Report details high risk ratings at Tipperary mental health facility

A report into a mental health facility in Tipperary has found one critical risk rating and five high risk ratings.

In a report published by the Mental Health Commission following an inspection at Haywood Lodge in Clonmel, it found that no areas of compliance were rated as excellent.

The commission published five inspection reports, on centres in Clare, Cork, Sligo, Tipperary and Dublin, which identified eight critical risk ratings and 27 areas of high risk non-compliance.  

 Commenting on the reports Dr Susan Finnerty, Inspector of Mental Health Services, said - “There are critical risks identified by the inspection reports in each of the five approved centres.   Safety is central to the provision of quality mental health services and finding eight critical risks and twenty seven high risk ratings is a matter of serious concern to the Commission. There has been repeated failure by some facilities to meet their legislative and care requirements.”

Haywood Lodge is a 40 bed single-storey building situated off the Haywood Road in Clonmel.

The approved centre consists of two units, which caters for Psychiatry of Later Life (East House), and Rehabilitation and Recovery (West House). Each unit has 20 spacious, en suite bedrooms, each facilitating direct access to a large enclosed garden.

The report said - Haywood Lodge, Co Tipperary, a 40-bed single-storey building had one critical risk rating for therapeutic services and programmes and five high risk ratings for recreational activities, general health, premises, staffing, and use of physical restraint. There has been no improvement in compliance with regulations from 2016 to 2018, averaging at 68% compliance. No areas of compliance were rated as excellent.

The numbers and skill mix of staffing were insufficient to meet resident needs. The therapeutic services and programmes provided by the approved centre did not meet the assessed needs of the residents, as documented in their individual care plans. This non-compliance was rated as critical.

No therapeutic programme was available to residents at the time of the inspection. The availability of occupational therapy and social work personnel was limited. A community occupational therapist only provided urgent seating assessments. The focus of the social work department was predominantly on assessment. The limited therapeutic services and lack of a therapeutic programme did not facilitate the restoration and maintenance of residents’ optimal levels of physical and psychological functioning.

Residents did not receive on-going medical care to address medical issues unless their condition deteriorated. In addition, adequate arrangements were not in place for these residents to access general health services and for their referral to other health services as required.

Fourteen of the twenty residents under the care of the psychiatry of later life team did not have access to recreational activities. The other six residents were able to access art and beauty groups.

Information was not provided to each resident living with dementia in an understandable form and language. The East House lacked large visual cues such as graphics and images to assist residents living with dementia in establishing their location.

The approved centre was kept in a good state of repair but it was not clean, hygienic, and free from offensive odours. There was a malodorous smell in the East House during the first day of inspection. A large, partially dried pool of urine and other stains were observed on the floor of one resident’s en suite facility. This was subsequently addressed during the inspection.

The bathroom in the East House was cluttered with clothing and wheelchairs on the first day of the inspection. The property room was also cluttered with clothing from residents who were no longer in the approved centre. These two issues were rectified during the inspection. A designated cleaning room and laundry room was in place. The approved centre did not have a dedicated therapy or examination room.

Two leather chairs in the East House sitting room were worn and in need of repair and replacement. There were only two tables in the East House dining room for ambulant residents, and a third table was missing from the room.

Following the inspection the Commission had serious concerns regarding the provision of care and treatment to the approved centre’s elderly residents. The Commission subsequently issued an immediate action notice to address these concerns and closely monitored the implementation of the service’s action plan.