Inspections find ‘poor practices’ and significant staffing problems in mental health services

Significant staffing problems in mental health service providers have been highlighted in a number of new inspection reports published on Friday.

Eight out of nine specialised centres visited by the Mental Health Commission last year were found to have staffing noncompliance issues ranging from low to critical.

Problems highlighted by inspectors included there not being enough staff employed and, in some cases, a lack of appropriate training.

In total, the inspections found two “critical-risk noncompliances” of staffing regulations, and 16 other high-risk noncompliances for staffing, individual care planning and risk management across centres in Mayo, Roscommon, Dublin, Cork, Louth, Laois and Clare.

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“There are risks associated with an inability to recruit and retain staff which results in an inappropriate skill mix to meet the needs of residents,” said inspector of mental health services Susan Finnerty.

“The provision of up-to-date training for staff to ensure the centre meets the basic and mandatory requirement for compliance is essential for the safety and wellbeing of patients and residents.”

Among the “poor practices” identified were insufficient numbers of registered psychiatric nurses, no occupational therapists in some cases, and numerous vacancies.

Staffing risk was considered critical at the adult mental health unit at Mayo University Hospital.

“The number of registered psychiatric nurses in the approved centre was not sufficient and not in line with the centre’s registration requirements to meet resident needs,” the inspector found.

While there were 39 registered nurses at the centre in December 2021, that had fallen by almost 25 per cent to 29 the following year. Immediate enforcement action was applied by the commission.

At the Cappahard Lodge facility in Ennis, Co Clare, staffing issues were deemed high-risk. While the numbers and skill mix were sufficient, some were not trained in basic life support, fire safety, the management of violence and aggression and the Mental Health Act.

Similar high-risk was found at the Drogheda Department of Psychiatry, where numbers and skills mix were not sufficient.

There was no dedicated occupational therapist and two vacant posts. There were also 10 nursing vacancies and a vacant psychologist post.

“A review of the nursing rosters evidenced that over the previous 40 day shifts, only 15 shifts had the designated complement of nursing staff,” the report noted.

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Similar issues were found at the Maryborough Centre, St Fintan’s Hospital in Portlaoise.

At the department of psychiatry in Roscommon University Hospital, not all healthcare staff were trained in basic life support, fire safety, and the management of violence and aggression.

Some training deficiencies were also found at the Carraig Mór Centre in Shanakiel, Co Cork.