THE REPORTS BY the Mental Health Commissions into their visits to St Senan’s and St Ita’s hospitals weren’t the only ones that they released.
Below is a summary of the findings from 10 others, with the full report available by clicking on the headings below.
Department of Psychiatry, Portlaoise
Both its male and female wards were visited unannounced on 28 March, at which point individual care plans were found to not meet “the full requirements” of the regulations.
It was also noted that due to a recent movement of staff from its ECT (Electroconvulsive Therapy) suite, the centre now had none with the required training.
Out of 31 regulations, it was fully compliant with 26 and substantially compliant with five.
Main recommendations were to improve the quality of its individual care plans, to nominate a complaints officer and to ensure that ECT was not administered unless related training had been completed.
Acute Psychiatric Unit, Cavan General Hospital
An unannounced visit on 12 June found that it was not compliant with the code of practice on the use of physical restraints, noting:
Recording of physical restraint in the clinical files was not done in all cases. The reason for not informing next of kin was not documented. There was no evidence that the episode of restraint had been discussed with the resident or discussed with the multidisciplinary team.
Out of 31 regulations, it was fully compliant with 28, substantially compliant with one, and had two which weren’t applicable.
Main recommendations were to ensure the privacy of residents, having found the unit’s garden courtyard “was overlooked by offices and wards in the general hospital”. All uses of physical restraint were to be documented in future, along with any reasons why next of kin were not informed.
Psychiatric Intensive Care Unit (PICU), Carraig Mór Centre, Cork
The main findings of an unannounced visit on 18 July were that there was no psychology service, which the report says was “unacceptable in a forensic team”. It also noted inadequate levels of “social work, occupational therapy and non-consultant hospital doctors,” also pointing out that the exclusion room was “unsatisfactory”.
Out of 31 regulations, it was fully compliant with 26, substantially compliant with three, minimally compliant with one and had a further one which was not applicable.
Main recommendations were to appoint a psychologist to the forensic rehabilitation team, to ensure that there was input regarding occupational therapy and social work, that clinical files should be organised better and that staff receive training in intellectual disability and mental illness.
South Lee Mental Health Unit, Cork
An unannounced visit on 18 July found that despite recent refurbishment, the female toilet remained in “poor condition” and that there was “little evidence of health and social care professional input to inpatient care”.
Out of 31 regulations, it was fully compliant with 26, substantially compliant with one, minimally compliant with three and not compliant with one.
The one issue of non-compliance was the premises which, in addition to the poor condition of the female toilet, was not wheelchair accessible. The layout of the unit also made supervising residents in all areas of it a “challenge”.
Main recommendations included a review of current laundry facilities, the erection of privacy screening and curtains, an upgrading in the standard of the female toilets and the maintaining of a single clinical file per resident.
St Stephen’s Hospital, North Lee, Cork
Inspected on 31 May, the report said that multidisciplinary teams were not fully resourced, with regulatory compliance, although still of a high standard, having falling based on last year.
Out of 31 regulations, it was fully compliant with 22, substantially compliant with five, not compliant with two, with a further two not applicable.
Individual care plans were marked as being non-compliant, with one patient having no plan. Therapeutic Services and Programmes were also listed as non-compliant.
Recommendations included individual care plans, appropriate locks on the male toilets and a reorganisation of the smoking area to prevent smoke from entering the resident’s sitting area.
Department of Psychiatry, Waterford Regional Hospital
An unannounced visit on 25 June found a “significant slippage” in the provision of individual care plans since the previous inspection. The fact that current facilities were “unsuitable and counter-therapeutic” was offset somewhat by building work already underway which is set to provide an expanded unit with “enhanced facilities”.
Another issue was the fact that the seclusion room had been used as a bedroom due to overcrowding.
Out of 31 regulations, it was fully compliant with 17, substantially compliant with seven, minimally compliant with three and not compliant with four.
Non-compliance was reported in the area of visits, with no dedicated visiting room and no communal seating area.
Individual care plans (ICP) also got the lowest rating. Having being fully compliant in 2011 when the 60 page ICP template booklet was introduced, pages were “generally not completed”.
Therapeutic Services and Programmes were also found to be non-compliant, as was “general health,” with no six-month physical review being carried out on a patient.
Main recommendations included individual care plans, better resourcing of multidisciplinary teams and six-month physical reviews.
Adult Mental Health Unit, Mayo General Hospital
Visited on 19 June, a “repeated failure” of having due regard for the safeguards as laid down in relation to seclusion was noted. Little evidence of resident involvement in care planning was also noted.
Out of 31 regulations, it was fully compliant with 23, substantially compliant with six and minimally compliant with two.
Recommendations were that individual care plans were required. The ones that did exist had been found to be “sloppy” and contained minimal information. The rules governing the use of seclusion needed to be complied with fully, this having been a recommendation in both 2010 and 2011 reports.
Immediate audits of both care planning and seclusion were to commence immediately.
A visit on the 20 June noted an issue with the way in which psychiatric admissions were recorded by medical staff, describing it as “poor”. Some six-month physical reviews had also failed to take place.
Out of 31 regulations, it was fully compliant with 26, substantially compliant with two, not compliant with one and had two which were not applicable.
The one regulation that was not complied with was “General Health,” due to its failure to carry out all six-month physical reviews.
Main recommendations included ensuring that all physical reviews were completed and that admissions were accompanied by an “adequate psychiatric assessment.”
St Anne’s Ward, Sacred Heart Hospital, Mayo
After an unannounced visit on 19 June, the findings were mostly positive.
Out of 31 regulations, it was fully compliant with 26, substantially compliant with three and had two which were not applicable.
Main recommendations were that staff training should be kept up to date, referral letters retained and advocacy services re-introduced.
Stemming from an unannounced visit on 19 June, the report noted that the front door was routinely locked and that a “significant number of voluntary residents were not free to leave the unit unaccompanied and depended on the availability of staff to access the wider community.”
It also found that the “physical care of residents required attention” but that this has since been addressed.
Among other findings, it suggested that a re-inspection visit may be required before the end of the year.
Out of 31 regulations, it was fully compliant with 22, substantially compliant with two, minimally compliant with two, not compliant with four and had one which was not applicable.
Non-compliance was related to a failure to provide individual care plans for all residents, a general lack of therapeutic services and programmes, a failure to provide six-month physical examinations and having an information booklet that did not reflect the current environment and services, with “no readily available information for residents on diagnosis, treatments and medications, including side effects.”
Recommendations included the urgent requirement to refurbish the bedsits in which residents stayed, along with paying more attention to “supporting residents voice and autonomy”. Individual care plans were also needed to be put in place, along with half-yearly physical reviews.
To embed this post, copy the code below on your site
have your say