Updated at 3pm
A NEWLY-CONSTRUCTED ‘high observation’ area built at Galway University Hospital has been used as office space, according to a report published yesterday by the mental health services inspector.
During an inspection carried out mid-March, the inspector found that the hospital’s psychiatry department had improved but the service “was in breach of the condition imposed by the Mental Health Commission on Individual Care”.
It said that some maintenance issues previously raised by the inspector had been addressed, but that the bedroom accommodation “was unsuitable for a modern mental health unit”.
It also noted the alternative use of the new observation area of the ward:
Regrettably, the newly constructed eight-bed high observation area remained unopened and was currently being used by the psychology department as office space.
The report also raises the issue of the activities nurse assigned to the centre, whose time “was not protected” and so could be called back for general duties. When this nurse was called away, “no activities were provided on the ward”.
The inspector’s report said security personnel from the general hospital were involved in physically restraining patients at the specialist department:
Physical restraint was used infrequently within the Department of Psychiatry. On the occasions where physical restraint was used the principle of least restrictive practice and resident safety applied….Security personnel occasionally assisted in physical restraint. As security personnel were not aware of, and did not have access to the resident’s individual care plan, they could not be compliant with section 6.1 of the Code of Practice the Use of Physical Restraint.
In its review of the centre’s admission, transfer and discharge practices, the inspector found that while the centre “was fully compliant with Article 32 on Risk Management”, its “policies on Transfer and Discharge were out of date”.
Separately, the inspector’s report for the acute psychiatric unit at University Hospital Limerick drew attention to staff training for dealing with violence and aggression: “A significant number of staff were not trained in prevention and management of aggression and violence.”
It said that residents did not have access to independent advocacy services “for a number of months” and that all residents did not have a risk assessment carried out.
New nursing posts ‘approved’
Responding to the report, HSE West said in a statement to TheJournal.ie that additional staff have been rostered to Galway University Hospital’s Psychiatry Deparmtent, “including 12 nursing staff who have been relocated from the former acute unit in Ballinaslow to the Acute Unit in Galway”.
A further eight new nursing posts have been approved for permanent appointment and are currently being processed through the National Recruitment Service. To strengthen the clinician governance, additional nurse managers have also been introduced in recent months.
Regarding the new high observation area, HSE West said that the ward has not been commissioned for use but that this “will be examined in the context of new staff being employed and the ever-changing clinic needs of the patients”.
On the issue of security staff from the general hospital being involved in physically restraining patients, the statement said: “Security staff are used in assisting staff in emergency situations only and appropriate training is provided.”
And asked about the suspension of activities on the ward while the relevant staff nurse was called for general duties, HSE West said:
A multidisciplinary timetable of activities is available for every patient tailored to their individual care plan. A nurse is rostered daily to the activities and an Occupational Therapy assistant is also allocated. Psychology, Social Work, Medical and the Pharmacy also have input into the activity programme and approval by the area Management team has been given for a Senior Occupational Therapy post to be recruited for the acute unit.
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