Report highlights issues with Mayo mental health facilities

A mental-health facility on the grounds of Mayo University Hospital has been flagged for noncompliance with HSE guidelines.

Inadequate staff training, an unfilled psychologist’s post and an unclean toilet were among the concerns raised in a new report into An Coillín and Mayo University Hospital’s Adult Mental Health Unit.

Inspectors from the Mental Health Commission compiled reports on both facilities following visits conducted last year.

Mayo University Hospital (MUH) was found to be 94 percent compliant with HSE regulations, an increase of 5 percent on the previous year.

However, An Coillín, which is located on the same campus, recorded 82 percent compliance in 2023 – a drop from 97 percent in 2022.

The 22-bed An Coillín facility recorded high-risk non-compliance under ‘Risk Management Procedures’ and ‘Premises’ and moderate-risk non-compliance in four other areas. It was compliant with the 28 other regulations.

An Coillín concerns

THE report found that five sets of fire doors in the facility were faulty. One would not release from its magnetic lock if there were a fire while another could not be opened from the inside.

Several faults were identified with the premises, including a cracked external window sill and scuffed and marked flooring. Litter was also observed at the entrance to the facility, including cigarette ends and drink cans.

While noting that the facility ‘was generally clean, hygienic and free from offensive odours’ two toilets were described as ‘malodorous’ during the visit. It was previously found to have moderate-risk non-compliance under the premises regulations in both 2022 and 2021.

The report also raised concerns about a staff grade psychologist’s post which had been vacant since March 2022. It found ‘documentary evidence of an unmet psychology need within one resident’s individual care plan’ during the visit.

It was also noted that one individual’s care plan was not modified to reflect their changed circumstances and ‘did not identify appropriate goals for the resident, care and treatment required to meet the goals identified’.

Residents were also not told about CCTV on the premises, while the inside of one dormitory could be seen from the internal garden. However, the report did note evidence that ‘residents’ dignity and privacy were respected’.

There were 17 residents in An Coillín on the first day of inspection on September 19, 2023, 16 of whom had been there for longer than six months.

Actions taken

ATTEMPTS have been made to fill the vacant psychologist’s post, while the unmet psychological need of one resident has since been met with a neuropsychological assessment.

A care plan identified in the report was reviewed and updated to reflect appropriate goals and treatment requirements.

All fire doors at the facility have been serviced and repaired to ensure they close and release properly. The facility’s entrance and toilets are being regularly cleaned while improved ventilation is to be installed in the toilets.

Signs have also been placed identifying the use of CCTV at the facility.

MUH

MEANWHILE, MUH Adult Mental Health Unit was found to have high-risk non-compliance with its premises and moderate-risk non-compliance in staffing regulations.

Describing the unit as ‘not kept in a good state of repair externally and internally’ the report identified six areas where the premises was non-compliant.

It observed dirty window sills, paving slabs and walls in the courtyard area, while peeling paint, worn and torn chairs, damaged flooring and exposed wiring and plumbing pipes were also identified in particular areas. 

The report found that not all staff had received adequate training in basic life support, fire safety and the management of violence and aggression.

There were 24 residents at the 32-bed facility when it was inspected between July 25 and 28.

Various corrective actions have been identified, and these must be implemented by the next audit of the premises in June 2024.

In 2023, the Mental Health Commission identified a ‘critical risk’ at the facility due to low staffing levels.

The latest report stated: “The numbers and skill mix of staffing in the approved centre was sufficient to meet resident needs. An appropriately qualified staff member was on duty at all times.”

Director of Regulation at the Mental Health Commission, Gary Kiernan described the high-risk non-compliances identified with the regulations on privacy, premises and risk management as ‘particularly concerning as they impact on the safety, dignity and human rights of patients’.