THE MENTAL HEALTH Commission (MHC) has found significant risks and a number of systemic issues at two inpatient mental health centres in Cork.
The MHC said that due to the serious nature of the issues identified in one of the centres, it was the subject of a focused inspection 10 days after its annual inspection in July. These two reports are the latest in a series which have highlighted concerns in a total of five centres in the Cork area in 2021.
Inspector of Mental Health Services, Dr Susan Finnerty said MHC has serious concerns for patients at the centres.
“It is clear from these reports that the two centres in Cork have systemic issues when it comes to premises, risk management, therapeutic services and programmes, and individual care planning.
“I was particularly concerned to note that the culture in one unit was reminiscent of a model of mental health care that might have been provided decades ago. There was a general attitude of negativity about the possibility of improvement in the lives of the residents.
“There was an emphasis on what they could not do, their potential for aggression, and the fact that they would always require this type of care. This resulted in limited therapeutic input for these residents, absence of care based on recovery principles, and an environment that was stark and lacking in comfort.
“It should really go without saying that we need to completely remove any last vestiges of this attitude and approach to mental health care from our services,” she said.
The Chief Executive of the Mental Health Commission, John Farrelly, said one of the key issues is around how the HSE oversees the centres.
“These reports indicate a need for the HSE to improve governance, management and oversight of investment in inpatient mental health facilities in the greater Cork area.
“The HSE has shown in other areas and in other counties within this CHO a clear capability to wisely use the funds allocated to it by the State. We will continue to be concerned about patterns of non-compliance across a number of centres in Cork and we continue to monitor this matter closely.”
The centres identified in the MHC report are 87-bed St. Stephen’s Hospital located near the village of Glanmire on the north-eastern outskirts of Cork city while Carraig Mór is an 18-bed Psychiatric Intensive Care Unit (PICU) in Shanakiel, Cork.
St Stephen’s Hospital received eight non-compliances on inspection, including a critical non-compliance on the regulation relating to individual care planning, and another on the regulation relating to risk management.
The report found that the risk management officer was not known by all staff; fire doors in two separate units were both failing to fulfil their function as fire doors – meaning that there were not adequate precautions in place to control for the management of fire risk; windows on two units needed to be replaced; and ligature points remained in the centre.
Carraig Mór opened in 2002. Following a process of regulatory escalation initiated by the MHC, the MHC and the HSE agreed that the number of available beds at Carraig Mór would be reduced from 18 to 10 from May 2021.
There are further bed reductions planned which are designed to improve privacy and dignity issues for residents and while critical and necessary construction works to upgrade the unit were ongoing.
Following the death of a resident at Carraig Mór, the MHC had carried out an announced focused inspection of the centre on 12 March, 2021.
It identified a number of specific measures and enforcement actions which related to the unsuitability of the premises at the time of the person’s death. These have largely been remedied and the specific actions undertaken, including the installation of a more comprehensive CCTV system within the centre, as well as a new fire alarm system, including sensors and new fire panels.
It was also noted that in further response to MHC enforcement actions and discussions, the centre was also required to implement an immediate programme of maintenance to ensure that the premises were safe and met the needs of residents.
The Mental Health Commission (MHC) is an independent statutory body.
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