Hospital facility in Cork ‘not suitable’ as psych unit

A psychiatric unit where patients have no access to fresh air and where a naked patient was exposed because of inadequate privacy measures has been criticised by the inspector of Mental Health Services.

Hospital facility in Cork ‘not suitable’ as psych unit

The 50-bed acute unit at the Mercy University Hospital (MUH), Cork City, was deemed “not suitable” as a mental health unit in its layout and size.

The latest inspector’s report describes it as “small, with a number of very cramped double bedrooms” and without readily accessible outdoor space “for relaxation, leisure, or exercise unless residents left the hospital premises”.

Of considerable concern was the lack of privacy. At the time of inspection, one resident was naked in a single room which opened onto the sitting room area.

“The resident was clearly visible through the observation panel of the door, which was insufficiently obscured,” the report said. The inspectors were of the opinion, at the time of inspection, “that insufficient effort had been put into ensuring that this resident was clothed and that their dignity was maintained”.

While the unit, which forms part of Cork North Lee mental health services, was “well-lit and clean”, the showers were small, with no ventilation, and “smelt damp and had mould on the ceiling”. A number of beds did not have privacy curtains and blinds were broken in most of the bedrooms and residents were visible through the windows.

Inspectors were unhappy that bedrooms opened directly onto the sitting room, which they said was arranged “like an airport lounge, with seating set out in rows”.

There was also concern about the number of ligature points and about “carelessness” vis-à-vis prescriptions.

Inspectors said that while there was a policy on the ordering, storage, and administration of medication, there was none on prescribing.

“In a small number of cases, the doctors did not use their Medical Council registration numbers... One prescription had not been signed or dated by the doctor but nursing staff were continuing to administer this medication,” the report said.

On the upside, the report said there was “strong evidence that staff worked hard to provide recovery-focused care and treatment for residents” and there was “strong multidisciplinary working and excellent therapeutic services and programmes”.

Responding, the HSE said corrective action had been taken, including placing privacy curtains on all beds, replacement of damaged blinds, and installation of frosted glass to preserve patient privacy. Areas where mould existed had been refurbished and an architect, in conjunction with the HSE’s Estates Department, has carried out a review and a draft refurbishment plan has been drawn up and is being costed. The plan will also address ligature points.

The HSE said a nursing matrix has been established to measure compliance monthly on documentation and the administration of medicines.

An inspection of the Department of Psychiatry in University Hospital Waterford found eight children had been admitted to the adult unit in the first seven months of 2014. Inspectors said it was “not suitable for children”.

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