Inspection reports find fourteen high risk ratings in two out of three mental health centres

On Tuesday 17th December 2019, The Mental Health Commission published three inspection reports from approved centres in Sligo/Leitrim, Dublin and Kilkenny which identified fourteen areas of high risk non-compliance in two of the three centres.    

The three approved centres involved are as follows; 

Sligo / Leitrim Mental Health In-patient Unit: a 32-bed acute adult mental health admission unit. Compliance with regulations has decreased significantly from 79% in 2018 to 66 % in 2019 and there has been no overall improvement in three years. This 2019 inspection showed seven high risk ratings in the areas of premises staffing, general health, privacy, maintenance of records, risk management and physical restraint. Seven compliances with regulations were rated excellent. 

Elm Mount Unit, St. Vincent's University Hospital Dublin 4: a 39-bed unit run in partnership between the HSE and the St. Vincent’s Healthcare Group. It is divided into three areas: an acute admission unit; a sub-acute admission unit; and a specialist psychiatry of old age unit. Over the past three years there has been some improvement in compliance with regulations however has been non-compliant with individual care planning and the code of practice on physical restraint for four consecutive years. In addition,  other high risk non compliances were privacy, premises, staffing, risk management and administration of medicines. Eight compliances with regulations were rated excellent.  

St Gabriel's Ward, St Canice's Hospital, Co Kilkenny: a 20-bed facility with residents aged from late 50s to late 80s. There was a very significant improvement in the compliance with regulations. In 2017 and 2018, compliance was 59% and 58% respectively. In this inspection in 2019, compliance had risen to 88% and there were 13 compliances with regulations rated as excellent; there were two excellent ratings in 2018.  

All three approved centres introduced quality initiatives which were identified on inspection reports. Sligo / Leitrim Mental Health In-patient Unit recently started ‘This is my Care Plan Group’ which informs residents of the care plan. Elm Mount Unit in St. Vincent's University Hospital had developed checklists to improve processes for physical restraint and searches while St Gabriel's Ward in Kilkenny had put a compliance officer in place which had assisted in the compliance improvements.  

Commenting on the reports, Dr Susan Finnerty, Inspector of Mental Health Services, said: “It is disappointing to see compliance in an approved centre dis-improve year on year and areas remaining consistently non-compliant over three years, despite the Commissions guidance documents and judgement framework. This is in direct contrast to the very significant improvement in the compliance with regulations in St Gabriel's Ward in Kilkenny with a thirty percent increase since last year.”  

“Overcrowding in approved centres reduces the dignity and welfare of patients and is something that is unacceptable” said Chief Executive of the Mental Health Commission, John Farrelly. “Overcrowding, continued Mr Farrelly, “in the female unit in Sligo/Leitrim and an increase in the number of people admitted with advanced stage dementia to Elm Mount due to the closure of a service in the Dublin region, is poor strategic planning for the mental health service and people deserve better.”  

Our statement in full can be found here.