Inspections find 'critical or high-risk' breaches at six adult psychiatric centres

Compliance at St Michael’s Unit at Mercy University Hospital in Cork went up from 69% to 72%. File picture: Larry Cummins

Inspections of six inpatient adult psychiatric centres has found that all of them have “critical or high-risk” breaches of regulations in relation to fire safety and staff training.

The Mental Health Commission also found that four of the six units had “high-risk” breaches in relation to the use of restrictive practices on patients — three regarding their use of seclusion and one in relation to physical restraint.

Director of Regulation at the MHC, Gary Kiernan said despite the introduction of new rules on restraint and seclusion in January 2023, some inpatient centres were still in serious breach of them and he urged providers to take “immediate steps” to bring their services into compliance.

The inspection reports found:

• St Loman’s Hospital, Westmeath — overall compliance fell from 74% to 64% in 2023, with eight high-risk breaches of regulations, including in individual care planning, therapy, staffing, risk management, restraint and medicines;
• Department of Psychiatry, St Luke’s Hospital, Kilkenny — overall compliance at 89% (unchanged), but with one critical risk breach on risk management and one high-risk breach on regulation of premises;
• Department of Psychiatry, Letterkenny University Hospital, Donegal — overall compliance down from 78% to 74%, including six high-risk breaches on individual care planning, staffing, restraint and seclusion;
• Acute Psychiatric Unit, Tallaght University Hospital, Dublin — overall compliance fell from 77% to 65%, including two critical risk breaches on risk management and premises regulations and seven high-risk breaches on general health, care planning, staffing, seclusion and restraint;
• Sliabh Mis Mental Health Admission Unit, University Hospital Kerry — overall compliance down from 71% to 69%, including five high-risk breaches on privacy, risk management, staffing and seclusion;
• St Michael’s Unit, Mercy University Hospital, Cork — overall compliance up from 69% to 72%, but there were three critical risk breaches on privacy, premises, and risk management and two high-risk breaches on CCTV and staffing. 

Inspector of Mental Health Services, Professor Jim Lucey said: “Our inspections discovered that daily fire checks and regular fire drills were not being carried out, while we also discovered faulty fire doors.” 

Mr Kiernan said in five of the six centres management did not ensure all staff were trained, including in basic life support and management of violence and aggression.