The process of a €4 million building programme to completely renovate and extend Carraig Mór psychiatric facility in Cork is set to commence as issues between the HSE and the governing Mental Health Commission (MHC) are resolved.
A fortnight ago the issues between the HSE and MHC were raised at Cork District Court as the MHC said that Carraig Mór, which caters for 18 vulnerable patients, was “not fit for purpose”.
The MHC has sought to enforce regulations on the HSE in relation to the facility. It was estimated that it could have taken two days of evidence and submissions from both sides at a specially fixed case at Cork District Court.
However, Catherine Kelleher, solicitor for the Health Service Executive, told Judge Marian O’Leary that the MHC had just written to the HSE vacating the original condition and replacing it with one which would now see the HSE commence the process for an estimated €4 million building programme at Carraig Mór, during which time bed numbers would be reduced at the facility.
Planning permission will first have to be sought for the development.
On the last occasion in court, Donal O’Sullivan, barrister for the MHC, said: “There is a huge degree of urgency to it. Unfortunately, the physical reality is that my client carries out inspections and there is serious concern about the physical building.
“I am not saying the building is falling down. But what it is used for is not appropriate and suitable… We are very concerned about the safety of people in the facility because of an incident in February,” Mr O’Sullivan said.
Ms Kelleher, solicitor for the HSE, said there were sensitive issues which should not be ventilated at a preliminary hearing.
Friday, May 14th, 2021: The Mental Health Commission (MHC) believes strongly that an agreement it reached with the Health Service Executive (HSE) this morning at Cork City District Court regarding a mental health unit in the same county will support the safety, dignity and recovery of the centre’s residents.
Following a process of regulatory escalation initiated by the MHC, the MHC and the HSE agreed that the number of available beds at Carraig Mór - a HSE-run psychiatric intensive care unit in Shanakiel on the outskirts of Cork City - would be reduced from 18 to 10 immediately, with further bed reductions in due course, to improve privacy and dignity issues for residents and while critical and necessary construction works to upgrade the unit are ongoing.
The centre was recently the subject of a focused inspection by the Inspector of Mental Health Services following a serious incident at the unit earlier this year. The centre had also received critical non-compliances in its 2019 and 2020 annual inspections reports under the regulations for privacy and premises. The centre had also been re-registered with five conditions in early 2020, three of which relate to premises.
Despite these and other regulatory concerns having been raised repeatedly by the MHC through inspection reports and in correspondence over the past number of years, the HSE failed to provide the necessary assurances up to recently. As a result, the MHC had been seeking to impose a condition that would have prevented the centre from admitting new patients until these assurances were provided.
Where service providers cannot provide assurances and demonstrate that residents are safe, the MHC has a legislative mandate to act in the interests of residents. In this case, the MHC has taken escalation and enforcement steps and, as a result, the HSE has committed to taking immediate steps to improve and update the service.
This morning, the HSE has agreed to limit the number of residents at the centre until such time as all proposed work, costing in excess of €4 million, has been completed.
It is expected that the full build will transform the centre from an outdated and unsuitable dormitory-style accommodation into a unit that will deliver 18 modern en suite single rooms with seclusion facilities, communal space and all ancillary services provided. It is also expected that the renovations will provide safer facilities for the residents.
“Today’s outcome is a positive development for the residents of Carraig Mór, the people of Cork, and our mental health services generally,” said the Chief Executive of the Mental Health Commission, John Farrelly.
“The reality with this centre is that the physical premises were simply not fit for purpose. Our inspection reports had repeatedly shown that residents had limited access to personal space, property storage or privacy in the dormitories; that the dining room and sitting rooms were too small, and that there were safety issues throughout the centre.
“It is essential that people who are accessing mental health services are afforded an adequate amount of space and privacy so they can recover from their illness as quickly as possible. Keeping people confined in tight spaces for long periods of time is not reflective of a modern mental health service.
“I am pleased that the HSE has agreed to reduce the number of beds in Carraig Mór to help ensure that all residents receive the care and protection they require while the construction works are ongoing. The fact that all residents will be accommodated in single en suite bedrooms once the work is complete is positive.
“I would like to think that the accelerated capital programme process which the HSE put in place to upgrade this facility could be used to rehabilitate similar old-style, dormitory type units through the rest of Cork and the country.”