Mental health centre found to be breaching dignity of residents6 May 2021
We have reported concerns around the privacy and dignity of residents in one of the country’s inpatient mental health centres, following the publication this morning of announced inspection reports on three units in Clare, Sligo and Roscommon.
“The inspection team found that the presence of security personnel in one centre when they were not required and without due cause was deemed a breach of resident dignity,” said the Inspector of Mental Health Services, Dr Susan Finnerty. “With security personnel walking freely through the centre when they are clearly not required, residents may understandably feel that staff and management believe residents to be a threat to staff and other residents on a continuing and ongoing basis. Having security personnel visible to residents is not acceptable and is an affront to their dignity and privacy.”
The two other inspection reports published today feature centres that recorded 88% and 94% overall compliance, including a new adult mental health centre at Sligo University Hospital, which opened in October of 2020.
“The new centre in Sligo replaced a unit that was housed in a building dating from the 1930s with residents accommodated in a mixture of single and shared accommodation,” said the Chief Executive of the Mental Health Commission, John Farrelly. “In contrast, all the bedrooms in the new, purpose-built centre are single and en suite, and most importantly, all residents are being afforded more privacy, dignity, and respect - all of which are key to recovery.”
The Acute Psychiatric Unit at Ennis General Hospital provides inpatient mental health care to the people of Clare and North Tipperary. It had a total of 39 beds at the time of inspection, with five beds designated to psychiatry of later life.
The centre achieved 64% compliance on the inspection - a decrease of 10% compared to its 2019 inspection - with 12 non-compliances recorded, including two critical and six high risk ratings. There were three conditions attached to the registration of the centre at the time of inspection. It was found not to be in breach of any of the conditions – related to staffing, the maintenance of records, and premises - although it was found to be non-compliant with the associated regulation on premises.
One of the critical risk ratings related to privacy. The inspection team noted that the centre employed security personnel for the purposes of assisting staff in physical restraint, if requested. It was also noted that the security personnel were on site during the inspection and one security person was observed walking the corridors and sitting in a communal area. Staff reported that security staff also waited outside the dining room at mealtimes and this was reported to be standard practice within the centre. The report found that the presence of security personnel when not required and without due cause was a breach of resident dignity.
The other critical risk rating was on the regulation for residents’ personal property and possessions as it was noted during inspection that the centre did not ensure that an accurate record was maintained of one resident’s personal property and possessions. In relation to the resident, stored money, cash transactions and balances were not always accurately recorded on account documents.
The MHC followed up on these areas of critical risk including issuing an immediate action notice in respect of the use of security staff in the approved centre.
The Adult Mental Health Unit in Sligo is a newly built acute centre that was opened in early October 2020. It is located on the grounds of Sligo University Hospital and replaced the previous admission unit in nearby Ballytivnan. The new facility has accommodation for up to 25 residents in single, en suite bedrooms.
The centre achieved 88% compliance on its first inspection, with three moderate risk and one low risk non-compliance recorded. There were two conditions relating to staff training and risk management attached to the registration of the centre. The centre was not found to be in breach of either condition on inspection, and it was compliant with the associated regulations.
Positive aspects identified by the inspection team included observations that ligature points had been minimised to the lowest practicable level; all bedrooms were single en suite rooms; the centre was kept in a good state of repair externally and internally; and it was clean, hygienic, and free from offensive odours.
The Department of Psychiatry at Roscommon University Hospital is not a purpose-built mental health unit, having formerly been a maternity ward. The unit is registered for 22 residents and, at the time of inspection, there were 18 residents present.
The centre achieved 94% compliance overall, an increase of 6% on its 2019 inspection. There were two non-compliances recorded, and there were two conditions attached to the registration of the centre at the time of inspection in relation to staff training and premises. Although it was not possible to record whether the centre was in breach of either condition because of restrictions imposed by the pandemic, the centre was rated as a high-risk non-compliance with the regulation on premises at the time of inspection.
The reasons why the centre was non-compliant on the regulation on premises were as follows: ligature points were not minimised to the lowest practicable levels; all bedrooms were not appropriately sized to address the resident needs; some radiators and valves had sharp edges; and the centre was not kept in a good state of repair internally in some areas.
You can read our full statement here.