Mental health facility criticised after failing to comply with regulations

A mental health facility’s care of residents has been described as “simply not acceptable” after it failed to heed a warning about complying with safety regulations.

St Stephen's Hospital in Cork City was inspected by the Mental Health Commission in August last year.

There are 87 beds in total in the hospital which is located north of Cork City. The inspections relate to Unit 3 of the facility which is used for the care and treatment of male residents with severe and enduring mental illness.

Inspectors found units were sparsely decorated, with insufficient furnishings in the sitting rooms, lack of personal items and wardrobes that were too small to store clothes.

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Residents displayed institutionalised behaviour, such as “pacing and congregating outside the nurse’s office and on the corridor”.

Inspectors noted an atmosphere of “tension and irritability” among the residents coupled with an absence of staff on the ground.

While there were activities such as walking, watching videos and gardening, there was no evidence of individually tailored activities.

Commission inspectors found eight non-compliances on their initial inspection.

The person who was responsible for risk management was not known to all staff, two fire doors did not operate, windows needed replacing and ligature points remained in the centre.

When inspectors returned 10 weeks later they found the ligature points had not been minimised and the locked fire doors had not been dealt with.

The fire doors in the main corridor were not closing properly rendering them non-functioning as fire doors.

The MHC subsequently referred its fire safety concerns to the chief fire officer in Cork City Council.

Commission inspectors found on the second inspection there was an improvement in the governing arrangements, but the centre received a high-risk non-compliance with the regulation on therapeutic services and programmes.

Appropriate supports were not in place to help residents with the activities of daily living and there was also no improvement in the minimal occupational therapy programme or input in place.

Subsequent monitoring has shown improvements in the availability and quality of occupational therapy inputs, inspectors concluded.

However, Inspector of Mental Health Services Dr Susan Finnerty said it was "deeply worrying" that they had to return a second time to ensure that the centre complied with regulations.

“ As an example, we identified a serious issue with fire doors at the annual inspection, which rendered them non-functioning. At the second focused inspection almost 12 weeks later, this issue had still not been resolved. This is simply not acceptable,” she said.

Mental Health Commission chief executive John Farrelly said every inpatient service in the country "knows only too well what they need to do to attain high standards".

When serious issues are pointed out, he added, “the very least we would expect is that the service in question make immediate efforts to assure us that these issues are going to be addressed in the near future.

“The last thing we want is to return to a centre three months later and find that no progress has been made.

“When that happens, we are left with no option but to consider all options at our disposal to ensure that patients and residents receive an appropriate level of care and treatment.”