A €13m, purpose-built mental health unit for long-term psychiatric patients opens in Co Kerry today but nurses’ unions are warning that a low skill model of staff ratio and failure to reach levels of experienced staff will lead to more assaults on nurses.
The 40-bed Deer Lodge at St Margaret’s Rd, Killarney, was built two years ago but has since been lying idle. Delays in opening the unit and transferring patients from existing facilities in the grounds of the Victorian-built St Finan’s Hospital has led to much criticism.
Earlier this year Siptu, one of the nursing unions, threatened strike action.
The Psychiatric Nurses Association (PNA) has also raised concerns about the ratio of nurses to residents, saying it fears there will be further assaults on staff as optimum staffing levels and specialist nurses are not being provided.
It hit out at the project as a whole, saying the mindset of HSE management has been “early twentieth century” and what is involved is simply “St Finian’s en suite”.
“The ratio of nurses to health care assistants in high-risk psychiatric units is normally 90% nurses to 10 per cent HCAs. But what we are getting in Deer Lodge is just 70% nurses to 30% HCAs,” Cormac Williams, PNA spokesman, said.
Many of the HCAs will have no experience in dealing with people with challenging behaviour and the ratio at Deer Lodge is the norm for elderly care, not psychiatric care units, Mr Wiliams said.
Deer Lodge will have a 10-bed unit for residents with enduring mental illness, with disturbed and challenging behaviour.
“Given the staffing configuration of Deer Lodge, we expect the number of injuries and assaults on staff and residents will increase in Deer Lodge as such a unit would need an adequate number of trained clinical staff familiar with control and restraint and dealing residents with disturbed and challenging behaviour,” said Mr Williams.
“While nurses welcome the new state-of-the-art building and facilities, they remain gravely concerned that the quality and standard of care including health and safety will be seriously compromised within Deer Lodge due to an out-of-date early 20th century service delivery model based on custodial care and low skill labour in a state of the art 21st building.”
No new modern service delivery initiatives such as crisis intervention beds or respite care beds set out in A Vision for Change (AVRC 2006)
are included in the new building project.
“Therefore, Deer Lodge will be a major step forward in infrastructural standard but a major step backwards in service delivery concepts,” said Mr Williams.
He said the Deer Lodge project was hampered by a poverty of ideas and ambition in HSE management, who see Deer Lodge as a relocation of the existing “St Finan’s Hospital en suite” rather than a new model of mental health service delivery in the county.
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