Clean bill of health for mental health facility

The Creagh Suite was noted as having a number of “best practice” initiatives in place when inspectors called – reaching a compliance with regulations level of 97%, a significant improvement on 73% in 2018.

The 14-bed unit had 14 compliance regulations that were rated “excellent”, including the provision of individual care plans; the provision of information and regulation; and privacy.

The report remarks: “The enthusiasm and commitment to delivering a quality service was evident”.

At the time of inspection, just nine of the unit’s 14 beds were filled. The centre is described as “a long-stay, continuing-care facility for residents living with dementia and experiencing psychological and behavioral symptoms of that illness”.

There was only one area where Creagh was sub-standard and that was staffing – with some staff not trained in areas they should have been, including fire safety; basic life support; management of violence and aggression; or in the mandatory training in Mental Health Act 2001.

However, the inspection did find that “mechanical restraint” was only used where a resident posed an enduring risk of harm to themselves or to others, or to address a clinical need.

“It was only used when less restrictive alternatives were not suitable. Its use was compliant with the rules governing the use of seclusion and mechanical restraint”.

The risk level associated with the rate of non-compliance on staffing had been identified as “moderate” in 2017 and 2018, but had improved to “low” this year.

Therapeutic services and programmes provided by the service were said to be “evidence-based”, reflective of good practice guidelines and “met and assessed the needs of residents, as documented in the residents’ individual care plan”.

“Activities provided included hand massage; dance therapy; art therapy; life story work; one-to-one social work; psychology; occupational therapy; medical and nursing. Chiropody; podiatry; speech and language; therapy; and dietetics were also provided for. A record was maintained of participation, engagement and outcomes achieved in therapeutic services or programmes, within residents’ clinical files.”

It was stated that accommodation for residents comprised of two three-bed rooms; two double rooms and four single rooms.

“Resident bedrooms were personalised, and they were clean and bright. There was a spacious and well-equipped dining room which was also used for recreational and therapy activities. There was a multi-sensory room for residents and a conservatory-style day room opposite the dining room. Residents in the approved centre had access to a secure, dementia-friendly garden.”

The inspection report for St Brigid’s Ballinasloe was published alongside those of Lakeview Unit in Naas, Co Kildare, and the mental health unit is St Brigid’s Hospital in Ardee, Co Louth – both of which had registered a high volume of non-compliance.

Inspectors visited Creagh Unit over a three day period, using a combination of document review, observation of practices and interview to access compliance with the regulations.

They endeavour to speak to residents to find out about their experience; talk with staff and management to find out how they plan, deliver and monitor the care and support services that are provided to people living in the centre; observe daily practice to ensure what they are being told is happening in practice; and review documents to see if appropriate records are being kept in line with the standards they are being told exist.

Commenting on the findings, Chief Executive of the Mental Health Commission John Farrelly said this batch of inspections had identified inconsistencies across the country in the provision of mental health services.

“The contrast between a centre with 97% compliance in Galway and less than satisfactory findings in Louth and Kildare is stark.

“The Commission’s evidence is that the mental health service is inconsistent across the county despite being run by the same provider [the HSE]. This indicates a deficit in the governance and management of our mental health services,” said Mr Farrelly.

The management of Creagh Unit will now have to provide a corrective and preventative action plan to address concerns raised over staff training.