Dementia care patients in ‘drab, bare’ premises

A number of mental health facilities have failed aspects of recent inspections because of inadequate premises, the use of untrained staff in restraining patients and the admission of children to adult wards.

The latest batch of inspection reports from the Mental Health Commission also found the facilities struggling with staff retention and access to sufficient therapies for their patients.

Inspectors were particularly concerned about the premises housing the Sycamore Unit at Connolly Hospital in Dublin which cares for patients with moderate and severe dementia.

“The day room was unsuitable as it had no features or furnishings conducive to caring for residents with dementia. It was bare, institutionalised, drab and required painting,” they said.

“The focus point was an open fireplace that looked dirty and required restoring. The curtains were falling down in places. It was completely unsuitable as a main communal area for people with dementia and required a complete refurbishment. The dining room was equally bare and drab.

“The garden was large and contained pots of dead or dying plants. The grass was very uneven and rough. There were no efforts to develop the garden in any way for people with dementia.”

Individual care plans for the residents were also found to be incomplete and there was no evidence that families had been able to contribute to the care plans on behalf of their loved ones.

The Jonathan Swift Clinic at St James Hospital, Dublin was found to be lacking in natural light, overcrowded and difficult to keep clean. “Current physical design is unsuitable to adequately meet mental health needs with respect for privacy and dignity,” the inspectors said.

The clinic had also admitted some children on an “exceptional basis” but it had no age-appropriate facilities and no input from the Child and Adolescent Mental Health Service.

St Vincent’s Hospital in Fairview, Dublin had also admitted children but some staff who had care of them did not have up-to-date training in child protection and the children’s files did not identify where or how they were accommodated.

St Vincent’s was also in breach of regulations governing the searching of patients’ lockers and clothing. Staff had not received training in conducting searches, searches were not always recorded and evidence of consent was lacking.

In another breach, a controlled drug was found left on an open shelf, a medication fridge was unlocked and some records were inadequate. The inspectors also recorded a breach after discovering student nurses had been used in restraining patients and that it was not clear if staff were trained in restraint techniques.

The facilities were given a list of corrective actions to take and timelines for compliance.