Three Mental Health Centres achieve 97% Compliance7 October 2022
The Mental Health Commission (MHC) has this morning published inspection reports on two inpatient mental health centres located in Mayo and one in Wexford, with all three receiving a 97% overall compliance rate.
The MHC was required to initiate formal enforcement steps in relation to one approved centre that received a critical non-compliance for the regulation on premises and was in breach of the related condition. There was a documented need for purpose-built accommodation, in an alternative location, to accommodate the needs of a resident and no progress had been made in providing this. While the approved centre took urgent steps to bring the service back into compliance, the MHC views any breach of a condition of registration, which has been applied in accordance with the Mental Health Acts 2001 – 2018, in the most serious of terms. The MHC will initiate appropriate enforcement steps in any case where a breach of a condition is detected.
Mr. Gary Kiernan, Director of Regulation said that it is incumbent on service providers to ensure that they have robust systems and assurance mechanisms in place to maintain full compliance with conditions which have been applied to their registration.
“Conditions of registration prescribe how certain aspects of the service must operate” he said “and are applied in situations where the MHC has specific concerns about the capacity of the service to maintain high levels of compliance with regulations.”
The Inspector of Mental Health Services, Dr Susan Finnerty, said it is discouraging to find an approved centre critically failing in one area when it was performing so well in many others.
“The centre is compliant with 32 other regulations, rules and codes of practice giving it a high compliance rating yet has failed to progress its own plans to provide appropriate accommodation for the residents,” she said. “We took immediate action in response to this critical risk and our enforcement action has resulted in the application of revised conditions of registration which we continue to monitor.”
Teach Aisling is located on its own grounds in Castlebar, Co. Mayo. Overall compliance at Teach Aisling remained at 97%, as it has done for the past three years. The centre is an eight-bed dedicated purpose-built, single storey building with single bedroom accommodation. It continues to develop as a specialised rehabilitation unit and the staffing and therapeutic programmes reflect this. At the time of the inspection, there were seven people residing at the centre. Two of the residents were actively preparing for independent community living, while four more were on a graduated rehabilitation programme towards independent living.
There was one condition attached to the registration of the centre at the time of inspection, which related to premises. The centre was both in breach of the condition and non-compliant with the associated regulation.
The non-compliance regarding premises was rated as a critical risk and was due to the unavailability of the central living room and corridor for residents. This area was predominately occupied by one resident which had therapeutic implications for all other residents. The premises was identified as unsuitable for one resident who required purpose-built accommodation on another site. Despite ongoing commitments by the area management team since 2017 to remedy this situation, this has not happened. There was no clear indication as to who was accountable for the decision not to proceed. No costed, funded, time-bound plan for the completion of the purpose-built accommodation had been provided to the MHC.
In response to the critical risk and breach of condition, the MHC initiated a range of formal enforcement steps which included a regulatory compliance meeting with senior representatives from the HSE. As a result of the enforcement process the MHC successfully applied further restrictions to the approved centre’s registration certificate. One new condition was applied which requires the service provider to plan and carry out specific premises works. An existing condition of registration was also amended which made the service provider more accountable for the overall maintenance of the premises. These new condition requirements place additional compliance responsibilities on the service provider. The MHC continues to closely monitor compliance in this area.
Selskar House is located in Wexford town. It is a modern, purpose-built facility which is situated on the ground floor of the Farnogue Residential Healthcare Unit and is shared with a nursing home on the upper floor. The centre accommodates 20 residents in single rooms, all of which are ensuite. Residents are all under the care of the psychiatry of later life team. At the time of the inspection, 18 of the residents were in the centre for more than six months.
Selskar House achieved 97% compliance with regulations, a slight decrease from 100% compliance in 2021.
There were no conditions attached to the registration at the time of inspection and no escalation or enforcement actions.
The centre received a moderate non-compliance relating to the regulation on premises as the inspection found the large internal courtyard onto which some of the bedrooms opened was out of commission. A wooden panel had fallen off in the main courtyard in May 2021 and scaffolding was put up. A decision was then made to close off the main courtyard as there was a risk of more panels coming loose and falling off - presenting a hazard to residents or staff using the courtyard. This constrained resident free movement to the outdoors.
An Coillín is a 22-bed single-storey building located beside Mayo University Hospital. At the time of the inspection, the approved centre accommodated 19 residents, 18 of which were resident for more than six months. Residents were accommodated in a combination of single ensuite bedrooms and shared dormitories.
An Coillín achieved 97% compliance with regulations, the same compliance rate achieved in 2021.There were no conditions attached to the registration at the time of inspection and no escalation or enforcement actions.
The centre received a moderate non-compliance relating to the regulation on premises as the inspection found that the centre was not kept in a good state of repair internally. The flooring in two bathrooms was worn and stained. Areas such as the wall leading to the garden needed plastering and painting. A contract to paint the centre by external contractors was agreed in 2020 but due to COVID-19 and the associated infection control measures this work could not be completed as planned. Painting of the approved centre was ready to commence at the time of this inspection.
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