Two psychiatric units for children among seven found with 'common concerns' at inspections

The compliance rate for the Centre for Mental Health Care and Recovery, attached to Bantry General Hospital rose from 78% in 2022 to 88% in 2023. File picture: Dan Linehan

Inspections of seven inpatient psychiatric units, including two for children, found “common concerns” across all of them, with four centres failing regulations on minimising ligature hazards and two units breaching rules on mechanical restraint of patients.

Reports on the inspections, published by the Mental Health Commission, found that four of the approved centres had increased their compliance with regulations, while three units saw rates fall. The centres are based in Cavan, Dublin, Cork, Laois and Mayo.

The Centre for Mental Health Care and Recovery, attached to Bantry General Hospital, in West Cork, has 18 registered beds, but only nine residents at the time of the inspection. It’s compliance rate rose from 78% in 2022 to 88% in 2023.

The inspection found that while the centre had an adequate number of appropriately trained nursing staff not all of them were trained in fire safety, safeguarding, basic life support or the management of violence and aggression.

It found that the administration of medication “was not carried out in a safe manner” and that ligature hazards were not minimised to the lowest level. Inspectors also said the centre was not entirely clean and made reference to “an offensive odour in one toilet and shower room”.

Two adolescent centres were inspected: Linn Dara Child and Adolescent In-Patient Unit at Cherry Orchard Hospital, west Dublin, and the Adolescent In-Patient Unit at St Vincent’s Hospital in Fairview, north Dublin.

Linn Dara

It said that while compliance at Linn Dara had fallen from 97% in 2022 to 91% in 2023 it has had a “high average” compliance rate of 95% over the last four years.

It said Linn Dara was registered for 24 beds, but that one of its two wards (Hazel) has been closed due to a shortage of staff. There are 11 beds in each ward and two beds in a high-dependency unit.

This partial closure, in place for two years now, has been much publicised by politicians and in the media. The report said that of the 11 beds in the open ward (Rowan), eight of them were being used at the time of the inspection.

It said there was an adequate number of appropriately trained nursing staff in place and that ligature points were minimised. There was a multi-disciplinary team in place and there was also a multi-disciplinary therapy programme for young people on an eating disorder admission and their families.

The report said there was a reduction in restrictive strategy in place but identified issues with three cases of physical restraint they examined. In two of the cases the children were not provided with “appropriate emotional support” afterwards.

St Vincent’s

The inspectors said compliance at St Vincent’s dropped from 87% in 2022 to 78% in 2023. It said this adolescent unit had 10 beds, with six residents.

The report said the number and skill of staffing was “not sufficient” and that the positions of occupational therapist and clinical nurse specialist in self-harm were vacant. It said that care plans showed that there was “evidence of significant engagement” with children.

Remaining centres

The four other centres inspected were Teach Aisling in Castlebar, Mayo (compliance down, 97% to 88%), the Acute Psychiatric Unit in Cavan General Hospital (compliance up, 83% to 85%), the Maryborough Centre at St Fintan’s Hospital in Portlaoise (compliance up, 93% to 94%) and the O’Casey Rooms in Fairview (compliance up, 91% to 94%).