Broken doors, cracked glass and rubbish criticised at psychiatric unit

Mental Health Commission finds 26 areas of ‘high risk non-compliance’ in inspected centres

 

Dirty and unfurnished rooms, inadequate toilet facilities, broken ceilings-panes, under-trained staff, inadequate space and no privacy are among the breaches in psychiatric units in counties Westmeath, Louth and Cork reported on Thursday.

In all, 26 areas of “high risk non-compliance” are detailed by the Mental Health Commission (MHC) in its latest report. Inspectors found three of the centres were unacceptably dirty and run-down, with many of the non-compliances occurring for the third consecutive year.

The MHC is an independent statutory body tasked with ensuring high standards of care and practice in mental health services.

The report says in St Enda’s ward and the admissions unit of St Loman’s hospital, Mullingar not all staff are up-to-date with mandatory training. There were 11 non-compliances with the rules around the use of seclusion, constituting a breach of human rights.

“Seclusion facilities were not furnished, maintained and cleaned to ensure respect for dignity and privacy ... The centre was not clean and hygienic, nor was it in a good state of repair with broken ceiling panes, cracked glass in the conservatory, two broken doors, rubbish on the ground of the courtyard and cigarette butts in the garden.”

The building housing an 18-bed psychiatric intensive care unit at the Carraig Mór Centre in Shanakiel, Co Cork was “outdated and not suitable for a modern health service ... Accommodation was in dormitories which were small and outdated and compromised privacy.

“The level of cleanliness and the condition of the toilet and showering facilities were of a poor standard...All three male toilets were malodorous, with dirty floors, unclean window sills, brown surfaces on bathtubs, an unclean toilet bowl and mould on the shower-room ceiling. Cigarette butts were observed on the corridor on the female side. This meant that current national infection control guidelines were not followed.”

In addition: “Residents in seclusions did not have access to adequate toilet and washing facilities.”

‘Non-compliant’

The department of psychiatry in Drogheda is a 46-bed unit which had 44 residents at the time of inspection. Though some compliances were “excellent” and there was “an impressive list of recently developed quality initiatives” the centre was deemed “high-risk non-compliant” in the ordering, prescribing and storage of medicines, and in its use of physical restraint.

“In no case was there documentary evidence that the resident was informed of reasons for, likely duration of, or circumstances leading to discontinuation [or restraint]...In two cases the registered medical professional did not compete and medical examination within three hours of the end of episode [leading to restraint].”

There was not enough personal space for residents to move around at St Michael’s Unit in the Mercy University Hospital, Cork. It has 50 beds and there has been some improvement in compliance since 2016.

“However...[It] has not been compliant with the regulations on privacy, premises and staffing for three consecutive years. Less than one third of nursing staff were trained in fire-safety.

“The centre did not provide resident-access to personal space for residents to move around. There was no garden. There was no access to appropriately-sized communal rooms and it did not have a sitting room.”

All centres provided corrective plans to the commission which will seek updates on these in three months.