Fire doors propped open by chairs and incomplete patient plans found in mental health inspection

The Mental Health Commission has found a string of non-compliances at one of the country's acute adult mental healthcare facilities. Picture: RollingNews.ie

The country's mental health watchdog has found a string of non-compliances at one of the country's acute adult mental healthcare facilities.

At the Department of Psychiatry, Connolly Hospital, in Dublin, one critical risk rating was identified, along with eight high and four moderate non-compliance risk ratings.

The inspector noted in the report that there has been no progress in improving compliance with regulations, rules, and codes of practice since 2016.

The critical risk rating was related to the facility not ensuring records and reports were maintained in a manner that would ensure ease of retrieval, and not all records were in good order.

"The inspection report found that not all resident records were developed and maintained in a logical sequence; that a number of files were not maintained in good order and had loose pages; and that two appropriate resident identifiers were not recorded on all documentation across a number of clinical files," the Mental Health Commission said.

The eight high-risk ratings included communication, individual care plans, general health, premises, staffing, risk management procedures, the code of practice on the use of physical restraint, and the code of practice relating to the admission, transfer and discharge to and from an approved centre.

It said chairs and waste bins were holding fire doors open and that a fire detector was rendered ineffective because it was covered in tape. Other issues included shortcomings in care plans and a resident observation checklist containing residents’ full names being left unattended on a corridor in a ward.

The findings were included in a series of inspection reports on five of the country’s in-patient mental health units.

One unit, Lois Bridges in Dublin, achieved 100% compliance, while an inspection of Grangemore Ward in St Otteran’s Hospital near Waterford city found increased compliance since a previous inspection.

Compliance levels had also improved at the child and adolescent mental health in-patient unit at Merlin Park University Hospital in Galway, although inspectors noted the seclusion room had been designed with a hard floor fitting, which posed a risk to resident safety. 

Other issues were also uncovered regarding seclusion at the facility and a condition was attached to the registration of the centre relating to the development of a costed, funded and time-bound plan to replace the current seclusion facilities, with the plan to be provided to the MHC next month.

At Eist Linn child and adolescent in-patient unit in Cork, three moderate non-compliance risk ratings were identified in relation to individual care plans, privacy, and premises. It had a compliance level of 90%, up from 78% in 2019.

Issues detected through the inspection included that the individual care plans did not identify appropriate goals for two of the five resident files reviewed.

The Inspector of Mental Health Services Dr Susan Finnerty, said: “It is encouraging to see that there have been high levels of compliance in four of the five centres inspected. 

"However, it’s disappointing to see individual care plans and premises feature prominently again in most of the reports. An individual care plan is a personalised guide to recovery and managing illness. 

"Without a complete plan, with input from the multidisciplinary team and the individual, the person receiving treatment is at a disadvantage. The plans are core to recovery and it’s clear in three of the inspection reports that there are issues with the preparation and maintenance of those plans.”