Mental Health Commission welcomes increase in overall compliance with regulations in in-patient centres1 February 2023
The Mental Health Commission has this morning published inspection reports for three approved centres in Waterford, Galway and Cork which have identified three high-risk, two moderate-risk and three low-risk ratings for non-compliance on legal regulations.
The high risks identified related to the regulation on the ordering, prescribing, storing and administration of medicines, the code of practice relating to admission of children, and the rules governing the use of mechanical means of bodily restraint.
In relation to the code of practice on the admission of children, there had been 10 admissions of children in one approved centre since the previous inspection. The inspection found that age-appropriate facilities were not provided. In relation to the rules on mechanical restraint, the inspection found that in two mechanical restraint episodes inspected the restraint was not ordered by a registered medical practitioner under the supervision of a consultant psychiatrist or by the duty consultant psychiatrist acting on his or her behalf.
The Inspector of Mental Health Services, Dr Susan Finnerty, said the MHC closely monitors the admission of children and young people under the age of 18 to adult inpatient mental health services.
“Children and young people should not be admitted to adult units, but when they are, there is a specific Code of Practice for any approved centre. While the centre in question had provisions in place to ensure the safety of the children, an adult setting is not an appropriate to deal with seriously ill children.”
The Chief Executive of the Mental Health Commission, Mr John Farrelly, referred to the positive trend of increasing compliance ratings in all three approved centres.
“There was a significant increase in compliance in all three centres ranging from a 3% increase in Galway, a 7% increase in Cork and an 8% increase in Waterford. The increase in overall compliance is positive evidence that regulation works in increasing standards in approved centres and quality of care for patients.”
The Department of Psychiatry Waterford University Hospital is located on the lower ground floor of the University Hospital Waterford. It comprises 44 beds in two areas, consisting of an acute unit with 14 beds (Brandon Unit) and a sub-acute unit with 30 beds (Comeragh Unit). At the time of inspection, there was a national capital plan to replace the building with a new 60-bed unit. The design team were to begin work shortly after the inspection.
There was one condition attached to the registration of the centre at the time of inspection relating to the regulation on staffing. The centre was required to develop and implement a plan to ensure all healthcare professionals in the centre were up to date in mandatory training areas. The centre was not in breach of the condition and was compliant with the regulation.
Overall, compliance increased from 86% in 2021 to 94% in 2022. The centre was non-compliant with the code of practice relating to admission of children and received a high-risk rating.
The Adult Acute Mental Health Unit, University Hospital Galway is a 50-bed unit located on the grounds of University Hospital Galway. It consists of four separate suites: Hazel, Ash, Holly, and Oak. Internally, the premises was found to be bright, clean, and generally well maintained. Works to install suitable ensuite doors in all bedrooms had started. Planned external work in place since the last inspection in 2021 to include the heightening of an external garden wall in the Oak suite had not yet begun. It was reported by staff during the inspection that they were waiting for a contractor to begin work in the coming months.
Overall, compliance increased from 83% in 2021 to 86% in 2022. There were no conditions attached to the registration of the centre at the time of inspection. The centre was non-compliant with five regulations. It received a high-risk non-compliance rating for the ordering, prescribing, storing and administration of medicines; two moderate-risk non-compliances for the regulations related to searches and clothing; and two low-risk non-compliances for the regulation on premises and the code of practice on the use of physical restraint.
Cois Dalua is a 16-bed privately operated approved centre run by Nua Healthcare. It is located in Meelin, approximately eight kilometres from Newmarket, Co. Cork. The centre provides continuing care and rehabilitation. In addition to 10 single ensuite bedrooms, it had six self-contained apartments. Twelve residents lived in the approved centre for more than six months.
Overall, compliance increased from 90% in 2021 to 97% in 2022. There were no conditions attached to the registration of the centre at the time of inspection. The centre received a high-risk non-compliance for the rules governing the use of mechanical means of bodily restraint.
Link to reports
Department of Psychiatry Waterford University Hospital Report 2022
Adult Acute Mental Health Unit, University Hospital Galway Report 2022