Not all staff at mental health care centres trained in basic life support, inspections reveal

Healthcare staff at Cappahard Lodge Nursing Home, Tulla Rd, Ennis, Co Clare, treated and communicated with residents in a respectful manner, but lacked training in fire safety, according to an inspector's report. Picture: Brian Arthur/ Press 22.

Not all healthcare staff at a residential mental health care centre were trained in basic life support, according to Mental Health Commission inspectors.

They also found that healthcare workers at Cappahard Lodge, Tulla Rd, Ennis, Co Clare, also lacked training in fire safety and the management of violence and aggression.

These were among findings of an inspection of the 18-resident facility last November.

The inspection report is one of seven annual inspection reports and two focused reports showing non-compliances with the regulation on staffing across eight out of the nine approved mental health centres inspected.

Of them all, just one centre — the National Eating Disorders Recovery Centre in Ballsbridge, Dublin — was fully compliant.

Some of the facilities recorded their worst report for years, such as the Drogheda Department of Psychiatry in Crossland, Drogheda, Co Louth.

The facility had four regulatory breaches in 2018, but 10 — including breaches relating to individual care plans and deficiencies in risk management procedures — were found in their November 2022 inspection.

In that space of time, they consistently breached staffing and general health regulations.

The Department of Psychiatry at Roscommon University Hospital also recorded its worst compliance and risk rating since 2018.

Then, two of its three non-compliances were rated as “high” and one as “moderate”.

Its November 2022 inspection saw its non-compliances rise to four, with one — due to “deficits in fire safety” — rated as “critical”, two as “high”, and one as “low”.

In total, the inspections found a total of two critical-risk non-compliances for the regulation on staffing, and 16 additional high-risk non-compliances for staffing, individual care planning, and risk management across centres in Mayo, Roscommon, Dublin, Cork, Louth, Laois, and Clare.

Susan Finnerty, the inspector of mental health services.

The inspector of mental health services, Dr Susan Finnerty, said: “There are risks associated with an inability to recruit and retain staff, which results in an inappropriate skill mix to meet the needs of residents.

The provision of up-to-date training for staff to ensure the centre meets the basic and mandatory requirement for compliance is essential for the safety and wellbeing of patients and residents”.

Inspectors noted that Cappahard Lodge staff treated and communicated with residents in a respectful manner at the Ennis centre, which was inspected in November last year.

They also said there were clearly defined goals, with associated interventions and resourcing in place for each resident.

But among the issues inspectors found was that the frequency of administration of medication, including the minimum dose interval, for ‘as required’ medication was not recorded in four of the five medication prescription and administration records inspected.

They also found that risks associated with suicide “were not reduced to the lowest practicable level”.

One of the two non-compliances at Cork’s Carraig Mór in Shankiel was because the registered proprietor “did not ensure that staff had access to education and training to enable them to provide care and treatment in accordance with best contemporary practice”.