Mental Health Commission finds high overall compliance across four centres
We have this morning published inspection reports on four of the country’s inpatient mental health centres and found high overall compliances across all four units.
However, the MHC is disappointed that issues around the presence of ligature anchor points and unclean and dirty rooms were apparent in two of the centres; matters that are not conducive to ensuring the protection and rehabilitation of residents.
The Inspector of Mental Health Services, Dr Susan Finnerty, said that the MHC are very concerned about the risks that ligature anchor points pose. “Two of the centres were marked down on the regulation with regard to premises partly because several high-risk ligature anchor points remained and were not minimised to the lowest practicable level. The presence of ligature points is something that services should always be cognisant of, and we would like to see more evidence that these are being urgently addressed.”
The Chief Executive of the Mental Health Commission, John Farrelly, said that it was positive to note the high compliances across all four centres, with all four units receiving ratings of 90% and above and two centres achieving 97%. However, he said that a lack of cleanliness is unacceptable at any time and can be viewed as disrespectful by residents and their loved ones.
“There is never an excuse for unclean rooms where people who are unwell are trying to recover from their illness,” he said. “Dirt and graffiti might seem like minor issues to many of us in the context of our wider mental health services, but for residents and patients using our services they could easily be viewed in a very negative and discouraging light.”
Cois Dalua is a 16-bed privately operated approved centre run by Nua Healthcare. It is located in Meelin, a small rural village approximately eight kilometres from Newmarket, Co. Cork. Accommodation consists of 10 single en suite bedrooms and six self-contained apartments.
The centre received an overall compliance rate of 90% which was down four per cent from the compliance rating in 2020. There were no conditions attached to the centre at the time of inspection.
The centre received three non-compliances on inspection, comprising one high-risk, one moderate and one low-risk rating. The centre received a high-risk non-compliance for the regulation on premises as the inspectors found that the service did not ensure that the physical structure and the overall environment was developed with due regard to the safety of residents as not all ligature points were minimised to the lowest practicable level based on risk assessment. The centre’s ligature audit documented that there were three high risk ligature points in the centre, and these three high risk ligature points had not been minimised at the time of the inspection.
The report noted that there were no escalation or enforcement actions taken by the MHC since the 2020 or 2021 annual inspections.
The Elm Mount Unit is a 39-bed approved centre situated in St. Vincent’s University Hospital, Elm Park, Dublin 4. The unit is a partnership venture between the Health Service Executive (HSE) and St Vincent’s Healthcare Group. The centre provides acute mental health inpatient treatment and care to people living in the Dublin south-east area.
The centre received an overall compliance rate of 97% which was a considerable increase on the 76% compliance rating it received in 2020. Although there were four conditions attached to the centre at the time of inspection - relating to the regulations on individual care plan; premises; the order, prescribing, storing and administration of medicines; and staffing - the centre was not in breach of any of these conditions.
However, the centre was non-compliant with the regulations on premises, for which it received a high-risk rating. Reasons for this rating included a finding that one of the isolation bedrooms was not clean and had a sticky residue on the windowsill, as well as dirty windows and graffiti on the wall. There were also areas in the centre that were not kept in an entirely good state of repair internally, and while a sizeable amount of anti-ligature work had been undertaken in the centre since the previous inspection, a number of high-risk ligature anchor points remained and were not minimised to the lowest practicable level based on a risk assessment.
The report noted that there were no escalation or enforcement actions taken by the MHC since the 2020 or 2021 annual inspections.
St Patrick’s University Hospital is an independent hospital and part of the St. Patrick’s Mental Health Service (SPMHS). The original hospital structure is an 18th century listed building. A variety of extensions had been developed over the years. The centre was registered to accommodate 241 residents.
The centre received an overall compliance rate of 97% which was down three per cent from a 100% compliance rating in 2020. There were no conditions attached to the centre at the time of inspection.
The centre received one non-compliance on inspection relating to Part 4 of the Mental Health Act, which relates to consent to treatment, for which it received a high-risk rating. The centre received this risk rating because in relation to one involuntary patient, the relevant form - which related to the administration of medicine for more than three months for an involuntary patient - did not document the specific names of medications prescribed to the patient.
The report noted that there were no escalation or enforcement actions taken by the MHC since the 2020 or 2021 annual inspections.
The Phoenix Care Centre is a purpose-built facility located at Grangegorman on the North Circular Road. It provides specialist tertiary intensive mental health care and treatment for adult patients with a mental disorder that could not be managed safely in an open adult admission unit.
The centre received an overall compliance rate of 91% which was down six per cent from its rating in 2020. There were no conditions attached to the centre at the time of inspection.
The centre received two moderate and one low risk non-compliance, and it was noted that there were no escalation or enforcement actions taken by the MHC since the 2020 or 2021 annual inspections. There were also a number of quality initiatives noted on inspection which included the residents of one unit creating a therapeutic garden under the guidance of the nursing staff that provided a social outlet, new learning experiences, physical activity, and promoted enthusiasm and self-esteem.
You can read our full statement here.
Cois Dalua Inspection Report 2021
Elm Mount Unit, St Vincent's University Hospital Inspection Report 2021
