Inspection reports

MHC statement on publication of inspection reports for 15 approved mental health centres

The Mental Health Commission (MHC) has published 15 inspection reports for approved inpatient mental health centres across Cork, Dublin, Galway, Kildare, Limerick, Louth, Mayo, Monaghan, Sligo and Westmeath.

The centres inspected were:

  • St Michael’s Unit, Mercy University Hospital, Co. Cork, which received 91% compliance with the rules, regulations and codes of practice.  
  • Child Adolescent Mental Health In-Patient Unit, Merlin Park University Hospital, Co. Galway, which received 85% compliance with the rules, regulations and codes of practice.
  • Lakeview Unit, Naas General Hospital, Co. Kildare, which received 82% compliance with the rules, regulations and codes of practice.
  • Jonathan Swift Clinic, St James’s Hospital, Dublin 8, which received 81% compliance with the rules, regulations and codes of practice.  
  • Eist Linn Child and Adolescent In-Patient Unit, Co. Cork, which received 81% compliance with the rules, regulations and codes of practice.  
  • Acute Psychiatric Unit 5B, University Hospital Limerick, Co. Limerick, which received 80% compliance with the rules, regulations and codes of practice.
  • Acute Mental Health Unit, Mayo University Hospital, Co. Mayo, which received 78% compliance with the rules, regulations and codes of practice.
  • The Brandon Unit, Portrane, Co. Dublin, which received 78% compliance with the rules, regulations and codes of practice.
  • Admission Unit & St Edna’s Unit, St Loman’s Hospital, Co. Westmeath, which received 76% compliance with the rules, regulations and codes of practice.
  • Blackwater House, Co. Monaghan, which received 75% compliance with the rules, regulations and codes of practice.
  • Units 2,3,4 and Unit 8 (Floor 2), St Stephen’s Hospital, Co. Cork, which received 74% compliance with the rules, regulations and codes of practice.
  • Drogheda Department of Psychiatry, Co. Louth, which received 71% compliance with the rules, regulations and codes of practice.
  • The Central Mental Hospital, Portrane, Co. Dublin, which received 69% compliance with the rules, regulations and codes of practice.
  • Acute Mental Health Unit, Sligo University Hospital, which received 67% compliance with the rules, regulations and codes of practice.
  • Acute Psychiatric Unit, Tallaght Hospital, Dublin 24, which received 63% compliance with the rules, regulations and codes of practice.               

The inspector found varying levels of compliance with the rules, regulations and codes of practice. One centre was between 90-100% compliant; five centres were between 80-90% compliant; a further six centres were between 70-80% compliant, while three centres were between 60-70% compliant. 

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

  • A collaborative music composition project was undertaken in St Michael’s Unit, Mercy University Hospital over a seven-week period, where residents worked together with a professional musician to compose and record an original song reflecting their experiences and recovery journeys. The project provided a creative outlet for self-expression and collaboration, with copies of the completed song made available to all participants.

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

  • Eight critical-risk non-compliances with the Regulation on Individual Care Plan; Therapeutic Services and Programmes; Privacy; Premises; Staffing; Maintenance of Records; Risk Management Procedures; and Rules Governing the Use of Seclusion; and five high-risk non-compliances with the Regulation on Visits; Ordering, Prescribing, Storing and Administration of Medicines; Register of Residents; Codes of Practice on Physical Restraint; and Codes of Practice on Admission, Transfer and Discharge, at Acute Psychiatric Unit, Tallaght Hospital.  
  • Three critical-risk non-compliances with the Regulation on General Health; Rules Governing Use of Electroconvulsive Therapy; and Code of Practice on the Use of Electroconvulsive Therapy; and five high-risk non-compliance with the Regulation on Individual Care Plan; Therapeutic Services and Programmes; Staffing; Risk Management Procedures; and the Rules Governing the Use of Seclusion at Adult Mental Health Unit, Sligo University Hospital.
  • One critical-risk non-compliance with the Rule on the Use of Seclusion; and eight high-risk non-compliances with the Regulations on Individual Care Plan; Therapeutic Services and Programmes; General Health; Staffing; Maintenance of Records; Risk Management Procedures; with the Rule on the Use of Mechanical Restraint; and with the Code of Practice on the Use of Physical Restraint at the Central Mental Hospital.
  • Seven high-risk non-compliances with the Regulation on Privacy; Premises; Staffing; Risk Management Procedures; Rules Governing the Approved Centres Use of Seclusion; Part 4 of the Mental Health Act 2001 Consent to Treatment; and Code of Practice on the Use of Physical Restraint at Drogheda Department of Psychiatry.
  • One critical-risk non-compliance with the Regulation on Residents’ Personal Property and Possessions; and four high-risk non-compliances with the Regulation on Individual Care Plan; Privacy; Premises; and Staffing at Units 2,3,4 and Unit 8 (Floor 2), St Stephen’s Hospital.
  • Six high-risk non-compliances with the Regulation on General Health; Premises; Staffing; Risk Management Procedures; Rule on the Use of Mechanical Restraint; and Code of Practice on Admission, Transfer and Discharge at Blackwater House.
  • One critical-risk non-compliance with the Regulation on Risk Management Procedures; and two high-risk non-compliances with the Regulation on Ordering, Prescribing, Storing and Administration of Medicines; and Staffing at Admission Unit & St Edna’s Unit, St Loman’s Hospital.
  • One critical-risk non-compliance with the Rules Governing the Use of Electro-Convulsive Therapy; and five high-risk non-compliances with the Regulation on Individual Care Plan; Privacy; Premises; Risk Management Procedures; and the Rules Governing the Use of Seclusion at Adult Mental Health Unit, Mayo University Hospital.
  • One critical high-risk non-compliance on the Rules Governing the Use of Seclusion; and three high-risk on the Regulations on Privacy; and on Risk Management Procedures; and on the Code of Practice on the Use of Physical Restraint at the Brandon Unit.
  • Six high-risk non-compliances with the Regulation on Food Safety; Residents Property; Premises; Staffing; Risk Management Procedures; and Part 4 of the Mental Health Act 2001: Consent to Treatment at Acute Psychiatric Unit 5B, University Hospital Limerick.
  • Two high-risk non-compliances with the Regulation on Ordering, Prescribing, Storing and Administration of Medicines; and the Code of Practice on the Use of Physical Restraint at Eist Linn Child and Adolescent In-Patient Unit.
  • Five high-risk non-compliances with the Regulation on Privacy; Premises; Register of Residents; the Code of Practice on the Use of Physical Restraint; and the Code of Practice on Admission, Transfer and Discharge at Jonathan Swift Care, St James’s Hospital.
  • Four high-risk non-compliances with the Regulation on Privacy; Premises; Risk Management Procedures; and the Code of Practice on Admission, Transfer and Discharge at Lakeview Unit, Naas General Hospital.
  • Three high-risk non-compliances with the Regulation on Individual Care Plan; Ordering, Prescribing, Storing and Administration of Medicines; and the Rules on the Use of Seclusion at Child and Adolescent Mental Health In-Patient Unit, Merlin Park University Hospital.
  • One critical-risk non-compliance with the Regulation on Premises; and two high-risk non-compliances with the Regulation on Risk Management Procedures; and the Code of Practice on Admission, Transfer and Discharge at St Michael’s Unit, Mercy University Hospital. 

The MHC requires corrective and preventive actions 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 at 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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