health centres is inadequate. We must continue to strive to ensure that every person in the State has equal access to a consistent quality of care across all centres. As the regulator, we will continue to play our part by pointing out inadequacies with this and other regulations where they exist.
The Adult Mental Health Unit at Sligo University Hospital is purpose-built acute mental health unit on the grounds of the hospital that opened in October 2020. The unit serves Sligo, Leitrim, west Cavan and south Donegal.
There was one condition attached to the centre relating to staffing (Regulation 26). The centre was in breach of this condition at the time of inspection and was issued with a warning letter by the MHC notifying them of this breach. The registered proprietor took immediate action in response to the letter and implemented an action plan to ensure compliance with the condition. The MHC continues to monitor these corrective steps.
There was an overall increase in compliance at the centre from 88% in 2021 to 91% in 2022. There were three moderate non-compliances with regulations and rules at the centre.
The Acute Psychiatric Unit 5B at Limerick University Hospital provides inpatient mental health services for the Limerick catchment area and it is registered to provide acute adult mental health care, mental health rehabilitation, psychiatry of later life, and mental health care for people with intellectual disability. There had been plans to renovate the seclusion room and the surrounding area in order to create a low stimulus environment, but no such work had been accomplished.
There were three conditions attached to the centre relating to individual care plans, staffing and premises, and the centre was not in breach of any of these conditions at the time of inspection.
However, there was a significant decrease in compliance from 85% in 2021 to 69% in 2022. The centre had 11 non-compliances, with three of these rated as critical. These critical non-compliances related to individual care plans, therapeutic services and programmes, and premises. As a result of the critical non-compliances, the MHC commenced escalation and enforcement actions following the inspection and requested immediate actions to be taken and that a regulatory compliance meeting take place. Following that meeting, a quality improvement plan has been received from the centre by the MHC and monitoring is ongoing.
The Department of Psychiatry at the Midlands Regional Hospital is located on the campus of the hospital in Portlaoise town. It was not purpose-built and has been operational as a mental health facility since 2004. The approved centre serves the population of both Laois and Offaly and provides 10 acute mental health beds for Kildare Mental Health Service.
There were four conditions attached to the centre at time of inspection – three of which related to premises - and the centre was not in breach of any of the conditions at the time of the inspection.
Overall compliance increased from 78% in 2021 to 86% in 2022 and there was evidence of progress to address some ongoing issues. The centre received five non-compliances overall, with four high-risk non-compliances with regulations relating to premises, staffing, individual care plans, and with rules governing the use of seclusion.
The Acute Psychiatric Unit at Tallaght University Hospital is located on the ground floor of the hospital. It consisted of three units: Cedar (female admissions), Rowan (male admissions) and Aspen (high observations), which accommodated 52 residents at full capacity. Residents are under the care of 13 different multi-disciplinary teams, through an in-reach model of care.
There were two conditions attached to the centre and the centre was not in breach of either of these conditions at the time of the inspection.
Overall compliance decreased from 83% in 2021 to 77% in 2022. The centre received eight non-compliances with rules and regulations and codes of practice overall, including one critical non-compliance relating to premises; and three high-risk non-compliances relating to the regulation on medication, the rules governing the use of seclusion, and Part 4 of the Mental Health Act 2001 – consent to treatment.
Blackwater House is a single-storey 16-bed building located on the campus of St Davnet’s Hospital in Rooskey in County Monaghan. It opened in 2020 and provides mental health rehabilitation, psychiatry of later life, and continuing/long stay mental health care.
There was one condition attached to the registration of the centre at the time of inspection relating to staffing and the centre was not in breach of the condition at the time of inspection. Overall compliance decreased from 87% in 2021 to 84% in 2022.
The centre received five non-compliances with rules, regulations and codes of practice overall, including one critical non-compliance relating to premises; and three high-risk non-compliances relating to the regulation on privacy, risk management procedures, and the code of practice on the use of physical restraint.
Adult Mental Health Unit at Sligo University Hospital Report 2022
The Acute Psychiatric Unit 5B at Limerick University Hospital Report 2022
The Department of Psychiatry at the Midlands Regional Hospital Report 2022
The Acute Psychiatric Unit at Tallaght University Hospital Report 2022