Nursing staff at a HSE psychiatric facility used the money of elderly patients to pay a priest for saying Mass and to buy items such as crockery, even though the HSE is supposed to fund such purchases.
The money was also used to buy thermometers, nail clippers, detergent, shampoo, and occupational therapy items after it was collected from patients, most of whom lacked the capacity for consent, according to the Mental Health Commission.
Commission inspectors discovered the practice during an unannounced inspection of Blackwater House, a mental health inpatient facility on the outskirts of Monaghan.
In a report published yesterday, the commission said a contribution of €15 was collected by nursing staff from all but one of 19 residents to fund a kitty, and while some of the money was used to fund communal purchases, it was also used on occasion “to purchase basic care items that should be provided by the HSE”.
The inspectors pointed out that HSE guidelines expressly state that residents’ funds must be safeguarded for their direct benefit and their benefit alone, and that the HSE cannot permit “pooling” or “general use” of the funds of many clients for the general benefit of some.
The HSE Patients’ Private Property Guidelines also state that it must fund equipment and hygiene items within wards.
At Blackwater House, residents’ pensions were collected by personnel from the administration office and the HSE maintenance charge was deducted. For each resident, the remaining sums were lodged in a Patients’ Private Property Account.
Money for personal use was then collected by nursing staff according to the residents’ needs and wishes, after which the €15 contribution was collected.
It was noted that the unit received no petty cash from the HSE and was entirely dependent on these contributions to purchase birthday cakes, ice cream, flowers, and other treats for residents, as well as some essential equipment.
Although the service stated that there was a fund for occupational therapy, the kitty had been used to purchase items for occupational therapy.
A small number of residents also received alternative therapies for which they had to pay €20. Again, no consent was obtained for the deduction of €20.
Following the inspection, the service undertook to discontinue the practice of deducting money from patients’ accounts for a kitty, to refund to residents’ accounts monies used to purchase items that should have been provided by the HSE and to provide a petty cash fund for the unit.
The HSE also said that all therapies are now funded by the HSE. The executive said it “welcomes the largely positive findings” of the commission in relation to Blackwater House.
Children admitted to adult psychiatric unit
The admission of six children to an adult acute psychiatric unit at the Mid-West Regional Hospital in Ennis has been criticised by the Mental Health Commission.
Staff reported there was no provision for educational services for a child who is resident. None of the clinical files relating to any of the children admitted were available for inspection and it was therefore not possible to inspect against the Code of Practice on the Admission of Children. Staff reported that training in Children First (national guidelines for the protection of children) had not been provided. Inspectors said the unit was not suitable for the admission of children.
The commission was also critical of using security personnel to physically restrain one patient, contrary to the Code of Practice on Physical Restraint which states staff using it should be aware of specific needs of a patient.
Inspectors said security personnel “did not have and cannot have access to the resident’s individual care plan”.
Some residents told inspectors they were concerned about personal safety and bodily integrity.
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