Cork mental health unit found to be in ‘poor state of repair’

Residents of a Cork mental health unit felt “claustrophobic” in a facility where there was no outdoor space and they were visible on CCTV to non-clinical staff without their knowledge, according to a new Mental Health Commission report.

St Michael’s Unit, a 50-bed facility on the first floor of the Mercy University Hospital campus on the south side of Cork city, achieved 72% compliance.

This marked a 3% increase from 2022, however the center was found to be in breach of two of its four registration conditions and non-compliant with nine regulations.

Three were rated critical: privacy, facilities and risk management, all areas in which the center had failed every year since 2018.

The facilities at St Michael’s were “in poor structural and decorative condition”, with marked and stained floors, graffiti on a bedroom wall, peeling paint in bedrooms, smelly rooms, windows that did not open and poorly ventilated shower rooms: two of these with mold on the ceilings.

“A resident stated that the location was an old building, that the showers broke repeatedly, and that the location was claustrophobic,” MHC wrote.

Residents lacked indoor and outdoor personal space, and relaxation and recreation areas were described as “confined.”

They did not have access to an outdoor space on site, and a greenhouse overlooking the river was closed and could only be accessed under the supervision of nursing staff.

Ongoing non-compliance risk not adequately managed

The center submitted a governance plan outlining actions to address non-compliance over the past five years and significant works were carried out, but “despite these efforts, the service had not adequately managed the risk of ongoing non-compliance”.

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One bathroom did not have a working lock, not all rooms had curtains, and in two cases, residents were unable to close the privacy screens on the windows inside the doors from the inside.

The two-bed dorms did not offer enough space to facilitate residents’ privacy and dignity.

There was not enough space to carry out medical checks in a way that took into account the dignity of the residents, and the medication room was also visible to passersby.

A CCTV system had been installed since the last inspection, but as not all CCTV cameras had signs indicating they were in place, the approved facility did not fully disclose the existence and use of CCTV to residents.

CCTV cameras were visible to non-clinical security staff as well as healthcare professionals responsible for the wellbeing of residents.

Other issues St Michael’s failed to comply with included the Code of Practice on physical restraint, despite no issues being identified in three restraint cases examined – two lasted less than 10 minutes and one between 10 and 20.

Despite proper management, the center failed due to a lack of staff training in areas including human rights, legal principles, and monitoring people’s safety during and after restraint.

Training for all staff in sexual safety, fire safety, violence and aggression management, and basic life support had not been completed.

Additionally, hygiene was not always maintained to meet food safety requirements and there were problems with fire doors and fire drills, the report said.

Although measures had been taken since the inspection, including additional signage for CCTV cameras and ensuring only clinical staff could see them, the facility had not provided plans to address the most serious issues.

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The report notes that “the approved facility did not provide acceptable corrective and preventable action plans within the required time frame” for privacy areas or facilities.

“The approved facility will be required to provide acceptable corrective and preventable action plans and the commission will follow up on the same and escalate accordingly.”

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