A new high-observation area in the psychiatric department of Galway University Hospital has not opened due to a lack of staff, according to a report. Inspectors noted the area was “used by the psychology department as office space”.
The unannounced inspection into psychiatric facilities was carried out by the Mental Health Commission on March 11th and 12th. At that time, there were 41 residents, with an additional six residents on leave.
The report found that while physical restraint was used infrequently, security personnel “occasionally assisted” in the physical restraint of patients. Where physical restraint was used, the principle of least restrictive practice and resident safety applied.
“As security personnel were not aware of, and did not have access to, the resident’s individual care plan, they could not be compliant with section 6.1 of the code of practice on the use of physical restraint.”
The service had an up-to-date policy on the use of physical restraint which included reference to the mandatory nature of training in prevention and management of aggression and violence.
The report found several instances where doctors did not use their Medical Council numbers when writing prescriptions, which is a legal requirement. The service had an up-to-date policy on ordering, storing, prescribing and administering medicines.
Although the approved centre had improved in relation to article 15 of the regulations, the service was in breach of the condition imposed by the Mental Health Commission on Individual Care. Each resident had an individual care plan but these did not fully comply with regulations.
Vision for Change, the report on mental health policy published in 2006, recommends that mental health service users should have an individual care plan to encompass psychological, social and biological treatments.
All residents whose clinical files were inspected had an individual care plan and 23 of the plans were inspected. The report found that while most of the plans were compliant, others were “vague and non-specific.”
An activities programme was delivered by one nurse, but when this nurse was required on general duties, activities were cancelled. Owing to leave, there was a lack of psychologists on three teams and one sector team was without an occupational therapist due to extended leave.
No occupational therapist was assigned to the approved centre and there was no occupational therapy manager for the Galway catchment area at the time of the report.