Efforts to shield mental health patients from COVID-19 clear from inpatient centre inspection reports18 March 2021
Today we published inspection reports on three of the country’s 66 approved inpatient mental health centres. All inspections were announced due to COVID-19 and each centre scored highly on overall compliance with rules, regulations, and codes of practice.
Aside from the high compliance, the reports also noted the efforts made by management and staff to protect their residents from COVID-19, including reconfiguring one building into separate zones to better safeguard especially frail and vulnerable residents.
“It is important to recognise the work that providers put in since March of last year to protect the people they care for, and we have noted some of these instances in the inspection reports that we have published today,” said the Inspector of Mental Health Services, Dr Susan Finnerty.
“In the case of these centres, this included the introduction of protocols such as visitor restrictions, cleaning regimes, the reconfiguring one building to better shield frail and elderly residents, and the allocation of one area of a ward for the purposes of isolation. While we were confident that these types of safety measures were taking place in centres from ongoing conversations that we were having with centres through our COVID-19 monitoring hub, it was reassuring to verify them at inspection.”
The Chief Executive of the Mental Health Commission, John Farrelly, said that the reports clearly demonstrate that mental health services worked swiftly with the MHC to keep as many residents and patients safe from contracting the virus.
“This is very clear when you consider the case of the former Blackwater House unit in Monaghan which was an old 19th century building with dormitory-style accommodation that was entirely unsuitable in the context of the pandemic,” said Mr Farrelly.
“Although the old unit was registered with a condition requiring closure by the end of 2020, the centre was highlighted as a significant risk both by the MHC and the HSE and, as a result, the opening of the new Blackwater House unit - which saw residents accommodated in single, en suite bedrooms - was expedited and residents were transferred to the new unit in late April.”
Blackwater House is a newly built single storey facility located on St. Davnet’s campus approximately two kilometres outside Monaghan town. The new premises provided accommodation for the residents previously accommodated within a 19th century hospital building. The approved centre was registered with the MHC on the 23rd of April 2020 to provide mental health rehabilitation, psychiatry of later life and continuing/long stay mental health care. It is a 16-bedded facility, which contained two spacious bungalows with eight single en suite bedrooms.
The centre achieved 90% compliance on the inspection (its first), with one moderate non-compliant risk rating and two low non-compliant risk rating. There were three conditions attached to the registration of this approved centre at the time of inspection relating to the prohibition of any direct admissions or transfers of residents to the centre; the auditing of individual care plans on a monthly basis; and staff training.
In relation to the care and treatment of residents, the report noted that not all the residents’ assessed needs for occupational therapy were met as this resource was limited. The centre was designated four hours of occupational therapy per week. A business case had recently been submitted for approval for a designated fulltime occupational therapist.
Haywood Lodge is located on the outskirts of Clonmel town, adjacent to South Tipperary General Hospital and St Luke’s Mental Health Services. It opened in 2012 and is a purpose built 40-bed facility that comprised two wards, East and West House.
The centre achieved 100% compliance on its 2020 inspection, with no non-compliances recorded in 33 different areas of inspection. The overall compliance was a 12% increase on its 2019 inspection, and a 32% increase on its 2018 inspection. There were no conditions attached to the registration of the centre at the time of inspection.
Both houses were similar in layout and each had 20 single en suite bedrooms. Both were designed in an octagonal style, each with two internal courtyards and were surrounded by spacious gardens overlooking the Comeragh Mountains. The premises were well maintained and were bright and airy. There was a visitor’s room, an oratory, and activity rooms that were centrally located in the main reception.
Due to the vulnerability of the resident population in the context of COVID-19, it had been necessary, on public health guidance, to introduce and maintain a variety of restrictions to safeguard the health of residents and staff. This included a restriction of visitors to two nominated people, visiting by pre-arrangement, and the introduction of a cleaning regime to sanitise the facility after any visit.
St Gabriel’s Ward is a 20-bed facility located on the grounds of St. Canice’s Hospital in Kilkenny. The ward was reconfigured into ‘Zone A’ and ‘Zone B’ to support a cohorting of the frail and vulnerable residents together in one area in line with COVID-19. One area of the ward was used as an isolation unit if necessary.
The centre achieved 100% compliance on its 2020 inspection, with no non-compliances recorded in 31 different areas of inspection. The overall compliance was a 12% increase on the 2019 inspection, and a 42% increase on the 2018 inspection. There were no conditions attached to the registration of the centre at the time of inspection.
The report noted that the centre had an attractive garden area, which was purpose-built for the resident profile. Residents were observed to use the garden space under the supervision of nursing staff during inspection. Overall, the unit was bright, clean, and free from any malodorous odours with a calm and caring ethos noted.
The report also noted that hazards - including large open spaces, steps and stairs, slippery floors, trip hazards, hard and sharp edges, and hard or rough surfaces - were all minimised in the centre. There was a minimisation of ligature points to the lowest practicable level, based on risk assessment. Each resident had a multi-disciplinary care plan which was developed and reviewed in collaboration with the resident.
You can read our full statement here.