Over 90% compliance with regulations for mental health centres in Dublin17 January 2023
The Mental Health Commission has this morning published inspection reports for four approved centres in Dublin 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 regulations on premises and on ordering, prescribing, storing and administration of medicines. In relation to the prescription and administration of medicines, one centre did not have appropriate and suitable practices including the recording of the minimum dose interval information. Where medication had been stopped, no stop date had been recorded. In 4 out of 10 files where medication had been prescribed, the files did not record the prescriber’s signature.
The Inspector of Mental Health Services, Dr Susan Finnerty, said it was positive to see approved centres maintaining high compliance rating, but spoke of concerns around the administration of medication.
“We know that medication is an important tool in treatment of mental illness. In order to reduce the risk of medication errors, we need to be sure that medication prescription and administration records are completed correctly.”
Mental Health Commission Chief Executive John Farrelly referred to the positive trend of high compliance ratings in the approved centres in Dublin.
“High overall compliance rates are testament to the work and dedication of approved centres to delivering high standards and quality care to some of society’s most seriously ill. The work of approved centres in the nation’s capital provides an example for centres across the country and indicates what can be achieved.”
Lois Bridges is an independent therapeutic service specialising in eating disorders treatment located in Sutton North Dublin. The centre has seven registered beds in single bedroom accommodation, in a two-storey building. At the time of the inspection at the approved centre, there were 4 residents present.
There were two conditions attached to the registration of the centre at the time of inspection. The two conditions related to the regulations on admissions requiring the centre to continue to implement and review its protocols and procedures for the admission of residents, including detailed exclusion criteria and to ensure access to necessary services and specialists, including but not limited to, a gastroenterologist.
Overall, compliance increased from 86% in 2021 to 97% in 2022. The centre was not in breach of any condition but was non-compliant with one regulation: ordering, prescribing, storing and administration of medicines, receiving a high-risk rating.
O’Casey Rooms is under the governance and management of North Dublin Mental Health Services (NDMHS), located on the first floor of a community nursing unit at the rear of St. Vincent’s Hospital in Fairview. Most of the residents had been in residential mental health services for many years. The residents care and treatment requirements were significantly focused on physical, palliative and end of life care.
The approved centre has 21 registered beds, however, at the time of inspection, due to the onset of COVID-19 precautions, the service had actively reduced bed capacity to 18 beds to allow for single bedroom occupancy. At the time of the inspection there were 14 residents, 13 of which had been at the centre for longer than six months.
There were three conditions attached to the registration of this approved centre at the time of inspection, relating to the centre developing a costed and time-bound plan to close the O'Casey Rooms, implementing a programme of maintenance to ensure the premises is safe and meet the needs of the resident group and staffing.
Overall, compliance remained at the same 91% from 2021. The centre was not in breach of any conditions but was non-compliant with three regulations: receiving a high non-compliance rating for premises and two moderate non-compliance ratings for food safety and risk management procedures.
In relation to the high non-compliance with the regulation of premises, residents did not have access to suitable outdoor space, fire doors were left opened using items such as a laundry basket, air inlets to the kitchen and activity room were dirty. It was also identified during the inspection that ligature points were not minimised to the lowest practicable level.
Highfield Hospital is co-located with the Alzheimer’s Care Centre (ACC) amid expansive grounds on the Swords Road in Dublin providing specialist rehabilitation, acute mental health care, and mental health care for older persons across its three distinct mental health entities within its purpose-built facility.
The specialist rehabilitation service comprised of two units, Tuke and Farnham. Tuke is a twelve bedded unit, and Farnham a ten bedded unit. Hamptead Clinic is an acute mental health inpatient unit operating with seventeen beds. Four further beds under construction and not in use at the time of inspection. The mental health care for older persons comprised of three units: Steele (female), Pinel (male) and Domville (mixed).
The approved centre has 102 registered beds, and there were 88 residents present at the time of the inspection with 56 of those in residence for more than 6 months.
Overall, compliance fell from 100% in 2021 to 97% in 2022.
The Phoenix Care Centre is a purpose-built facility located in Grangegorman adjacent to the Technical University Dublin. The approved centre has four wards located over three levels, with two psychiatric intensive care wards. The centre has 54 registered beds, and at the time of the inspection there were 36 residents present with 4 residents in residence for more than 6 months.
Overall, compliance remained at 91% since 2021. The approved centre was non-compliant with three regulations: receiving a high-risk rating in relation to ordering, prescribing, storing and administration of medicines, and two low risk ratings relating to searches and staffing.
In relation to the high-risk rating on the administration of medicines, the files inspected were missing vital information that is required in the regulation.
Lois Bridges Inspection Report 2022
Highfield Hospital Inspection Report 2022
O’Casey Rooms, Fairview Community Unit Inspection Report 2022