No privacy screens between beds at Cork mental health facility

An inspection of a mental health facility in Cork found its residents were not receiving adequate privacy or outdoor space.

Two of the residents at the Carraig Mór Centre in Shanakiel did not even have a privacy screen between their beds.

The Mental Health Commission found the 18-bed psychiatric intensive care unit had critical risks in three areas.

The inspector’s report on the centre noted there had been no improvement in compliance with regulations, rules and codes of practice over a three-year period. Compliance was 64% in 2017, 71% in 2018 and 65% in 2019.

Inspectors noted the centre rated excellent on eleven counts.

Three of its non-compliances were deemed critical and two high.

The centre was non-compliant on privacy grounds as residents’ privacy and dignity were compromised. Some 11 beds were observed within the male dormitory, limiting privacy and dignity. Two beds did not have a privacy screen between two residents, and residents were not facilitated to make phone calls in private.

The centre also received a critical risk rating for its premises, which was deemed non-compliant on several counts.

Residents did not have access to personal space as the male dormitory and the communal dining room were not appropriately sized, while there was also an insufficient number of toilets and showers and inadequate furnishings.

Female residents were not provided with sufficient outdoor space as access to the garden was limited.

Issues relating to the use of seclusion were also identified, including that residents did not have access to adequate toilet and washing facilities.

A number of high risks were also identified, including in relation to records maintenance. They were not maintained in a manner "to ensure completeness, accuracy and ease of retrieval", according to the inspectors’ report.

The centre provided corrective and preventative actions plans to address all areas of non-compliance. The Mental Health Commission will seek an update in three months to ensure the plans are being implemented.

The inspector noted several positive initiatives at the facility, including a weekend therapy service, renovations in some areas of the centre and an animal-assisted therapy pilot programme.

Separately, the Mental Health Commission also reported the Department of Psychiatry, St Luke’s Hospital in Kilkenny saw its compliance levels increase by 22%.

Based in St Luke’s General Hospital in Kilkenny City, the facility has 44 beds in two units. It has seen its compliance levels increase from 46% in 2017 to 73% in 2019.

Since 2018, a support services manager had been appointed in order to improve premises, hygiene and catering processes, and the inspection found there was a culture of implementing quality improvement audit tools to monitor and evaluate standards of care.

High risks were identified in four areas, including in relation to privacy because the window in one shared bedroom dormitory did not have blinds or curtains, and the centre was over-capacity on several occasions.

It was also found not all staff had up-to-date mandatory training in basic life support and safety, and the number and skill mix of staffing was insufficient to meet residents’ needs.

Children at the centre did not have access to age-appropriate advocacy services.