Three mental health units score highly on annual inspections7 April 2021
Today we published announced inspection reports on three of the country’s 66 approved inpatient mental health centres, each of which has scored highly on overall compliance with rules, regulations, and codes of practice.
One unit in Tallaght improved its overall compliance by 42% in the space of 12 months, while the other two centres – based in Killarney and Waterford city – both scored 100% compliance.
“Notwithstanding the very poor condition of the seclusion room in one of the centres, which we never wish to see under any circumstances, overall the three units performed very well on inspection,” said the Inspector of Mental Health Services, Dr Susan Finnerty.
“Although cleanliness and adequate maintenance is the very least we would expect from services, it is, nevertheless, encouraging to note that all three centres were, for the most part, kept in a good state of repair externally and internally, and were clean, hygienic, and free from offensive odours. It is also reassuring to note the effort that services are clearly making to ensure that residents are being offered and provided with an appealing programme of therapeutic and recreational activities to assist with their recovery.”
The Chief Executive of the Mental Health Commission, John Farrelly, paid tribute to the HSE for working with the MHC to expedite the transfer of 20 residents from an old unit to a new facility in Waterford.
“The old unit had a condition attached to its registration by the MHC to move to the new building by June of 2020,” he said. “However, it became clear at the start of the pandemic that infection control measures, if they were required, could not be adequately managed in the old premises.
“We worked with the management of the service to ensure that the residents – all elderly and long-stay - could move to the new unit two months earlier than planned and it is very satisfying to note from the Inspector’s report that the new unit was fully compliant when the inspection took place in November.”
The Acute Psychiatric Unit at Tallaght University Hospital is located on the ground floor of the hospital and consists of three wards which accommodated 52 residents at full capacity and consisted of shared dormitories, with a limited number of single bedrooms
The approved centre used an in-reach model of care, with 12 multi-disciplinary teams. However, due to the risk of COVID-19 a reduced number of multi-disciplinary teams were visiting the centre at the time of inspection. The multi-disciplinary team specialities included general adult, psychiatry of later life, and rehabilitation and recovery.
The centre achieved 97% compliance on the inspection, an increase of 42% over its 2019 inspection. Although there were six conditions attached to the registration of the centre, the centre was not in breach of any at the time of inspection. However, with respect to one condition which stated that the centre shall develop a costed, funded and time-bound plan for works to be carried out to the seclusion facilities, the centre recorded a high non-compliant risk rating relating to the rules on the use of seclusion.
In this respect, the report noted that the seclusion facilities were not furnished, maintained, and cleaned to ensure respect for resident dignity and privacy, as the floor of the seclusion room in one of the wards was marked and the radiator was dirty. Residents in seclusion did not have access to adequate toilet and washing facilities as there was graffiti on the bathroom door of the seclusion rooms. Not all furniture and fittings were of a design and quality so as not to endanger patient safety; and hard edges were observed around the windows in both seclusion rooms.
Apart from the issues outlined with the seclusion room, the approved centre was kept in a good state of repair externally and internally, and was clean, hygienic, and free from offensive odours.
The centre demonstrated a commitment to improving quality. The quality initiatives that were identified on the inspection included the introduction of new activities to the therapeutic programme which included yoga, art therapy and a ‘keeping well during COVID-19’ group. In response to the COVID-19 visiting restrictions, the therapeutic programme timetable was expanded to include evening, Saturday, and Bank Holidays activities.
Deer Lodge is a purpose-built, residential mental health recovery unit. The unit opened in 2017 and is situated in Killarney, County Kerry. The approved centre provided mental health care, psychiatry of later life, and mental health rehabilitation. The centre consisted of four households - Mountain View, River View, Wood View and Lake View. All were connected by a central thoroughfare.
The centre achieved 100% compliance on the inspection, an increase of 18% over its 2019 inspection, with no non-compliances recorded. There was one condition attached to the registration of the centre at the time of inspection relating to staffing, but the centre was not in breach of the condition and was compliant with the associated regulation.
The report noted that within each of the four households, each resident had their own en suite bedroom with access to a sitting room, dining room, quiet room, kitchenette, and an internal landscaped garden area. The centre was kept in a good state of repair externally and internally and was clean, hygienic, and free from offensive odours.
Recreational activities included arts and crafts, gardening, newspaper groups and music sessions; community outings in the centre’s own bus; use of an electronic tablet; and cinema, using a projector. Recreational activities were provided on weekdays and weekends.
Aidan’s Residential Healthcare Unit is located within the Waterford Residential Care Centre on a site adjacent to St. Patrick’s Hospital on the outskirts of Waterford city. Aidan’s is a new, purpose-built rehabilitation and psychiatry of later life facility, which was co-located with three other long-stay accommodation units for the elderly.
Residents were transferred from St Aidan’s Ward, St Otteran’s Hospital, Waterford, to Aidan’s Residential Healthcare Unit in April 2020. The new centre accommodated 20 residents at full capacity. There were 13 residents in the centre at the time of inspection.
The centre achieved 100% compliance on the inspection (its first), with no non-compliances recorded. There were no conditions attached to the registration of this approved centre at the time of inspection.
The approved centre was a modern, single story, square shaped unit with an internal courtyard garden and an external front garden area. The unit comprised of a sitting room, a dining room, a multi-sensory room, an activities room, a family room, a visitor’s room, an assisted bathroom, a kitchenette, a laundry and linen room, and storage areas.
Accommodation for residents consisted of 20 bright, spacious single bedrooms all with en suites. Each bedroom had direct access to a garden area. Bedrooms were equipped with electric beds and ceiling hoists to assist residents with mobility issues. The approved centre was kept in a good state of repair externally and internally and was clean, hygienic, and free from offensive odours.
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