AN INSPECTION by the Mental Health Commission found that the acute mental health unit at University Hospital Limerick was non-compliant in eleven areas that were subject to assessment.
The inspection of Unit 5B last June found it to be critically non-compliant with regulations in three areas and non-compliant in eight more.
Inspectors found the unit to be “kept in a state of disrepair inside and outside”. This was deemed to be a critical non-compliance which was also the case with individual care plans, therapeutic services and programmes.
Among the faults found on inspection were a glass privacy panel on a door in the High Observation Unit that had been broken since July 2021 (when the last inspection was conducted), a leaking toilet with a pool of water on the floor, and overflowing showers.
Beds, wardrobes, and lockers were reported as being in disrepair, while paint was peeling in some areas and a ceiling repair had not been repainted at all.
Outside the ward, the paving stones were “very dirty and badly stained, a stone bench was very dirty and badly stained. An area above the bench had graffiti on the wall. The walls around the garden were very dirty, some had cobwebs and chipped paint and others were stained. One garden bed had dead plants.”
“There was no programme of general maintenance, decorative maintenance, cleaning, decontamination, and repair of assistive equipment. ”
Outside of maintenance, the inspectors’ report found that “residents’ records were not maintained in a secure and good order. Loose pages were evident throughout five clinical files compromising a risk to residents right to confidentiality.”
“There was no documented evidence to indicate that the responsible consultant psychiatrist had assessed an involuntary patient’s capacity to consent to receive treatment. This patient was treated as being unable to consent to agreeing to receiving further treatment.
The report continued that “details of the discussion with the patient, in relation to the effects of the medications and their risks and benefits were not documented”.
At the time the inspection took place there were 11 people who were being detained under legislation and two wards of court among the 35 in-patients.
The report also found that “the High Observation unit which accommodated eight beds was operational. There had been plans to renovate the seclusion room and the surrounding area in order to create a low stimulus environment but no such work had been done.”
It stated that there had been a significant decrease in compliance overall from 85 per cent in 2021 to 69 per cent in 2022.
Reports from 2018, 2019, and 2020 showed there were no critical non-compliances with regulations and in 2021 there was just one.
As a result of the critical non-compliances identified last June, the MHC commenced escalation and enforcement actions. It requested that immediate actions be taken by management and that a regulatory compliance meeting take place.
Following that meeting, a Corrective and Preventive Action Plan was agreed and monitoring of the progress to implement the plan is ongoing.
