The Clare Champion Clare news, sport, entertainment and local notes
The HSE has issued a formal directive banning over-occupancy at Ennis Acute Psychiatric Unit (APU) after an audit found a male patient was sleeping in a corridor space, which was abutted by two wards.
This new instruction, which was issued recently, also ends the practice of using an activity room and non-accommodation areas for bedroom space once the maximum bed occupancy for the unit of 39 is reached.
Serious overcrowding issues were identified in a report published recently by the Mental Health Commission after a re-inspection of the APU, based at Ennis hospital, on October 23, last.
The report found that residents of the adjacent two bedrooms were required to walk past the bed containing the male patient when leaving and entering the ward, providing him with no privacy and no facility to secure personal belongings.
“At the time of inspection, another resident was rummaging through these personal belongings, which were laid out on this bed in the corridor. Staff reported that the activity room continued to be used on occasion to provide sleeping accommodation.
“While this was now being used less frequently and for a single resident only, it was an inappropriate space and necessitated the bed and personal belongings being shunted in and out daily when the room was required for activities,” the report stated.
“Staff reported the APU continued to be overcrowded most of the time, with the average bed occupancy running at 113% capacity. The practice of transferring residents to Unit 5B in Limerick Regional Hospital due to overcrowding, continued. This was not in the best interests of residents.
“The sector teams were not adequately resourced and health and social care professionals were stretched. This limited the range of therapeutic services and programmes available to in-patients,” the report noted.
The re-inspection follows a previous unannounced inspection on March 21, 2012, which noted the EPU was overcrowded on 30 occasions between January and April, 2012, to the extent that residents were required to sleep in an activities therapy room.
The report also noted that the 2011 Inspection and Re-inspection reports made 10 recommendations, six of which had not been acted upon.
When contacted by The Clare Champion for a comment on the report, Clare PNA representative, Denis Meehan said the practice of inappropriate accommodation was no longer an issue following a direction from the inspector and HSE management.
Mr Meehan explained once 38 beds were full in the unit, patients seeking admission had to be sent to Limerick in the first instance or Galway if Limerick was full.
The HSE acknowledged inspection reports had noted where patients had individual care plans and where input was provided by health and social care professionals, the assessments and interventions were of a high standard.
However, where full multi-disciplinary input was not provided, the care plans had input from nursing and medical staff. Inspection reports require consideration by management and active management of the recommendations to ensure compliance into the future.
In relation to therapeutic programmes and interventions being linked to individual care plans, the inspection reports of the past three years noted substantial compliance.
The HSE stressed the full range of programmes are constantly reviewed to meet patient’s needs. Greater multi-disciplinary team inputs into individual care plans continue to be developed and arrangements are in place for health and social care staff to attend multi-disciplinary team review meetings when required.
Liaison with day hospitals and the community mental health teams is also being improved.
A draft policy on the management of persons with Mental Health Intellectual Disability (MHID) has been prepared in consultation with various stakeholders for it is now ready for sign off by the Regional CPPPG Management Committee at its next meeting.
A schedule of training has been prepared for 2013 by the Area Director of Nursing in consultation with line managers and heads of disciplines, which includes training in seclusion and physical restraint and is being rolled out as part of the overall schedule of mandatory training across the Mid-West MHS.
