Commission report finds deficiencies at Cork mental health facility

An annual review into a Cork mental health facility found difficulties accessing healthcare, dirt and disrepair and a lack of compliance with the rules around restraining residents.

St Catherine’s Ward, located on the grounds of St Finbarr’s Hospital was marked 73% compliant in the recent review by the Mental Health Commission - a 5.2% decrease in compliance from 2023.

However, the centre was marked not compliant in the areas of Food and Nutrition, Individual Care Plans, General Health, Premises, Medication, Maintenance of Records, Risk Management and Mechanical Restraint.

The centre was found to not have adequate arrangements in place for resident access to dietetics, physiotherapy and occupational therapy (OT) assessments.

Unmet needs

This meant a number of residents had unmet needs for these services; nine residents were identified as requiring a dietetic referral, one had been referred to the dietitian in March 2024 and the referral to primary care was refused.

Residents were also awaiting a physiotherapy and an OT referral, and the centre was awaiting responses at the time of the inspection.

The report noted that some areas of good practice were observed, saying: “While there was an increase in the total number of non-compliance found, the service provider’s efforts in working towards compliance and quality improvement was evident and encouraging.”

However, the inspector wrote the centre itself “was not clean”, noting that “dust and cobwebs were evident in some bedrooms and the smoking area of the garden. Dirt was evident on disposable privacy curtains, bedroom walls were stained, and chairs located in the evening lounge were stained and dusty.”

Not all hazards in the approved centre had been minimised, and ligature points identified on both this and last year’s inspection were not sufficiently minimised.

The centre in general “was not kept in a good state of repair inside and outside,” with cracked or peeling paint, broken radiator covers in bedrooms, damaged flooring, and skirting boards.

Missing information

Not all records were in good order, and residents’ medical records and individual care plans were missing information. The centre was issued a high-risk non-compliance mark in the area of mechanical restraint, defined as “the use of devices or bodily garments for the purpose of preventing or limiting the free movement of a person’s body”.

The clinical files of two individuals who had been restrained for enduring risk by mechanical means were inspected, and inspectors found no documentary evidence that mechanical restraint was only used when less restrictive alternatives were not deemed suitable, or information on attempts to reduce or eliminate the use of restraint.

The clinical files did not contain a record that specified the duration of the restraint, and the oversight committee did not undertake a review to determine the appropriateness of the practice.

The proprietor also did not notify the Mental Health Commission about the use of mechanical restraint within the timeframes set.

Remedial works completed

The service provider noted that all residents have now been assessed as appropriate by dieticians and therapists, and remedial works have been completed, while a plan of future works has been identified and a funding request has been submitted.

Meetings on mechanical restraint have been held, and restrictive practices eliminated.

A new audit tool has also been introduced to monitor compliance with the code of practice. Cork Kerry Community Healthcare told The Echo: “We welcome the publication of the Mental Health Commission annual report into St Catherine’s Ward on the grounds of the St Finbarr’s Health Campus.

“We acknowledge the areas of non-compliance identified during the annual inspection, and are working with the commission to address these areas under the corrective and preventative actions process.

“Works to address all areas of non-compliance have been undertaken, some have been completed — including ensuring compliance with codes of practice — and some works in relation to premises are in the final stage of completion.”