Fire safety risks among problems identified in HSE-run psychiatric units

A series of shortcomings such as fire safety risks, staff shortages and inadequate therapies for patients were found across Health Service Executive-run psychiatric units by Mental Health Commission inspectors last year.

The commission published annual inspection reports on Thursday and these noted serious issues at the psychiatric unit in Connolly Hospital, Blanchardstown, Dublin; the acute psychiatric unit 5B at University Hospital Limerick; and the Ashlin centre on the grounds of Beaumont Hospital, Dublin.

At the time of the inspection of the 42-bed acute psychiatric unit in University Hospital Limerick, “a major fire risk was identified in the form of a missing fire door”, says the report.

“This door was crucial to the approved centre’s use of separate zones in order to accommodate horizontal evacuation in the case of fire. This was rated as a critical risk.”

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The commission said individual patients’ care plans were “not satisfactory” and “there was no evidence of a comprehensive discharge summary being completed and issued to a relevant healthcare provider within 14 days for one resident”.

Ceiling damp

The centre had no occupational therapist and parts of the unit “were in a poor state of repair internally and externally” with scuff marks on internal walls and signs of damp on the ceiling.

At the 47-bed psychiatric unit in Connolly Hospital, inspectors found “significant safety concerns” including a missing leaf side door to a fire-door.

“This was first reported for repair in February 2021. However, this had not taken place by July 2021 despite repeated requests. This could impact on the [unit’s] evacuation process should an evacuation be required,” says the report.

There was no evidence of fire drills having taken place, the need for which had also been highlighted by the commission in 2020, and not all ligature points had been minimised “to the lowest practicable level”.

At the 46-bed Ashlin Centre in north Dublin, “shortages of staff restricted therapeutic opportunities” and there was no record of a fire drill in the previous year.

Commenting on the reports, inspector of mental health services Dr Susan Finnerty said it was "disappointing and unsatisfactory" that some centres were failing to "consistently improve".

Consistent failure

“It is a significant concern . . . when a centre does not make any improvement in overall compliance over a number of years,” she said.

“We would expect that the registered proprietor and management of any centre which finds itself consistently failing to improve overall compliance – as well as being in breach of one or more conditions and receiving critical and high-risk ratings – would undertake a meaningful review of its protocols and procedures and work with the MHC to help ensure that they can provide the best care possible for the people in their care.”

Commission chief executive John Farrelly said: "We acknowledge some centres are struggling to retain staff and support levels for patients, given the ongoing pandemic and the impact that this is having on our health services.

“However, there is no excuse for not having in place appropriate fire doors to protect patients, or not holding a standard fire drill once every six months, as required under law.”