Mental health inspectors criticise HSE over failings at psychiatric units

Mental health inspectors have criticised the HSE for a series of failings at adult inpatient psychiatric units including admission of children, inadequate physical assessments and occupational therapy and for not labelling residents’ personal property.

Mental health inspectors criticise HSE over failings at psychiatric units

Mental health inspectors have criticised the HSE for a series of failings at adult inpatient psychiatric units including admission of children, inadequate physical assessments and occupational therapy and for not labelling residents’ personal property.

At the Owenacurra Centre in Midleton, Cork, which caters for 24 residents, inspectors from the Mental Health Commission (MHC) said they only had access to approximately five hours occupational therapy per week: “As a result of this limitation... the occupational therapy service was unable to meet all residents’ needs."

There were only two showers available for residents’ use at the time of inspection. Inspectors said this was “insufficient for the 21 residents”.

A HSE spokeswoman said they accept the findings of the report and that they have agreed a plan with the MHC to address the occupational therapy deficit. She said they are awaiting funding for additional resources.

The Department of Psychiatry at University Hospital Waterford (UHW), a 44-bed unit, was criticised by the MHC for a “low level” of compliance with regulations, at 57%.

Admitting eight children to an adult unit was among the shortcomings identified, a practise ongoing at the centre for more than a decade, as previous reports show.

The unit was also criticised for inadequate physical examinations which “did not consistently include an assessment of residents’ body mass index, weight, waist circumference, blood pressure, smoking status, and dental health”.

The centre was also criticised for failure to keep accurate records of each resident’s personal property and possessions: "Cash balances did not always correspond with the balance recorded in available records."

In its action plan response, the HSE said new cash recording documentation was implemented and arrangements for safe keeping of cash sums are now in place.

In relation to admitting children, the MHC said “age-appropriate facilities and a programme of activities appropriate to age and ability were not available” nor did children have access to age-appropriate advocacy services. The report also said the Admission of Children policy “did not address the procedures in relation to family liaison, parental consent, confidentiality or the requirement for each child to be individually risk-assessed”.

In response, the HSE said there have been ongoing difficulties in identifying "Treating Consultants" for admitted children due to recruitment and retention challenges of candidates from the specialist register for CAMHS.

They said the “inability to identify clear responsibility for the care and treatment of admitted children has impacted on our ability to approve and implement a revised Childs Admission Policy”.

However the HSE said the Child Admissions Policy has been updated to include the requirement for each child to be individually risk-assessed. There was also a proposal for the provision of an Independent Advocate for 1.5 days per week.

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