THE health watchdog has been asked to conduct an investigation into care at a Spanish Point residential facility, after several deficiencies were revealed in a recent inspection conducted by the Mental Health Commission.
Mental health support group, Support Link, has asked HIQA to conduct a review into the Cois Mara facility which, at the time of inspection on November 27, 2013, had 14 residents ranging in age from 52 to 77.
Support Link highlighted the findings of the report, including a lack of specialised nursing staff, no occupational therapist, physical therapist or proper therapeutic intervention.
The group claimed it was “disgraceful” that residents were paying €134 weekly, despite the absence of a multi-disciplinary team and other basic services. It alleged the HSE is breaching the Mental Health Act by keeping it open as an ‘unapproved’ centre since 2002.
Apart from the renovation of the accommodation, such as extending the activities room and shower rooms, the report did not outline any major improvement plans in other areas.
It did acknowledge that bedrooms were comfortable and many were highly personalised. The report also noted that many of the residents were in the care of the mental health services for a long time and most had transferred from Our Lady’s Hospital in Ennis.
It revealed only one nurse at the facility had training in intellectual disability, despite the fact that all residents had this disability, ranging in severity from mild to profound.
The Mental Health Commission recommend that residents with an intellectual disability should be under the care of a specialised mental health disability team. It also recommends all nurses employed to provide care for residents with an intellectual disability should receive training in this area of expertise.
Cois Mara is owned by the HSE and residents each paid rent of €134 weekly to cover requirements. All residents’ pensions were collected by a clinical nurse manager. A money order was then drawn to cover rent and this was lodged in the HSE rent account. According to the report, the balance of an individual’s money was divided in part for lodgement to the resident’s own post office account, while the remainder was kept for the individual’s immediate use.
All residents contributed €20 weekly towards a “comfort” fund, which was used for the benefit of all clients.
“Nurses provided some therapeutic activities as time permitted. An art therapist attended once each week and pet assisted therapy took place weekly. No resident attended a therapeutic activity outside the residence.
“The consultant visited about every two or three months but residents did not have individual multi-disciplinary care plans and no member of the team visited, except the consultant psychiatrist.
“A review of five clinical files indicated that two of these residents had not been reviewed by any member of the mental health team in 2013 to date and two further residents had not been reviewed since March 2013.
“While residents had care plans, these were all nursing care plans and there was no evidence of multi-disciplinary team input, except for one assessment by an occupational therapist for a resident who required a specialised chair,” the report stated.
The Mid-West HSE had not responded to a number of Clare Champion queries at a time of going to press.