Inspection reports

MHC statement on publication of 12 inspection reports for 11 approved mental health centres

Bloomfield Hospital remains subject to enhanced regulatory oversight on foot of focused inspections

The Mental Health Commission (MHC) has published 12 inspection reports for approved inpatient mental health centres across Clare, Limerick, Laois, Waterford, Cavan, Wexford, Monaghan, Mayo, Sligo and Dublin.

The 12 reports include the publication of two focused inspection reports for Bloomfield Hospital in Dublin. The initial unannounced focused inspection at Bloomfield, which occurred across five days during the period December 16, 2025, to January 7, 2026, took place after unsolicited information relating to safeguarding concerns - in addition to concerns on the quality and safety of patient care in the centre - were brought to the attention of the MHC on December 16, 2025. A second unannounced focused inspection took place at Bloomfield on 31 March.

Commenting on Bloomfield, the Chief Executive of the Mental Health Commission, John Farrelly, said: “The centre remains subject to enhanced regulatory supervision by the MHC on foot of the findings of both focused reports, while the Health Service Executive, as the principal funder of the service, continues to provide support and oversight to the centre’s new senior management team. The special measures that we have implemented will remain in place until the Inspector of Mental Health Services is satisfied that the centre is compliant with statutory requirements.”

The centres that were subject to their annual inspection were:

  • Cappahard Lodge in Ennis, Co. Clare, which received 100% compliance with the Rules, Regulations, and Codes of Practice.
  • Tearmann Ward in St. Camillus’ Hospital, Shelbourne Road, Co. Limerick, which received 93% compliance with the Rules, Regulations and Codes of Practice.
  • The Maryborough Centre at St Fintan’s Hospital, Co. Laois, which received 91% compliance with the Rules, Regulations, and Codes of Practice.
  • Grangemore Ward at St. Otteran’s Hospital, Co. Waterford, which received 88% compliance with the Rules, Regulations and Codes of Practice.
  • The Acute Psychiatric Unit at Cavan General Hospital, which received 84% compliance with the Rules, Regulations and Codes of Practice.
  • Selskar House at Farnogue Residential Healthcare Unit, Wexford Town, which received 84% compliance with the Rules, Regulations, and Codes of Practice.
  • The Acute Psychiatric Unit at Tallaght University Hospital, Dublin 24, which received 83% compliance with the Rules, Regulations and Codes of Practice.
  • Blackwater House in Rooskey, Co. Monaghan, which received 83% compliance with the Rules, Regulations, and Codes of Practice.
  • An Coillín in Castlebar, Co. Mayo, which received 79% compliance with the Rules, Regulations and Codes of Practice.
  • The Adult Mental Health Unit at Sligo University Hospital, which received 65% compliance with the Rules, Regulations and Codes of Practice.

The inspector found varying levels of compliance with the Rules, Regulations and Codes of Practice for the 10 centres subject to their annual inspection. Three centres were between 90-100% compliant; five centres were between 80-90% compliant; one centre was between 70-80% compliant; and one centre was between 60-70% compliant.

Some areas of good practice observed over the course of the inspections included:

  • There was a strong commitment to high-quality, person-centred care at Cappahard Lodge through the implementation of a safeguarding review implementation group, which met on a regular basis and discussed potential safeguarding incidents, and provided training and information sessions relating to safeguarding concerns.
  • A new dedicated palliative care suite at Tearmann Ward, which is supported by appropriately trained nursing staff, provides families with greater flexibility to visit and spend meaningful time with loved ones, facilitating close collaboration between family members and staff to ensure that the individual receives personalised and compassionate end-of-life care.
  • The sensory room in the Maryborough Centre continues to be developed, offering a quiet space for anyone who is over stimulated with the sensory items identified as having a positive effect on service users, including those living with Dementia.

The critical and high non-compliances observed during the inspections were:

  • Three critical-risk non-compliances with the Regulations on maintenance of records, staffing and risk management procedures; and one high-risk non-compliance with the Regulation on individual care plan for the four Regulations inspected at the first focused inspection at Bloomfield Hospital
  • One critical-risk non-compliance with the Regulation on risk management procedures, and three high-risk non-compliances with the Regulations on individual care plan, staffing, and maintenance of records for the eight Regulations inspected at the second focused inspection at Bloomfield Hospital
  • One critical-risk non-compliance with the Code of Practice on the use of electro-convulsive therapy for voluntary patients; and seven high-risk non-compliances with the Regulations on food and nutrition; individual care plan; general health; ordering, prescribing, storing and administration of medicines; staffing; risk management procedures; and the Rule on use of seclusion at the Adult Mental Health Unit at Sligo University Hospital
  • One critical-risk non-compliance with the Regulation on premises; and four high-risk non-compliances with the Regulations on therapeutic services and programmes; staffing; risk management procedures; and the Code of Practice on admission transfer and discharge at An Coillín
  • Four high-risk non-compliances with the Regulations on general health; privacy; and risk management procedures; and the Code of Practice on admission, transfer and discharge at Blackwater House
  • Four high-risk non-compliances with the Regulations on general health; ordering, prescribing, storing and administration of medicines; risk management procedures; and the Code of Practice on the use of physical restraint at Selskar House
  • Three high-risk non-compliances with the Regulations on premises; the ordering, prescribing, storing and administration of medicines; and risk management procedures at Grangemore Ward
  • Three high-risk non-compliances with the Regulations on premises; risk management procedures; and the Rule on the use of seclusion at the APU at Tallaght University Hospital
  • Two high-risk non-compliances with the Regulations on therapeutic services and programmes; and general health the Acute Psychiatric Unit at Cavan General Hospital
  • One high-risk non-compliance with the Regulation on therapeutic services and programmes at Tearmann Ward
  • One high risk non-compliance with the Regulation on premises at the Maryborough Centre.

The MHC requires corrective and preventive action plans (CAPAs) from all services where non-compliances are identified, each of which must address each non-compliance specifically. The MHC monitors the implementation of these CAPAs on an ongoing basis and requests further information and action, as necessary. Enforcement action is taken when the MHC is concerned that the care and treatment provided in an approved centre may be a risk to the safety, health, and wellbeing of residents, or where there has been a failure by the provider to address an ongoing area of non-compliance.

All critical risk issues are considered by the MHC’s Regulatory Management Team (RMT) as a matter of course. Enforcement actions commonly arise from inspection findings, quality and safety notifications, and compliance monitoring. Enforcement actions available to the MHC range from the aforementioned CAPAs (at the lower end of enforcement) to removing an approved centre from the register and/or pursuing prosecution (at the higher end).

Links to reports

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