State watchdog criticises mental health facilities with no care plans for residents

The State’s mental-health watchdog has expressed concern at the continued failure of a number of care facilities to draw up individual care plans for vulnerable patients.

In its latest series of inspections, the Mental Health Commission says it is "disappointed and concerned" at the failure and will take action against centres which repeatedly fail to comply with regulations.

The commission has the power to deregister a care centre – in effect shutting it down – though this is used very rarely.

Under mandatory care regulations, all centres are obliged to have a plan that specifies the treatment and care required for each resident. These plans should be regularly reviewed and updated.

Inspectors found that Cappahard Lodge, a 32-bed residential unit in Ennis, Co Clare, was repeatedly in breach of conditions requiring proper care plans for residents.

During an inspection last July, these plans were found to be deficient, and conditions were attached to the unit, requiring it to comply with regulations.

Inspection

In an unannounced follow-up inspection last October, inspectors found it was still failing to comply. There was no evidence in some care plans of any input by a multidisciplinary team and the required interventions for achieving the goals of some residents were inappropriate.

In another case, the goal and the intervention were documented as being the same, while in others the interventions described bore no relation to the goal identified.

Inspectors found that in one care plan a patient was noted as being in psychological distress, but no intervention plan was identified.

The department of psychiatry at Letterkenny General Hospital has been criticised in an inspection for failing to ensure there are adequate care plans for the third year in a row.

Inspectors found little evidence of multidisciplinary involvement, such as psychology or occupational therapy, in drawing up these plans at the 34-bed unit.

“The members of the team identified as attending the weekly reviews were medical and nursing staff only,” an inspection report states. “Much of the review of the [care] plan was more like a progress note rather than a plan with a specified intervention and a responsible person for carrying out the intervention.”

At Carraig Mór, an 18-bed unit in Shanakiel, Cork, care plans did not adequately capture the goals, interventions and resources required to implement care and treatment.

The commission said care plans are vital as their aim is to ensure that each service user is treated as an individual with resource requirements specified.

“Treatment of each service user is then based on his or her specific needs. This is integral to the concept of recovery, that treatment is focused not just on patient management but on working with individuals to ensure they can recover,” it said.