ReportOfTheInspector... - Lenus, The Irish Health Repository

PloIRIIIJ had • IepJ ripl IIIICkr elUllu\i IcpbllOll 10 be ........re
of the.r n&hu. NOIICQ oecdcd 10 be dispbo~ promi... IILIy ill lhie
admiIIion and Other wards lIIfonnull pal_IS 01 IIIoN IepI ri&:hJ:a.
Whilst the servlot appean!d to deal IGeqllalely WIth CGmpWabl and •
10& .... kept of al. wmpIaoalJ and IICIioII takCIl. lhiere . . . . IIftd for •
.nIICII ~ltIlS procedure wIudI ..... va.llbIe and k _ to all staff
membcn. 'The ma. . .melll tcam met ~kly and tllere .... III _11&1
review 01 lhe leMa: and ... annll&l report .... produc:ecL 'The ~
c;:edure book 1e11ltllOUI c:k., JWdaIIoe on proc:edurea was ,n tile proc:cII
01 bc11ll updated I' tbe time oIinspection. A key woltcr, pnmary nurs-;111 or tClm alloo;alilloll)"lem needed to be COIIIodcrcd for _
... rds
of Ihis
Ind IU ~tafr necded '0 be ellCOllrap to wear ... idcll"r;·
tatlon badge.
Jc:mce
fllciJjl~ fOf Eel were Mlisfll;lory as .... the COIIX1II form in
ill tIlls lema:. 'The Royal CoIk., 01 r.ydIiItnsU' Guidclona wom:
displayed ptOmltlCnlly '" !be tteatmc:nl _
1lIere ..... 110 wnttcll
IIIformllUon fOf ~tienll and reiltiva 011 ECT and thiI nccdcd to be
OOIISidcrtd. A p"'-ECT nllBllll doecI< card I)'IICIII alto nccdcd 10 be
iruroduotd. There .... llIftd for. wntlea 1Cd_ pobcJ In 1l1li_.
>ice: and tbe method of rec:ordilll and Aon. 1nI0IlM _ _ ~
oIlCclusion nce6ed upcblUII- A ~ book .-..Id be kqM In cad!
are. Md. nu.notll now cban should be introduc:ed..
The
use
llIere Will 110 wrillen admdlion poIio:y I ... illoble iIIlhe ~ area.
IlIvoIunllry admissionl forms were 5ipcd by tbe (OI'dUlllnt plyo::h.. I""
Ind NCHOI woo had been approved by the CEO, There were cIaor
disdoa.p: lui(leijnet Iv.ibbk and known 10 aU Aa", AITIIIfC'II>CIIII for
pal~nlJ' Ihcr-eare _
IUlderstood by pilticnlJ &Dd .nuea (\OWn if
~. On dlIdw." e a pIIIOCnl .... "vcn' thon note indiat"..,
the medicalion prclCribcd. IIIe nUl appoin\lDC1II I' cM ClOit"fOltoclIlI
dcpartaacnl &lid ,he tclcpho:'IIac oumtac. 01 . . IIoIpttaL A f..... discfluJC' report .... tell''''tIua twO...eh to till pal"""" paenI prac-
titioner
A WTlllcn pob;y fOf the ordenna. pnKflbiDa- MOnIIC' aDd admiaist..lioa 01 aD IIICdoo8cs .... bem&; IIptiItcd at llIe . . . 01 >Mped1Oll.
The 510np are. and \IllIIIfIOI'1 qslCIII bcl_..;II .... Mtidaaory,
The 00II 01 lhe pharmacy III tiullCrvit'e .... £19O.OOl
"The" Wfll •
reh.boblllioa policy willl weekly MnodlWd remws in
Wlrd 10. The money "....... _nl ')'IIem within the hotpilll wu "lisrK lory bul • W,;UCII money IIWIIP'menl policy ihould bI: produced.
on
An intcmlll)'ltcm 01. rdclTllto e.,h Ocpllnmcnt WII in Opemiool till
it would be ptcfcrlbIe Lf III ",1~tJ bad In opportunily 10 lcIL... die
LWIJ Md I\lend mcllUlllflll ImlWlJ/Workl\c:",," lCIi",tiet,
times in 11IiI ICrvicc ..:n Ilexiblc.. Whibt OII-aotlll IIId wblual:ill
imprcwcmenIJ had Ilkcn pIIoe in IhlS hotpLIai in lbe 1111 nlllllbn 01
yel", lhen wu I need 10 OOIIlinuc 10 (00:\II 19K1folly OD ISpectI 01
]MIlkntl' privaey and di"my. The II5e 01 CllIUJ..Ilt or romplftmco .....
Ilion of dormiloria,lIbelloed penon.aJ dothio" elfy IIOCftt 10 pe"'"
dodun, and 1'1'.--.1 poacaions in LDdiVKIual kd.bIe JlOnLI" IpICt
and loikl nqui$iln and equipmenl 10 wWl 1'1'l"I0II11 clothilllllClCdild
funher imp~nt in IOfIIe arcu.
Y'"
The quality of food Iv.il.ble to pltienll WaI IItilfactory, .....11 wm=
provided.1 MId.Uy ICCO.'pllLble limes Ind ana.:b WeT<! .vaillble ClUINde
normal me.1 timet.. Uowc:vcr. mcnLlll needed 10 be formaUy ~
penodically. The physical envirunrroent of din,"", .nu had improwlId
c:olllidcrlbly ovn the ye,,, bul on-soina impnwemenl _ tequiml.
tome .re.... Then ...., oct-JOina uainina of catenna ... There welt
dct;ipllted MnOkiIll Md no-smotina arealllld ippfOPIiIte Mp"""
01 dftlpated .rc.... SmoIun, in food prqlfIrllion Md dutilll arca _
«.
not
allowed.
The .rvlce .... ororkin, on the pt"Od\lC'lioa of • drift WOII ... JIldy
IUlement for the III»potalllld local lIlIitJ. A Nfety c:onlfTullCe bid IlOl
yel b«n 'ppoInted.nd I~re WU no IIfely IfIUment IvailIble 1ocaIIr·
A Iw.Ird idenuratioa ludit bad 001 yet ' Iken place. There ... 110
wTillcn poIiL:y on manual handling but Ihis WIll be;na disnlJled. s.Jlaff bad b«n trained in lifti", techniqUCI.nd I record WII kepi 01.
trainin, proatlmmes Ind the names oItoo.c. who luendcd. There_
• fin commiucc and I lot: wu kept of III minor OUlbrew of
the 1<:I)on t.ken. llIcre WIll also. loa 01 fire prevention Ifainin, Q)UI1CI
for Ifltf Ind fire drills ..-en held in the hotpitll cvery SIHLrday. It.
dear ellCray manacctrM:nl system <:lpCrltcd in the hosPtaL It. 101 01
matntenanc-c wort wIIicb needed 10 be carried out ..... also kept. TIle
maintclWICIl PflII;I"IDImC ..... alto reviewed ~arty.II ... ..,.
aested that ~ dcanin& miJhlllc added 10 th;'~.
fire"
--..n,
AOI;aI 10 lUpporl dlJlical services in SI Bripd'l UotpLtll .... ytJsfll;-Ircl ",(re adtqUl~
COIII-LIhlntJ NW'U rdcfl1llleucf$to dcdde on the urrnI:Y of~'
mcnlllnd who would sec the patient. Lcuef$ to the rcfel""rli .flClltlleftt OUtlmrnc:dialely following CO<ISuJlltion. There WIll no IppGUlt~
.,slem In Operllion. Two conwltanlS in thia servic:e wc", CfIPICd ..
to<)' Ind out'pIIl1cnl facilit;es in lbe catchment
~nerll pno;titioncB kne .. to "boa! to du'CC,
UQWf:vcr. lhierc was no record of donIoI:i.Iiary ..... tllll bf 1IICda_
c;aI ... ff and this needed to be COIIIICkml. The COIIJIlltant on call proridc!d • IiaoIon Kmte ..,tb tM Dtarby PoruuncWa Gt.ncnI HOIptII
and the speed of lapome was IlIUIIItdiIIte. t~r. 110 record ..., kept
""iaison ronsuJtllioDlllId of !he outeoma.
domiciliary vUitin&.nd
~1.IaU.
Tbc TUIlIIlMor .... ~Ied bf the Royal CoIIep: of hydliltllSU
for InI'n,nl- 1be hoIpIw had Ipproval from An Bard AItI'lllalJ for the
KOOndmc-nl of &encrll lllined nunes to the se""," .. pari of Uw,r IoU:
_It pI)'I:hlatric tnlinillJ module. Tbcn: .. ere no .cll<knt plydliItric:
nllQCI in this IoU'\l1tt. On.pllJ in-scmoe tllmi", lor nU"'1DI and cater_
In, Italf "'11 carried OUI and a record was kfpl 01 III lra.nin&
rotIrKI
and those IIIho luenckd.
There WIt In empllasis on edllClWIJ the public on _ntll Mallh malten and the Mental Heallll AuoOatioa. GROW and AWARE Oftrc
lICt;vc in the c:atdl_nt Hea. InConnotioG ..1udI_ • .-...Lt. . 011 IoctI
Krvkct: 10 ~tinllf needed to be ""proved.
n.e semce .... no! involved in racwdI to eVllllate ICfVICI! dfeCl,ve _
_
but this was beina o:miIItml- TbeK ..... ellaict --.ncc ill
the Western Health Board IrU and memben from tlultemte parudpiled '" -WIJ' or tbc _I~ the lis' meeh'IJ of wIIidt .... m
~plcmber 1992.
flECOMMENOAll0NS
I.
Dilk>&ue to commence with the I lIthoritlts In l'ort.uDCllII t lolpiw
to negotilte I n KIIte admission liMIt 01 not _
tlwt Jwcnly five
beds for the KIIle plydliItric: ia.,.lient NeOI or EM! Galway
pllirnlJ.
2. The plans in rcillioa to I"ticftlf ""Ill I mHIW bandicap and tbc
elderly in St B,;pI'J" 8&IlinWoe. lDdudlllJ cle-deupltIOIl, to be
~ ""tll III JOOIIIIS pauibk.
3.
Ward amalp/Mtion and cIoAreIlII outhDed In tbc pUn for Se B,;,od'. Iioapilal B.lhn..... to be lIUl.llted Ill . . . III pGIIible.
4.
H",,~uppon acoommocbt)OCl to be nude available III the EMI Gal.... y catch....:nt aKI in onkr to make the rcubibtllioa oIl"locnu
ncc:din& Ihis <lep-cc of lIIpPOrt '" ,he commun'ty .-.bIe.
179
~nc:e in Alhlc:alue.
III IlIe C'(MInty.
Approlllmlel)' fifty ..tienll wen: In f~lcr can:
IN.rATIENTSERVICES
AI !he "me o{.~ le>'\"ntecn "hca" wt:re be .... cared for iD
lbc llurty bed KYle unil .1 RI*:OIIImOII Gclxrll HoIpilll. A further
ICVClIly four JlIloenl5. of whom twenty four were Iona....,. pryduIt~
.nd the rem.inder were aerialnc palients..."re cared tor in SI i'lli'd',
Ilospolal, Castlc:re., In .ddilion, ibcn: Mre Iih«II IN'ticnll In • hi&b.
,uppon community rcsidence in the JI'OUndI of SI I'1olritk', .. hlch _
",p.ded u belll3 pan of IIIe hoIpIlal Ind ,n cRtct ~ed • • Ihird
q",.
'There wt:rc pllJU 1(llransfcr lhe 1"""1I'y rQU' Ioq.... y pIIloenll 10 restdcnlilllKWmmodalion, FQU • ..-ouId be lruskrred 10 !WO houIeI in lhe
IfO\Intk of St Patrid:;', .. hile the I>Iben would be - , , " t e d ID
~ HOUJe . Strokcslownlllld In Rntmm: HOIQC. BoyIt.
STAJ1'ING
'There _re Ihree ronsuIllnlS. four NCHDs. _ Or• . - k r or..t.o
... on-all two n""lI pcr week for the \oac-tt-r wardI in SI Pltnd: ·,
tuJI !1IIIt ~
Ha.pilal. one full tune oocupational tbcraplll, _
workcr and (\Ill! . .11 time dliropodiJl employed by lbe~. NllrIioa;
lIaff COMlSltd of (!lie QIIO, four ACNOs, 'COl NOI. Id ONo.. K~nl,
levcn nurx., (our CPNs and !wo.koboI COIIIIKllon IlIId • stiff nul'K
who .."re bued in the IlcoboIlrc:ltml:nl «nuc ia the County HOIpital,
ROKQmmon.
COST
ne tOR of tbe IotMCe ill 1992 ... ~Itl)' £U ...Dioa.
GENERAL CO."IMUiTS
A CGaUIIunlly.bNcd IeMCe _
HI ePlblnlwd ill tbc R _
KrvIcc, althouJb an ,lIIkpendcnl ~or bcadqvlrtcn -.sed 10 be
CIIlbiQbN In Rc.rommon \O'OIll,. _ the Ale ..,th 8o)-k. The __
",unity nllrtet t..ed 11 SI Ploti'd',. c.ckrc:. aIIo n«ckd IQ lrM&fcr
10 their KClon. A wt:\romc dcytlopment _ • plan It) t.--rc. lhe
I"enty fOUf lona:~l'y patient. in SI 1'101rid'l tocommunity-b6Kd fKlII·
~ Ind 10 .. vc COMidtTltlon \0 tbe dc~JMtlon oI1he ",1III'n;1I1
18'
,Cn.IIW f.al.ly in SI P.triclc's where care _
MII\& provickd by •
primary Rn: physici.n.
"The llIJ1.rlC.tI! increase in admis:Iions to acute ,n'p"llCnl care la RI»common";'l1OI: Ihis (.cllil), Md been IRIUlCl'Ted fl'Olll Caalkn:. 10 b
common • • • miller 01 o:onoera.. The MimIMiul rale of O\-er woa pe!"
1,1))) of pDp"IlI.,on _!he It.igIICsl ill the rountry. Th.rty beds-.ed
an O'iCflCnt.ooas alld incff"lCient acute jn'p"licnt c:ompooc:DI.
All 01 the COInmunit)' f.cllmes ~tcd _re 01. hlJll Ilandard i/llI:rB
of dcror aod flll'1U$hinp Ind the new da)' facilit), ill S'rottitO'fl'll_
particularly imprCSSlve. 8eause of the unUJed IpIU in thll buildi...
there WIIllu"'''''';al potcntial for other activilie. 10 be c:amed 001.
I wntlen operational policy, llllIna the pII~. aunalDd
objoecIi_ in uch unit and day se..-.ir:e. TheN: ~ needed ID !If
duplaye:d for both p"l>C:nll and risllon. NlltILIl, can pIanI for pitieell
~iDJ the Roper Mockl of nuBina _
ill UN: aftd the Q/'C ~
Wpmcd II random were loond satisflClory. Whi~ • 101- kept at
ID compbinu and of I!IC ICbOn liken by staff, !bere _ a !ICed fa I
wntlen QOfIlpLainu procedW'C which ""lUkI be available aftd kDOW'IIlO
IU IlIff. lhe.e _ lID fonnal mectwlIsm of ,"fonnina patients 01 tbtir
npu and wnttell DOIi«I III thll rc:llrd _ded 10 be considered.
There _
Hellth bo.rd members via;ued Ihis servic:e on I ye.rt)' t.is and servi<c
ob;«1i'la ...-ere Ippraillld. "The management karn of lhe semee.-t 011
I monthly basil and minulu of cach meelina wCrt kept. An uti ...
review of the service was carried out and. ytarly report was ~
StI" ilkntlroeation bed&ClI _re worn and a turn IIlloaltion system_
IDOII 10 bo introduo;cd. Wlrd uniltcam rtlCCtinp were held tWlOl! pe!"
week in ROIaImmon and 0IItt per week in Caltkrn. NMict: bOIIrdI"
ward arus and lhe reportins l)'Stem wbidt iDdxated K!."l'Y la _
O'iCr I twent)' four hour period were $III1fKtOry_
11 ... lumllMI the servke was worldlll on the production Df a n~
infOfm.llI>Oft lyUcm or procedun: boot. lenina 0111 dnr I\IlIkbIICS 011
pooccdlln:'ll .hid! would be ..... bble 10 all ,tall'. This would !ICed to !If
revlCwed alld updated on. n:gulat bM.is. 'llIe sel'VloQC was .... .-ider·
ins the prodllCtlOll of In mforTRation halldboot or leallcl for poIl.on KrtuWon to the KUtC unit. It WIU
notcd tllll tMre _ knll)' prod\ll:ed illrormllion for palkntl and .ell ti..es on pII)'dIiaU"
illness or ehelllOlhcrapy but literature from the: Schizop/lrenia AstOCt"
II.on Ind fhe phlrmac:e:utlcaJ companies _
IVlIilllble.
.c.o
~lu.sion _
not UiCd in this service aDd • l)1ttm of sptciaIIIUrsm,
Iud Tt:~d tM n.eed for lechaio.... 'Ibm! ... All EO pn)t<:II:QI Md
the fllClhlJel for EO .1 lhI: pl)'dtsatric: ImII, ~ ~""'rat
HOIIopIlal. wcre tatllfactory. 1K Royal CcIk~ 01 PIycb&atriIca GlidelineI n«ded 10 be dQpIayed p<OIII:IDeDlIy in Itw: ECT UUUDeDI nlQIII
Md .he _ n t lorm ~ 10 be I.IpIiIori ~ IBlrI"Iduo;uoa 01 • preECT nwtalll Oow cbarI " ' ougeskd. 1loc ICMCe DCeCIed 10 CD8IIcr
produci", .... riue. infonN.lioD for ~litab aDd re .... wa a. ECr.
No "nllen ..:I1r\UoI.ion pobcy was • .-.u.bk III the ~ an:. but
one ..... under con,Kkn.1QII by the 1e/VlCe .1 the tUne 01 inlpecuon.
Approved NCH Os 1I&Md invohmll.,. admission forma. Commuru.
ClItion wilh referral &genU was prompl with • d'ldwJC !encr beinl
Jen. 0111 w'lhln 1hI« dlys. P•• ienlJ dddwacd from the hospilaJ were
liven IlJI .ppoinuncnt card and Ihree dlys supply 01 tMd::ieItioII.. TlIe,t
...... ","lItn poIocy for ordcriD&, prao;ribLna. llor ........ IodmiI>iMralion 01 mcdkiDC$. TIle stonp: area .nd Inntpan ')'UCnw were
taldl.... ory.
The Mlndard and c:boice 0I1ood .nilahIe 10 pelic:DIJ oI1hi1ICMoc . .
talt5f.... ory but. fonnal re\IICW 01 the..at\ll needed 10 be ......x.td.
Nevertbelea.
were prO¥ided .t IONJIy ~bIe .....
Ihcrt was adequate .vailability of. SMCb ouaIdc IIoOf.aI _aJ limes.
"The new PII,lenu·1hop aad c:antem II St I'Itrid', HOIp. .... Callcrca
..... WtU .cocked and Ihc lKilitiel.vaiIabIe 10 pilltenll ..... VIiIlon WCIl'
""llactory. There ...... ..noIt;inJ policy With ~Ird lII\OI(i"l .re..
but Ihe 'ianpoMiD, of no-t.mOtinJ .reas IlCCded 10 be improved.
me'"
A wriUen ..Iely ..lIemenl lor the hospil.1 and ~ unlll . . be""
prepared .1 ,lit time of inspection and • tartly romrmnec Md been
'ppointee!. 'There _ no ...,utn poIiqI'" .... mtallwldl .... but hMf undo:.pte uailllll& 011 bftiD& IcdltUqUoef; IUId I........ . .
QqOtnJ. TlIere " ' • lire ODIIIfDiucc in !hit ~ . . . 10& ... It;cpt
of trai""'l C(IIIIIeI whoc" _re • .-.ilIbIe 101" IlIff ~ Wllh !lie:
IIIIDtI of those wbo .11Uded.
Ita"
Oul-poottenl fKihtla in County R~ were NlatllClory1lol:_·
plttent clinK: 11 SI PIImct·, Hc.po'" Iud ben relot:llcd 10 the
c...tk.tI Utili .. Cenlre UId lhI: facib\leS lhere M:'C .,;kquaIC. TIle",
..... D appoInliMnll II)'IICIOl ... openlion .ad "'.~rI M:le Kill 10 lbe
Il'rernJ Il'=n. wilhin Ihree days. Donllnbary .","... by ~ ...If
...... limited bllt • tilDon l.tIYMx !II"II pr<Wkkd 10 IM Counly HotpI'"
I"
AlId C(lunty homts . nd • rea:lrd of .11 liaison ronJult.tions and 0lIlc:oma wu kept In patienu' <:ISe nota. There WII em.,...,.. 011 cd"""t-
m,
the public on mental health matleD .nd tllere were
bcf~
UOUPl .TlIdIed to some c:ommunity raidencft. GROW was 1IC!;'l' 11\
Boylc &Dd ID Ca$llere. and AWARE ..... Ktlve In Boylc. The Wesu ..
Heallh Board's Health Link Paper ..... hich was cmlribuled with the IcQI
newspapen _ • rnajell' future of lite R(JICI)(MI(MI tcrvia: and aU sutI'
aaoci&led with it were 10 be congratulated.
A policy review <:ommillce c:onsisting of IIIe RMS, CNO. COfISWI&DI
sllff and idministrator needed 10 be cstablished 10 review.nd upda~
Idministrative policies in aa;ordancc with lC\'\'icc needs. current cood
pncIice 100 nalional aoo international Ircn.dJ. All illff nceded \0 be
informed of poJiI:i« perllncnt to their responsibilities .nd dutielllll.l
documenll lion n«ded 10 be readily .vliI.1Ik to penonncl for study
.nd cl.nr...uon.
RECOMMENDATIONS
1.
Indepeodc:nt sectOr headquarlen. to be csllblWled in
and Castlcru.
R~
10\1011
2. A polICY renew "OIIUlllttee 10 be: cstlblisbc:d 10 review ad/nulisUII.
ive poOCict.
3. A written admiuion policy 10 be produced for lhe A~ute UIU~
Counly Hospil. I, Roscommon wit h . view to rcduc:in, tM hiP
levcl of .dmissions 10 Ihe Unit.
MAYO PSYCHIATRIC st: RVl C£S _ t991 INSPEcnON
lNSPECTE D ON U ANO n OCTOBER. 1"3
GENERA L DESCR IPTION OFnlE SERVICE
The populalion of lhe catchment IrCI wo Ipproximately I IS.ooo"'"
it WIIS divided InlO five J«t01'1 lIS follo ...:_
-...
....
--
,,.,,
"'"
mm
""""'"
."""
""-"'
"..
",..
Sf MARV'S IIOSrrrAL
1"*0 hundred and wn,. SI."( Pllic:nl:l wcre ......... modltcd la SI Mwy"
HoIpiII] and ,,,,enty rune paticnll wcre ~lnI in SI Tcn:t.l'l
UnJt on the day of inspection. There wcre 820 ~ 11,1 the Nrvio:e
dwi ... 1992 and of thc:K, 691 111'1:"' 10 SI TereM', UlliL FOUl PlIiet>1II
became -Ioaa.....y dllnn, 1'192.
COMMUNITY FA CUJTt[5
There were twelve lQw~uppor' communny ralde..oe. ."h K~ty ....
plica and .utr K~n pen<ll'll III raidmoo on \!le day 01 iMp«t1oll.
lbc:re wcre IWO mcdjum-supporl COINIUIIIitr ~ .,111 UI_
pI.aca lvaiblMe. all piaoeI ~ oc=piecI aI tile t.- of ~
Tbere were two <by IIo$pIlaIs ";1.10 forty pbca Md 202 pr.- rq.-Icrcd and In averqc daily 'II~ 01 thllt)' Ii~. llIen ftnI lift
day antrs with ",venty pIaea and 261 pel'1Olll re,,"ered and all 1>11'·
lte daily attendance of ,;x,)' rune.
Sl'''n'L,,"c
M~
su.m.... ~ olr... COIIIIIltaDIS and _
f\iCHDt.
o.e
PI)'dIoIopl .....0 occu.,.tionalthc:n.pdU and IlJuem adIIIiIIIIuat_
IIlff wcre employed. 0rM: bundred and ciJbty IlIrcc II\L11iQl WIn .... re
abo employed indl>din& one 010 and Ii.. AOIo..
GEN£IlAL COMMEl'ITS
1lacrc _ . ~ iD tile aumber 01 pllueall ill SI MAry'&. Howe..r.
the overaU boIpilllialion nle I' ~Ie'" three per um of
population remainord hiJL AdIDiIIbI ra\Q wcn Mo ...,.. Flartllft.
~ altbou&b there . . . Of
rMIc aumbn oIlodccn wIoolpClIt
periods of up 10 _ Wttk ia 1Iotpi.... IlIey ""re . . ~ ill ,Iw
' 1
adlftlMlOn filUres. It .... est,mated thlt 200 IodJCI'1 would be adnutkd
in the alm:nt ),ur. TIlls liberal U$C oflhc IodFr fKl~ty &Dd !be ftcIII
of ti~ people remaIned I$ lo<I,el'1 well: mattel'1 of_m. This ~
lice had DO bti;s in IIw and should be diKontlnllecl.lt mipt lllve Ilea
Mceuat)' 10 re~ tome I*litnlS in a CJ1III "1~bOII _nu&bt . . .
adrnitIlion unit bdon: matin& I placemc:At do:cision the followina 1lIOI1IinJ. H"..~r, plhenllshould notlllve Mn adnutted for Ionfer IhII
th"" period of tl~ nor should they hive been admItted 11 kJdsen.. •
...... the pnaice, to ..... rds other [han the IKImiWon IImt.
The ~p! of I COfI'Imllnily_based teCIOr heldqlllrtel'1 and/or dIf
ho.pilll .. the focus of lCCIor Klivit)' hid not been puped by tlIc
Mayo ..,.ch latric Krvice II[boo", pre misa _re eilher IVlillble Of 011
line in IU five seeton. Too much emplwitl wu pllttld on providiat,
Krvica III St Mary'l HOIJIitalllld the admluion unit. HOwt'VI:r, Ibm
wcre a nllmber of illteresun, and oonstructive dt:velopmenll iD tlIc
popell!le. A rommunity residence wbidI ...... due to opo:n ill SnaIonI
... in$pmed IIId thell: ..... propoullo ckvelop the IfOIII'Id fIoDr 01
the s.cred Hurt Home in Cutkbar, The <kvelopme:nt 01. tb: fDr*!'
Dtslrict tro.polal In BaIiusa, which induOc:d • hi&h-RlflPOl'l ~
... allo propoRd.
The Impn:.!vemoenu whICh had been midi:
10 lhe admilAon IUlit iD SI
Teresa', .. ere noted Ind furthe r Unpr11V'Cmenll_1lI
planned.~.
• IlIirty bed KIIte plych.ia[ric unit IhoIIld be <kveloped In MlYO Ga-
enl Hospitll.
Conditions in _
of the I'lIIIP home., ineludin, Rock House. St MII,
tin'l Tel'TflCe and Kiltima", were I matter of _ m altho\lgh it ...
pleasins to lI(He that IIoC'gcMillions were under ..... y to purdwe .II~
live _mocIItion in Kiltima&h. Thete ~ were in wtt'nt oced 01
IIP1fadin, if lhey Wl:re 10 I;OOlInue in U$C for ",,1iC'RI care
A nwnber of the ......0" ill St Mary'. Iohou.ld lllve ben de ..........
tithe lllllionl)' of the patients, pI!Ilicularly female Plliellts. W1:1l: ddI:dr
and were recelVl"l lDIinIy physic:IJ <:all:. It ...... noted tUl I IIUIIIbU 01
the wards had been dl!Q)qted IilIce the 199'2 insp«bon IlItholl&b ....
ofthc rem.au".., wards wcre Rill in Deed ofll:fllrbishmclll. 'ftI,ere link privaq in .... ny of !..be ..... rds.
It .... I maller of COQI;Cm that an automatic lire alarm Iystelll.ne! In
detection a)'Slem lIad not been installed and I1 ...... ur&ed thlt !his be
brouJht into operation immediately. lbc inQammlble RltllR of""
186
oIlhc ~m, was also ., a:n;em. as iIIItInc:cd by ., fIR ill me 01 ~
unltt I!Id il _
uraN IIto Wit Ibis 1IIIIkt be: IUended 10 • IOOIl •
J'IO"ible.
The t.undry _
hIDrdclut for woRen from 1 heallh aDd lllely POUIt
01 >iew Ind il WII fell tILIl 11 dooIaId be doRd down IIId leMot$ __
I.... ed OUI. as _
lbe QK . .tIt tbe SIcftd Hurt Home.
A _k:ome dc~lopmenl SInce !be pmriouI inspectlOll ... lbe 1111_
duetion 01 ...-nnen opel1lhonal poIicia in eadI oIlbe IIftIII 01 tltc: lema:
which IIIIW lhe PUrplllC. aima aDd ob;Mioa of uch sinc:c lhe last
inspe<:tion TheK policies were: 10 be re:vjc,wcd by lhe m.n.menl
learn on In Innual basil and Illuw ill lhe li,hI 01 cha"ll"l I:imImThe polJcin IhouId be I'O'Ilioncd .. heR !bey M:re: ....i .. bk 10
ncryone Ind, in panitu..... 10 pllieol:l and Yl5ilon.
R.,_.
f.....,.
NURln, care plans M:IC very mudi m Ibclf ...
in IhiII lema: I!Id
!bere _ no -er-! model of Dmsia& care will! IpC(i&: ph, ~
dala and review dales. Re_bIe COIIlilIulI,. 01 aune woff.... exllUd
In Iha Krvtee and a KU....mn, &I'fIII8'I1II'I1 (".. _ _ ... baa&
oo.u.dcrc:d. No priroaIy DUf1UII or u:am 11_ aIIocac-l)'RC'III'" III
operation and sW! did IlOl wear idtatdbboa bIdIn. Wud IIIIIIICQI
~1lIIp look pIaoe every ~ WHU bul _lIUles orme _
kepi 01
these 1D«tu,.s. 'The: ....d reporuaa i)'SU'ftI indocal,. -..:tlYity in tbc UIIII
oYer. I_nly tOllr hour period ......listKtory. wen: lhe warel DOIice
boIordl "hid! ..ere clIedr.w 11 raodom.
Thc:rc WIllS a need for OIIJoilll inlensive traanin& 0I.wt in lhe \IN 01
nunin, care plans. Nunin, care: pia... wefC: IIKd ill the WalpOI'1 and
B.,lIinrobe day " nues and the notes. .. Iudt were iaIp«Iw 1I rand<Im,
were lI"afaaory and IpfIrOpOI.tc I".. S\IdI ..I . 'There ... ftO pr0cedure book Kill", OUI dear I"~ OD auniBI proccdurQ kw D.....
iaa ...tr bul il wullftlittSlood 1hIl • poup ... revie.... tltilsilutlioG
Witlt a VIew 10 prodll<llll a III11'1l11C mtorlllltioa ,~ tor the nun:
Iobyo xrvice.
No fonnal ~ cDsted 10 lIIfo.- palil:nU oIlheir r1Jhtl and IM
1III1tc:r neetkd 10 be oonwdr;red. WbibI • 10& ... kCJM 01" a.pIIifttl
reo;civcd and I(II0n !lte... tJt(rc ... a DC'Cd for a wnltca compIaiIIu
p!OCItdurc wPlidl tIIouJd be ..-ailable III . . aR. 01 lhe 1Cnk:e and
known lo.lI.c.ff _mben. AlloafonnaOOn htno.fbook for pllllenUi and
rc"liva 1nl ~i", produr;>ed Ind ...:MIld be made avai ..bIe 011 admISsion 10 IIIe:
'Jbcore WIll 110 locally proIIuccd l"fOl'llllboll for
kmee.
'"
~Iicnll Ilnd relltivC$ on p&yo;hillric illl'lCSl or rnemothcnpy bul informalion from 'IGIunl..,. bodies. support FouP& arod ,he pIWmaoeutX:II
oomparua .... lvaillblc and widely used..
SccIIISion ud fUlrainl _re not used iD this KrW:e. There _ I .....
ICn ECT proIoc:oll~lI~ iD the tRlunenl _I aDd lbe Royal CoIIcJt
of hydllaur.11 Guickhna _re JWOIninenlly ditplIyed. Trea_
flabla _re adequate ud!be conKnl form in \lie for ECf _SlIisflCtory. 'The pre-ECf nuninc cbcd: $YSIem WIS Sltislklor)' bul wnltttl
informllion on ECf _ not lvaillble for ~1~nlJ Ind Il:lluYe$. At the
time of inspection •• wnllen admission policy for Ihe IdmiNlon \lDil
_ under Il:vie ..... The policy oflakinl in iodIC" needed to be o;()Qsilkred in 1111: lIaht of review of the I(lmiuion policy. The 1'fXt"
.... hereby NCHo. s.i&ned Lllvolunt.uy Idmission fOI1l1l .... hich were CQUIIlersiped by lhe consultant psyo;m.lritt abo DCeded to be ODGSidcrcd •
pen 01 this revie ... There were no proble .... with referral qenll and I
diKlwae note I((lOmpuued I palleDI OD diJclw&e fl'OlO tbe KMce IlDd
IIWl1ID&r)' WIS iuued 10 the ""tknt'l FDCral pncIllioacr wilhin.ma
"'"
Apart film W11Nic:al Ill,., Ihcn _ no fQnnll aa..aual review of the
~ by the II!.lII.IlCmenl IUm. 1lM: team mel rqularlyon an lIIforIIIIl buiJ ulhouah minutes _re not Itept oIlhete 111«1. HultiI
board memben vislled IM Krvice l...;ce 1 yur. However. il .... 1IOI
dear .. to .... hen board memben boJI visited SI M..,. .. Ha.p;tu.
There .. u I wriue .. policy for the orden .." preteribi .." S10rqe IlDd
Idminisl .. tign ollU m.edodnes. DUpcnsinllnd rcwrdinll)'SlclII$chedtcd al I'1Indorn Ind found UlisflCtory. There were deIlpted
smoIti", and no-smokilla Ire.. in Ibis Krvicc but there _ I need
for IppropNle lippolli"l of dc:sipaleci IIIIOtlq area. Wriuenlllcty
Rlle"",nll fOO' lhe boIpolll and Ioeal UnIts adhered to the lIaJ>C1ani1_
~ 11.1 by the Hcllt.b.. Wel)' aDd Welfare 11 Worlt Ad.
A ufel)' oornmilloe hid bee.. appoiIIled Ind ufely a..ti1S underny 11 the lime of illspectioa. Some lIaff memben wne UII'friIIiIII
\0 co-opcn.te in lhe C!OIIIpIction of' hazard eontrol forma. w!Iich ....
allIed \be need for an CJllCnsiw la-tcrvice ..:lion pIIn. whc.reby all JU4
rettiYed Intnm, on ul aspccII 01 ufcl)'. Some. RIff memben IIad
IppropNlc Inlninl 01\ ufe Iiftilla ,"hniqUCIlnd I rec:ord _bp( of
alIlrainln& ~mes. It _tbe inlenlion of tbel Krvke WI.u ItaII'
would undcflO In.,n,nl on • pbucd basil Oft ufe lirtinJ. A wnllC1l
policy on manual hlndlinl .... also needed lrod this policy shOIIId be
I.
\88
.vailable in eKh .re. of the sem.:e.. The rll'C l;OIIIIIIiuce had bftn anWpmattd with the health and wety commUlH. It. \os . . "Pt of aD
su.ff tnillin, cowses in fife pre-=tion &ad there . . . IlWllImaaCC
contract which eru.um! tlult all equi:pmeal . . _atKd in aood
worklrIJ order.
The ..,ow>d:r; and tM.WcIin&J 01. SI; MMy'1 HOIpi\.ll ftre ~ ....:U
maintained. loternal and Utcrtlal sippoItJoa needed 10 be improvtd
and c:ontide... tioo! shouJd be JiYCtlID 1LlYin& bill11(11A1lippom. parts
of County M.)'O _re III • GKIt-=btllKa.
"The qu.lity or rood for palients ..... ulisflClDr)' .nd th8 kitchen an•
..... hygienic, weU equipped and Wl:U maint.ined. The /Mnu ~Ic was
reviewed every two weeks. Howe~r•• dK.Iia: of menll &houJd be .vail.bIe ID palients .nd menlll Ihould be di:l.pllyed 1/1 appropriIItc an__
"The decor .1Id I')'OUI iII_ 01. the di.nini una III the boIpIllI .-<led
10 be improved and the cvenin&: telll 4.00 p.tIL . . IC~ far 100 early
and nudeclll) be revM:wM. Ou.I-patiHll fxihtics;. the Cltduacnl_
Wllre ull$lldOry ItId there ... III ¥PCJintmeal.,.ua 11 SI; MidlIoEI',
0.,. HDlpiIal. C.debar. l.ettcra 10 rclnnaa qcAtlloIowIna-~
ca! CC)QJUJ1I!ion ISIUed witIIiD one ID leVel! cb,.. 011 DCaIion, _
NOiD and • oommllftily pI)'duI\riI;: .une carried (l1li1 doInidliuy "";ts.
Domiciliary VIIIU by the n\lf1Ulllllf( ftre revleWld pcriocIio:aIIy by the
approprl.le CXlR$UItanl and dUel aurJia& ofJiocr. It. a - ICfVI(:C: was
pnwidtd 11) the SKrcd Heart Hospilal and Mayo (k-=rII H.,.ta1 and
the IpeCd of rcsponlC Vllried ..:cordil!, ID Deed. ,... only ODe pqina
lID;! was .v.il.ble in this ICrvice. rcqlleltl for IiIiIoa ~lItlolll were
inVlrilbly received by Ihe NCHD OD dUly. It. record was kept of Iialton
IXlIIIlltUlions .nd of lhe re.ulu.
The ICrvIce was KCrcdittd by the R.oyaI CoIlcp 01 ~triIIt &ad
by the hilh CoI.Ic~ of General Pr-=ti~ for ..cdicII ~ but
. . -.at approved by AD B«d AItnMiI far 11_ IniIIlIII- la«rvice
vailllbIe far 1IurJia& JU1t Periodic
traiIwr&
and updIta for a/lltlfl' aIIo needed 10 be ~mt
_u_
nwaa ...
It. rq;iocW ethb a:mmillec wIIi<:b iIdIIOed -.ben " - tile MIo)'O
IervIte . . in pbec. MoalhI)' IIIediCII .1XIi1
wIlD kIokcd It
po/ypbrmacy. quality or elM: IIDUS and procedIRIlor ECT ~
0Ibe, thinp _re held iD !hill scoite. nere . . oaaoiIII iIIwoIftlDUt
01. .u.tr membera in ~ proioctI 10 _
tht effeI;U of lM
dtVtlopi", commllnily acrvicel in relalioa 10(') tuIddc. (b) road t...m.:
~DII.nd their relationship with ~Lauy, &ad (e). compvaliw
_u..
'89
WEST GALWA V I'SYCHIATRIC SI:!RVlCE
- 1"3 INSPEcnON
INSPECTt:O ON 7 DECEMBt:a, 1"3
GENERAL DESCRIPTION Of THE SERVICE
n l E WEST GA LW A Y I'SYCHIA nuc SER VICE
The c.t,hmcnt population ...... Ipproximltely 96.lKXllnd WIS divided
into three I«\ors Ind IlulHector IS rollows:
-......
,,..
,,,
"
....
COMMUNITY t'ACILrnES
Th.e.e _
I dly hotpItll lt Danesfield in GalWly aty. I dly (:entre In
OllwIY Cily at Ualla Padraie and day centra 11 Carnroe llId Clirdell.
STAmNG
Medic:l1 wit o::orulIted of tbe diaicaI dim:tor ...100 .... alIo 1"Iof_
of Piydliluy 11 University College Galway aDd two ~LI.III PlY'
dnalrilta. 'There _re alIo NOW'.. two ~ two )llltionaIlbeoapilts. thm: IIOCiIl worters aDd lixty . . nllr1ina aalf.
COST
The OOIt of the lervice In 1992 . . ~k:1y a..1IIiIioa.
Wll..50N'S IIOUSE
l..oeatcd within the erounds 01 Merlin Part thit; ~ hid ICCOI'II.
JIIOIbtioJ\ for leven )!IItic:n... Atlhe time of iIupccrion, there wcre oIIIy
Ihree residents. 1"'0 of wbom were female, IllI Ihree _re ~rfIOW
pal~nll from Unil 9 and an IlIelMkd the relubihlllion prosramme.
Three pbc:ea "'en: rnerved for IQideDlll11Ite (oe pal~nts ,n the akoboI
prIlIJIrnmc: in the ..tjolllllll hou"e, "'1~Dts pt.id .(10 PCI' week ill real
and bnvihl lhelr _"11 food. The ~ are. aIIIIpriKd one double
and one . . . room rnerved for the aIooboI provammc and one double and one l i . room (or the psydtiltric residenu: there _Il10 I
room down.uir$.. The house ... fuml$hed aDd deconlN
utisflldorily. There _
I bouKkuper empLoyed for Icn bo\I.n per
Wttk and emeraclKJ l..-cnly four hour nuBinI ~r ... avail.bIe fT(lal
UDn 9.
si.
At..CO HOL COUNSELLING SERVICE H OUS E
Thll hou$e provided adequate ICCIOIIlIDI'ldIlion.nd .... III.-..:lively IWIlII:hed .nd deanted. The IC'Moe .... 1'W'I by \WO <XIUIUe1lon. The
lvenae number of penona reptered _ 10. The terricc providtd •
trellrroenllpproadl wluch opented OD I (our week basis lad Included
invoMi:rroent ..,Ih paltenl', familiea. htienll were n:fcned lor delOlilX:ilion by lencral pnctitio:)ao:n while OIhen were referred ducctly
(rom
the CMUl\lly department and the pi)'Chiatric urnl of Uniw:1'1itJ
ColIc.., HOIIpitll. A review" of !Ius refcrnll)'llcm .... required.
GENERA L CO MM ENTS
A disappolnl~nl of the 1C'rvM;e
was tbllthe overflow 01 Wal Olll .... y
B.lIinasloe oontinued \IIIIIbJ!ed. for
the fin! tcn months of 199) the numhen IIad Incre_d heyond !be
flJll'l' for 1992. On Ivcrqe. leII or more Wef;1 Olll_y pat ~nts 'NCn: iD
the adIIUSIiocI. llnilS of St BriJid'1 I1 any one time. This ham9'=red tbe
funaionina olllllt Krvict and denied sur:b patients the care which tlIey
'NCre enl.ll.\ed 10 fftleive I1 lhe psydIiIItnc ulIIl in UIIM ....,y CoUqI:
HoIpItaI, Olll,.,.y. Some Wcst Olllway patients who Wn: denied boIPlatiutioa in lhe psydlialric: unil in Galway rtfultd 10 10 10~'
_ ' - WIth disMU"OUI re:sulta.
pal~n!1 10 SI Brisid'l Hospital,
UDlortUIUIleiy, deIpou lKill'" prOYidcd It MerliD Put, tbe lad of
ODIIIIIlltment of the Wal Oalway tervil:e 10 provide a o;«n~\IeDSiY'I:
ptycblalril: tervice 101" its aolclunenl area .... dilqu.ietlna and had beeII
a major impediment 10 forwud I1lOYt!ment in SI BripJ·... It appeared
11111 the Weal Olllway 1CrvM;e ~ JCncnl practil~r1 and
othcn to pa-. on Iesa ~bIe patients 10 SI Bri&\d·... Thil had re:sulted
!",UI admimoa rate from ,the WCII Galwly catchment .rel 10 SI Bn,-
id s 0(2 pcr 1.000 plp\IlallOll wttidI _ • little lea 1_ lhe.am...:ioCl
rale for lhe entire Counly Kikb", wrW;e, 'There tL.d bcm • numbc1"
0( incicIenu U1SUII from t.his pDC1lll .lllluGc and pI'IIf:tioI: wIIidI_ of
the lllmOsl .nd I B - c:oncem. In _ t yan IWO pIIlirnU. bcia,
$Cnousty pf}'dliatril::ally ill ftTe denied ~ 10 lhe ~)dua~
l1li11 in Un,vel'llly CoIkp HOIpiIll c;v..y and were dBlcad directed
10 SI Bnpl's. Ncilher of these palic1tts ~Ktied SI Bripd's and boib
commillfd MIIdde. AlIOIher palienl "'reeled 10 SI Bripd'.. ""'" _
he.vily inlo.ale!!, ...... found on .rrtvallheTe 10 be moribund, Imllledi.IC lransfer 10 PoniullCllla and ~lItion ruullcd in rn:oveT)', TbcIc
""re pncIlcei which noI:ood)' could 'IInd over.nd which were of moll
profound ronoern.
The Pf1ICIK'C whereby patients from Well GalwIoy were put on PUM
Clenirale. simply for IIot poIrpoIC of haVUl, IlIem conveyed by Oarda
cscon 10 SI 8ricid'. HOIpiIll, Ballinuloc it 10 be dcpHGled in the
IlRlllp rnaJlMr poMiblc. ThII prao;tiI% ... Q)aIIdercd 10 be • funclarncnlll invuion of civil ~berties. It ..... leInol tllal il bad omuTed m
relatioa 10 • fift~n )'Ur old bo)' in the Wftck ~ldy print 10 tIIiI
~Ion but the bof ... released the foIIowitI, da,_
Forty three bcdI _re qWle ldcqu.llC to wrvioe IIIe catclllnml aru
popuI.lion of96.ooo, 11'" dif&uh 10 undcnland 0, bco..a.ould_
be .v.il.ble, panieull/'ly IS' strio:l-Wiuion poI.:y_ cnloroed wilh
admilWn decisioN beina made udusively by consult.nll. Two flClOn
mi&hl upl.in why Ihis nllmber of beds were c:omidcred ,Mlt/fidenl 10
meet the needs of lhe calmment area. Finlly, dcIpItc the admiuion
policy, lhere wcre IIW ilII~tc admillioM ,nd KODQCIly, the
1c",tb 01 lI.y of lhoIe admilled ... c:u:a&!V'C, It ...... 10 be hoped lbal
0III;:e the bed numben inc:ret*d 10
lite IleW day ....111 bepa
10 fUllO;lion, lhere would be: UI end 10 thac l...-Icn and cbr«I..mu.__ from Welt Oil .... ' to BallUwIoc,
lift,,,,,,
Unit 9, Merlm Plr1r; HOIpIIIl, Galwlyllld 11IIXtIt/f bttll refurl*hcd.,.
IIad lhe: d.y hoIpilal and EO suite .1 U~ry CoIlep HOIpIlIl. TV
I'III'PO'e of Ihls l1li11 ... 10 proviok lor tbc reUbi!llltiool of west GalWI)I
patlellts who ""rC III SI Brip.I" HOIpIIII, BIlIilWloc, Twc:nty (m:
of the W"" OllwI, palienlS III SI B.·' load '-." brouJIIIIO Uml'
ror reh. bihllhOll. Of these. nine bad bcC1I rdlabillllled 10 -.mumly
care, flve IIad been rflurncd IS -wuuillbll:" .nd lhe remalndo:r ...,re
atoll 11 lhe unil. The: reil of the places in Ultit 9 were occupied by
pllients transferred from tile psychlauic unil, FOIIr!HB of lhe Unn 9
11110 • !Mlknl'S brocbllK wIIodI _ beq cIr.tkd. A reoord _ kept
01 all senoutl a)mpWIIIS Md Ibt: IICtioa wen it! e a c-. Md tbt:re
was. Kplr.tc InCident report book m tile Krvia:. ~re wall .adequate
'Vlll.bility of he.lIh WllClliora Ic:.lkllln lhe Krvice bul Ibue .... no
locally produc:ed information fOl' pelieoll Md relallvell on _nlal iIl- . ~R' WeR' Wuo;alional petxDl aad.wr _Imp rela ..... to VIr_
psyo:IIatric: mndi~ and trutmau and lhere was illfonnauo.
on psydli.lric: dill. from lhe voluntary bor;ties.nd the Royal CoIkp of
l'lydlialrislS. but the dlNribulion of Ihll lIIlormation iboukI be betkr
orpnised. 'There was no Locally prodUCled illfonnatlon rOl' plucnlS and
Il'latives on o:hemothct1lpy but Ic:.lku from the pllannxcuur:al rom,
p&IUa _re ~Iy used.
He.lIh board mcmbcn did no! visit Ibis KIYioc and IlIcrdorc tbcy did
not bve .n opportunity to Ippralle KIYioc objectiVes .."h SI.ft. To
-'st in tbe ma ....cmcnt 011'" selYioc. there .. ere quanerly In·houK
COOUninee >neeunp which InvoIvcd aD berdII 01 dcplrtmnu.. 1bac
were primarily information sluinllf _mp but IIIInUIa ~re kept.
ti&n.ed.nd recorded. 'There ... an IIIAUlI ~tlllal review of lhe Hr_
vice bul no annual report had been produoed for c,the, 1\191 01' 1992.
The Eer fadH!ies 11 Universily CoIlcCC HOIpIIIl were soo<L 'The _ -
lelll rOl'tll in use .... SIItisfactory.nd \hIm: . . . . .-rmea Eer protoml
available in the IlUltMnt arc .. The Royal CoIIc::p ol I'l)'dIlIlntU
Ouiddincs on Eer should be promUocntly dasplaycd ill \be IIUUDtM
room. A pre and post Eer nuninl =ord ')'Item lohould be ronsidcrcd.
There was no written informauon fOl' p1t~\S and rel.t,vu on ECf.
Thclll ...... no w';lIen .wnw.on policy .vailable ill the adnuuion IKL
A _llInl psy.:hiatriSl siJn':d all Involuntary ~ fOl'llll ud ;1
_ the polio;y ,n INs service for an NCHO to <;OIIract tbc ronsultanl
PI~hialrisl followinl an initial _ n l 01. p1t~nl ~t"'l for
~mission. The .:o",ullllll. from lhe report of the NCHO. would then
~vis.e on a dispoMl dttIIioo ,cla."" 10 cad! m(ltvidual taX. 'The West
O.....y Krvioe had ~ lheir_lioa I)'Ikm Wllh IllfclTal
'&Cnts and a.d IdenUficd • I..,nly fi¥c pn ant delay III - - . ...
dIarp SWilmIIrk:5 10 I"ncral pncttlionen bul IIIe Kma: intcnodtd 10
IOCtify !hd maner. There ..... In inilial ducbarJc note p-en 10 every
pal~nt On dllCllarl" from this Krvice, an .ppotnlrMnt card for OUI,.\Jenl consullllion and the IClc:pbonc 1I11mbc-r 0I1l1e ltoIpIlIl ..... also
IIW:1l. The lervioe conducttd .. IUlludc MIfWY ol Fncnl pnctttoonert
III relation to the: provi5ion 01 thc: psydulUic ICOia:.. 1be n:sWts 011_
,,,
tM impltmentation oIa Jmoluf13 policy. smot... 1hould be ~
III food pt"cpan.li<Ia and dim", areas.
Of protllb!t~
There .ppcar~ 10 be a probkm ,"th I lot... tool It the UllIt "
Universly ColkF HOIpital. Remcdialwort ... requared ia all are•
... here water Iu.d leaked IItroqh and Olher IeCtioaI ~utred internal
decoration. There appeared 10 be I problem ill tu teMOe "";th n:prd
to relular routllle maintelWlCoC work. A \os 01 the -1Idm&. rout_
....' o t e _ work required I.boIIld be prod\Iced and priontiled and a
monilorl", .".em dtoukl be put in pIaoe to elllUlt' it ..... attended to.
The quality of tile ,ign~ting. boIh inlernal.nd utcrn&l, in this $CTVice
... as IIIoIOSfIClOry.
Aa:eu 10 lupport (linicaL services lUd! .. chiropody. p/lyskMherlPY ett
....... tisriloCloty. TMrc ... ere indi..;duahsed eommunity care plalll for
all cvmmu.nlty raidcolll with • weekly I)'StCm of formal Rl..;c ...... hic:h
was monitored and m:orded. The level 0I11011pi1al ~ from
the «IIIUIlunily res.denca and "......, IIomes . . quilOl small and the.
lICIive involvement of the. Gal""y Meat" Heallll "-ia\p ~
IhILt there was a6e:quatC JOciaI inIcpatioD of raiOc: ..1I 11110 IlOIIIIIWIIIty
settmp. Out-pa~nt tacililJei in the atdunenl arca -.cn: 1IIo~
and lhe faahl.a al Oifde .. and Carnroe weft p:IOd. The DtIt-plllJmt
din~ 11 Unive"';ty CoUc:p= HOSpItal .... 11 \be ~ Wllt Md
althoua:h tile facilities; .... cn: 1IIo1l$fACtOry. the IIIc::atlon .... iIIappropriIlC.
There . . no IoP;a!rUIOII"hy the prydILlIriI: ~ ahoukl not.vaiI
01 the ordmary out.patient department for all DUI·plltieGt COIlIllllltiom
in O.L .... y city. This mallcr $hook! be Rl,"iewcd.
Consultanl p-),(,hiatrl$1I ...... all refernl lenerl .nd MW pat~nll and
lhere was an .ppoinlmcnlllyotem ill opctltioe. FoIlowi"l OUI-plltienl
comullalioa. lcllerlto rcferriDt; acneral prIClitioMrI iIIIued wit.billt_
days. There ... cn: no COIIIIIIWlt doa\ICiliIr}' _U in lhe 1CrW;:e buI
NCHDs made JUdI .....1lI al the. reqllftl 01 ogmmUOtty .,.,miatne:
Duna. RcwrdI of domidIiuy .wt"" by medicallUlf and the outcome
0I1heK ...ere not kept. [)omiciliafJ visiUIII by llIc g(lIa
IJ pI)'da.
line nu_ .... " , - 0 by the CNO ... IppI1IP1IIC -'tant P'Y'
duilnK. A medical
sen1cc .... provided III UII/VtfSII)' Coaep
HOIpLlal and Merlin l'at"t HoIptal by llIc COCIIUItIIIl plydu~ ....
NC'HDs Ind this terricc ..... AlIisbctof)'. ThI: tenior plydliatrit: NCHD
ICa)mpanicd the medicalconsWlanll on dtaIcaI rwnds It Merlin PIrl:
HOIpital. An independent record .... kepi iIIlIIe Actiknt and Emoet.
&crq Departmenl of University CoUc&e HOIPital 01 all ptyClualrie IW·
IOn oonsuLtahOnl and out/;'Ol!\e$. No independenl record ..... hpl in
u.a-
•
197
othc:r Ioailions bul nolCl were kept in eadI individual palknll' ~
r".
The ICMce ..... ~tdued by lhe Royal CoIleac of hydllattiW aad
the Irish CoIlcae of Gene ...l Pn.,,;t,ligneQ for medical IrainlJll. I1 .....
promiorlal appI'OVIII from An Bard Ahl1llUlis fOf nunc lrainina buI
there _re no piychiatoic nW2 I~ in lhe W5Iem repon. 'Thm!
..... on-aoon& in.Jc""i« lt1Iin"" fOf.ll
and .rn.n&emenll were also
Ixinl; made: fOf rQ ....... I"ion I...inl", updales for lhem. Recordl "':R
kepi of III tratnin,,,,,uh lhe names of II\o5I! who .nended,
".ff
There wu load qL1l.lily informalion on IoeallCrvices whi~h wu III8ck
.vaiJable to p&lienll and II\.ey were encour1lcd Ind enabled ID ..... ke
use of wmmunily facilities, Thc communily n:sidc:~ .nd JI'OUP
homc:s in Ihis lervicc were homely .nd matnl'lnc4to I ..I"factory sundard. The Ment.l Health Association bnndt in O,l_y ClI$und that
there ..... IIkqL1l.le emphasis on edLlc:lllilll the public on Mp«U 01
menial health.
The SCIV1Ce participated m the Repona! Ell\iQ C<-mlll~. StIff
InC'mbe.. in the SCMQ: were mvolved in ruc.rdt projects. IIlDIt pOtIbk
bein, • IIIIjor Rudy on I'Ime DiIordc.. and • study 011 ScI$Ollll "ffees·
ive Disorder. the rauJlI of _hid! were 10 he po.ablithed. This Sl'Mole
had • number of ..:Im,ntStrative pobaes whid! wcre made .vaiJable ill
cach chnlCa.l Ioailion. On inspection of lhe policy doc:umcnu. it ...
ILOIcd that there wu.n automatic review rnecb.nism in place but theR
wu • lendenc:y to confuse ICrviec Idaluwiln.tivc polio;ies with IIIosc 01
ptrsonncl .nd Indullrial u:lltions. Thit matter wu 10 be rectified
IocI.Uy. Some addilion.l.dministratiYl! policies rellti", to IocII Sl'Mtc
needll, current JOOd practice and IUIlional.nd inlern.lionll trenO!; '""'
required. A lmall ~ policy review oommillec RIouId be establIShed
DCIInprilin& $Cruor membeR of the mul1i~lkiphn.1}' IUms Wltb • ..;c.
10 makml rr:wmrDCndaliDnl on policy requiremcnll of the Sl'rvItt
RECOMM t'"..ND"TIONS
I.
AdmlllioM or tn.nsfers from West 0.1_1 10 St 8n",1'1 HOIpIW8.11111&"01: to o;c_ when the UniV!:rsity CoIlcae Hospital f\)dII.In.. Uml has. full COIIlplcmcnt of $0 beds. Tbe Well G.t-May ,,","vice 10 bccon!c DCIInplctely autOllOf\"lOl.lS withoul relianoe on IPY
rlClbticl ~ by lhe East Galway Krvice.
2.
The use of Unit 9 10 be reviewcd 10 cnsure ill mOlt cffective use.
..
,
CHAPTER TEN
REGISTERED PSYCHIATRIC
HOSPITALS
ST PATRI C)L'S HOS,rrAl, OUIU."i - .,,) II\iS'ECT10N
INS'ECTED ON)I MARCH, .,,)
GEN ERAL DJ.;SCRIPTlON Of' nlE SERVICE
_«IIOflIi·
SI P"rict', HOIpital wbidl_ escablisbod .a"GhIlH.."
national hOlpit l1 wu administered by I SoIord of Oo~mon and ......
the fint psydtituric 00Ipi1A1 established in lrelalld, There ...... do.e Iiol·
IOn bctWffn SI Plotndt', HOIpitallnd the Marby J)'ydiialnc: Will in SI
Jlmes" H06pIIII. NIlrIin& ilaff from SI Plotrd', provided _
lInilY
~I'VICCS for the SI lama', ca\dtmeal am .hidI_cd of AlQ.) of
IlIc Eastern Health Board. Twmty mae bail in SI Plotrict .. HOtP~
1II'm! IUtwentcd by lhe Elite", Hcaltb Boerd 10 ICI'\'e tile co'lIinlllll&
care nccdt of the catdnnc:nl area. lbc cby omtn for the elderly lad
tile day wppor! «!Itn located on lhe campus ol SI Patrd', were
funded by the ~cm Health Board.
'Tb.ere were nlOlC ....rdI.,'Ia)l)1 beds in the IlOSpllal. Fow1Hn _11·
..., .,.ydli.tl'illJ and In nlll'1in& stilt wc:re employed by lhe 1Cma:.
There hid been IOIllC noticeable dc:vclopmcnll Iiace the 1111 ;lIIp«\oon
~Iudjnllhe exte nsive upaDdilll of l.Iraror, IIIe free mndinJ "'"ldin"
19'
for ECT needed 10 be updated. The II'Icrab standards in llIiI bospiw
-
_
NlIarKtor)' and III conllDued ~Ptl1lioa ... JIf)'dualrie
fKility illlronJly r«I)mmcndcd..
ST PATKI CK'S IIOSPITAL DUBU.~ -1"3 INSPECTION
INSPECTED ON 11 DECEMBER. 1"3
GENERAL DESCRlmON OFntE SERVlCf
There _re JOI beds in se Pllrict'l H~w WIth thirty.u.......aes
11 thl! hme of inlpcaioa.. ~t)' cl&bl bcdlomt merYCd for Ealem
HuJlh BoanI palioenll. Additional bedJ _re IIOIIXllma IIKd for Eastern H l!aJth Board palli!l1l1 if beds won'f IlQ.IVlilable III the ptydIiatnc
WIlt ill SI l an'II:$" Ho.pilal but LheK palJenll WOIlId be IBIIIfcncd bid;
10 se lames', .. toOI! .. .w:ancies atOll! ill the ........ Thlny IlIrtt health
boIIrd palioenU _re ~Icd ,n se ' 111....11:'1 Hmptal . . the: lily
01 inspectIOn,
Some
oI lhe toilet fAcilities in the wards _re
time of inspection,
be.na; uptllldrd 11 the
The
pouibility of c:onveTlin,1 lCClion 01 onc 01 the fc_1e lidrnissioa
IllUlI where I ID\IlI DlIOlber 01 KUtdy iU pLllien .. weft nu.ned. into.
_ell bed inll!oWVI! ate wPl, WIthout lily iaf;:reaee in ""'lIlt nune
1IafTi", complement, .... beinl inVClliplCd.
The level of pLlticnt care pd the pb)'1ical1lld deoont,we JUnoundmrp
III SI Pltrid', _re 01 the biJbeIl order.
211'
ST EDM ONDSDO RY IIOSr rTAL, DUB LIN - I") INS ' EcnON
INS,ECTED ON l6 J ONE, I")
GENE IlA L DESCRIPTlON Of' THE SERVICE
Forty onc:
voI\IIIW)' pellCDts were IttOlI1IDOdaled la liIC rlfly bed SI
Edmundsbury tiOlpll&! on liIC day or inspection. Thcre ..ere 382 admiJ.
AGns in 1992. seventy eipt or .. hich wcre fint admislionl. Ninety fM
petic:nU bad been lrandernd from St Pllricl:'. HOIPiI&! to SI
Edmundlbury Hospilll dunna 1992..
Med!cal care _
pnMdcd by oOllSuhln1 wlf from SL Patriet'l
HOIpiI&! and nuninallattcomisied of onc: ACNO.lwo NOs and e~
Illll nunes. A llnuly itlCflpist and • bdllviour plydIoIllertpiA 1110
visoled the boIpilal. ADtill&ry KTVic:a IIIth u !kntdU)'. cbitopod)'.
physiotbcnpy and OI::IaIp.tionallhenopy were 1.,.;:lIb1e 011 camput. The
P'...,ral pncIltJOner _Ii"ll which hid become • ","nl rUI",", of
the Itrvoca 1I Edmwodtbuty Ippe&r'ed ID 1lI¥I: ceased Iinee tbe 19'12
inspcctioL
The tland.ud of <kwr. hy~..., and pelienl care ...... of the tupaI
quality.
ST EDMUNDSIU RY UOS'rTAL, OUDUN- I") INS' EcnoN
L..;s,ECJ'El) ON 21 DECEMBER, I")
CENERAL DI::SCRIPTlON OF THE SERVICE
SI Edmundsbury Hoepitai .... run by and iD _jullClioa ..... 01 SI
htrido; ·. HOIpital, Dublin, Fifty beds were .Vlillble .1Id they MI1i
II'fIJI#d In ~n&lc I'OOIIUI woOl !he exception of Ihree double roora
TWenly It¥l:n voluntary PIUients were aocommodlled in IIIe hoIpilallt
IIIC lime or iNpeCtioo.
MWic:aI <;are ..., provided by COIIIIIIwIl. M.aff from SI PJInd: 'I UId
nlll'1ll18 SlIff eon$rIted of an ACNO, two NO. u.d ~Ievea 11." 11_
In iddilion,. nurIC beh.aVlOUr tbclllpost aad I ptydlolopst .ttcDCkd on
• KSSIonaI buiI.nd l~rc wu.lso. famity thelllpbt. Onc nunc Kted
as all Ga:U1N'11ona1 theTaptst A IICftior IOeIII wor1r.tr v$tal the IIoIpotal
10 dc&t lrith IkohoI IIIISIIKB 1/1 poYpI aad with iadi>id!iaIL OtilDllll
IWT. ckrical staff and a _
Wl:rc: abo cmpIoJyM.
ECf was not .dministeTtd in the boepital aad pIIlimts ~rc: broupt
to St Patric:k'l Il ~tll for ECf tR.-ment wbcn it wu TeqIlll"M. Tbt
IKQKnmOdation ..... bn&bt. pk_t IIJd dl«rfully decorated.
Sf JOIIN OF GOD HOSPITAL. OUJ;UN - I"J tNSPEcnON
INSPECTED ON' MARCH. IMJ
GFJliERAL DESCIllF110N OP1l(£ SERVICE
51 John of God HOIpital_ 'ounded ia 1882.l1li iDckpc.ocllt printc
hospital tpecilli$in, in the tre.tment 0( ptydultrio: diIorderl. Tbt
hospital islN'" of. widtr rw:lwort of 51 John 0( God ICMoes proYkIuIa
CVe 'or people with ptYChiItrio:
and abo for people witb Itlnlin&
rnne.
tlitrlC1.llties.
PlIlLOSOPHY OF SERVICE
The mission SlItc.ment for the hoIpital ftIIpbasiIed the need 10 brin,
be'!ina and comfon to the lid:: ud 10 !btu f..u.es by dINtiu - .-ion aDd IIo.p.tahIY. Tbt Mliptal ~ tIIit IIIiIIioa by."-
Ib&MtI profe.ional dIIIic:aI
Itandards III . n enYirollmeftt f;(IIIdudn: to heall", IDCI weD·be....
I. Fnwidin, quality pqdIlitfl(" can: of tile
2.
ProvidinJ paltonol care: of the hlchtsllUIXIIrd.
J.
I"ro¥idina: eo:I\ICItioa ...
~Iopmcnt
of m/I.
..
lfIWIII in
IGfIPO'"1
01 tbc profaaionll
Provid'IIJ the community wilb mentll helltb information IDd
4.
education.
ST JOHN OF GOD IIosprrA L, STILLORGAN
~11.l eons.iIled of I modem 220 bed hoIpitll Cl1cnna pmIoIrIa.
nllllly for people "';th IC\Itc psychiatric illnaa, WIth ~hll U"",
altC"", for IIcohoI related problems. adoIe$ocnl ~yc:b .. try IIId the
~yrniatry of old qe. The hooIpiulloCCl:pled rdcITIIt of priVltc plticnlS
from the cauntry as I wbole Ind. in addition, provided. an in.patoent
flcibty for the Eutem Hellth Board', Soutll Eat Dublin cammunlry
psyc:lIi,";c: service which operaled from the Qualn Mhulrc Family Cen·
tre I1 BlloClrroclr. County DUblin. "The b()$pilll wa actively involved
in unckr &raduale and post &raduale educalion in mcdldnc, nuning.
psyclloloay, $()(ill work Ind OCCUpationlllherapy throuJh III linkaaes
with Uninrs.ity Colleae, Dublin and Trinity Colleae, Dublin.
The
DEVELOPMEJIoTS SINCE THE 199Z INSPECMON
The"" hid beep ,\noo;tural developments in lbe boI.pIlll tmCZ tbe 19'T.!
~ iftdudm& the compIclC ref\lrbilhrnent and utcftliorl of the
wJf re5taUBIIL In addItion. l!WIy other unitS and corriOon were d«of.
Ited. SI RlphiIC:l"l Un,t ",hich prcviouily Cllcred exctlUoively fOf
paticllll ",ith IlzhcimeL'$ dilease conWMd I number of beds Cltenna
for the ~)'("hiatty of old &le. This unit catered for palicllll with both
functional Ind orpnlc: disordcL'$ which had redu«;d tbe pressure 011
IC\IIC beds in lhe I\o5pital. The unil as a resull hid become I mud!
more buty Ind lively piKe MIll I higher turnover of pahenll. In 000·
junction ""th lbe Menlll Health A5s0cia11on of Ireland, lbe boIpLw
had published I dir«tory of 1'CIOUn::es cnlLtled Good PrxIlca III M_
III Unit" for 1he Borou&,h of Dun l...qIUIire. The Order·, poIicy __
11&1 .,.. qullJty auuruoe, Q ....,y I. A<do. wu launched in 1992Orient.llon KSIiont 1II'I:re held for all hoIp!!.I.l
Ind quality_·
ana: ICIDIII w~n established irL all dcpartmelLlS durinll99l.
.u«
A IfOUP hid beell c:allblisbed to eum;nc the role 0( the IIoIpotal ill the
naliMa] and intcmIIllonaI de~lopmell!J irL ~)'dli.try. T1Iif
li&bt of
JrOUp which ..... known as Vision 2000, included Itlll' memben from
I.... commUlliry cal~hnoent IlI'U 1oCrvK:e It 011&;11 Milwre in Bladlrod-
STAnlNG
Mcdica.l II. ffilLl calWllcd of four c:onsulllnt ps),,:hiIUil!J inctudillj ltoe
medical director Ind seven NCHDI. "The pa~dicalll." COII5l1ted d.
...
two hlll-11I'ne Md two J*1·11mC IOCiaI woRe .... IWO KIWor ..)'dd'
0JIIIs. live ooxu.p&tional IhI:l1IpD11. lour of .. hem ~rc IIIIped 10 the
1C\;V1ly ot.nrc Ind onc to tile ~nt unIt no.. nllnlll& compkment
tOCIUcd. 121 .. lIole limc equlvalenl pollS ....:Iudo"'. du«tor of nlltlUlJ.
two _ant d"mon of nllnlllJ. IWO nune tll'on, onc nichl MlpCnDUndenl. one deputy niJht wperintcndent. m: o::Urp nlll'Kl Md ICVCII
deputy
nllt'KS witlllbe rc-.tdcr be"" staff nW'lCa HId MloIdcDt
.-
wrtc
ADMISSIONS
Therc ..ere 1.B15 I'Im,_ 10 the St Joha 01 Cod Ho.piLll ill 1992
compared 10 1.769 for 1991111d I.m for 19116. TIle O\ImlII_bcr of
Idrnlssiont had illCfel.1ed rcfl«tllll'" ~_ In IdmDIioas from the
CI...in Mhllirc catchmenl ilfCll Km..c J.nd from tM private ICmcc. TIle
bed occupancy In lhe hoapiLll varied qWlc Jiplfantly OYCT lbe YUf.
TK.c ~rc 186 p&tie-nlS rcaidelU In Fcbniary. 1992 ~ 10 162 In
A\I&IISI. 1992 and 161 in Otccmbcr. 1992. TIle bed 0CCIIpIIICJ for
I!oIpiLll for 1983 .... 2QS IIId 1Nl rcdIIced over UIc ,an 10. Iow 01
163 in 1989. The bed Ql;CUpMC)' for 1990 _178, CIOIIIp&Rd witIIlMl
in 1991 .nd In in 1992. Five poinl two per cellt 01 pnvalr ~
"cre On tcmporal)' ceniflCl\let; compared 10 UU per cent for public
*
............
GENERAL COM..'YIENrS
Ai IlIled in prcvioos reports. tbe UDR ambic~ 01. tlIis!ootpiLll _
of thel1lpeulic activity. The lIandani of fumitwc. decor IIId
hypenc in the hoIptlal .... NltallClOry IIId iu cont;nlled rcPlI1lUOll
11 &11 approved ptychialril: ~ltll1ioa fOf a furttwr Id moathJ _ tare-
onc
KrvedJy n:com/IIClIded.
The Order'. policy manual
Oft
qUllity _ _ entitled
o-tIIJ ..
Artiooo .... made .... iLable for inspection. The qIIIilty _ _ 1 _
~re ~ every _ _ iD tbcLr mdelWOIIIt 10 1$ Ihc qlllhty 01. care
IlIIIdarda ob;mively. StaB" INOQIlted..,lIt tIIiI Wtlallve aDd tlw: VWoa
2000 initillllve _re 10 be Cl
•
d for mar dfoftIl ia -1ItiIItmt
Ihc boopital 11 a ocntft 01. ~ in rclati(lll 10 pl)'dlaatric IIcaIUt
"".
'nIc:re .... a .nUC!! opcntiollll policy iI AdI .... &lid Ay ICf\Iiec
llIuq the I"'fPOIC- aims aDd ot,ecltva 01 !be __ 11 wOIIkI be prricfable it lhac potic::ic:, _
p(*tioMd 1t1Icre tbrJ - * I be mod br
,.,
and INdc: .vailable 10 pIIl1ellll and VISIlon. Calli plus for
_Ili in opention and It..: _&reed model or III11S1I11 care .od
..... It..: OIlim model Nl,ln;inl f;aJ'e pI'lII mec:ted 1I random WH: $11111fKtofy. 'JlM,re WIli no not_ Infonrulll plltienlll ...... '" pubCuIU.
involunl'l)' palicnu of lheir n"'llI .nd this oecdcd 10 be ~red.
'JlM,H: ..... no ...... in~n c.:omplalnlJ pl'ooedllre .vailable and known 10"
1t.1r Immbe,.. bul ,11 pallents IUVlng lhe I!ospital on ditch,. . welll
asked 10 complele. queslionnalre indicating lheir $IIliIl'acllOll or diMaliltldion with aspecu of ~rviI:c provided. All oompl.linu made in Ik
hotpolal _Ili recorded. ~re
In .nnual Iliview or the IItf"ice br
the .......,elnClII team whim met 011 • wukly buit and ... anmaaI
tqIOtI ..... prodlJttd. A ropy 01 thI$ report was proridcd 011 IIIiI
~ryonc
~ticnu
w'"
llllJ*lion.
The prim.1)' nll"'"& 1)"I~m which hid been introduced ~lIIb1cd I pili~nlto identif)l. key wort~r Wlthlnlhe J)'Stem to discll$s .ny problems.
AU IlIft wortmg in lhe boapitlll wore id~nliflC&tion bldle. which eaKd
rommWlalion. "There ....... nuninl informllion ')"Icm or proecdIn
book $Cl1inl OUI clear guidance on pl'(lCedurC!$ which was IVlli\.Ibic to
all IlIff ItId ..... regu.llrly reviewed and upc1atcd. TIleIli ...... into<·
.... Iion IwxIbook for palicnu on admilsion 10 the baspit-.J IIId ~
_ldequaU! .... ilIIbiilly 01 hellllh ftiucalioo Icaflell. The beIlltla •
c:allOll JfOlIp orpllised iftfllnllltMIII temil'lln for palients and IlIIaUYa
011 pl)'l;hillulc illncs:$ and OII ...rious forms or chcmolherapy.1lIcreI WT'inen lCdusioa poIlc:y and 11«11IIlon boot Ind nurtoi.n.&
tbuIt
were kept. TIle ICdU$ion policy ..... IlIviewed Ind 1,Ipc1llcd 011 !be hI
Februal)', 199). It WII SUlJCSled Ihll the wording on lhe 1I\1.1'1i1tg now
dwt be chanted and there ..... a need for • mwlnl plMI in !be ICChIr.ioII room. The facilities (or ecr were Atlsfactor}'. 1lIe1li ... ID ecr
proIoeoI and the Roy.! CoIkJC or hydUa.lrisu Quicklinl!l wre pront'
illcnlly displ8yed. The procedure for ECr was A~Of)' but it _
lUftC$Ied WI the pre-ECr nllnUlJ cb«t-eani J)'IWII and the _ _
form reqvued __ __ mocii&abOal. LotalIy prodllCl!d wrrttn
now
intOllNlUan for paticnullld relali_ on
Ecr was.1so reqllimi.
A wntten Idmisslon polity w......,lable in the Idm;,.;on 1ft. and
lXlnIuJtllll ~ydUa.trim Ii&Md .11 involuntary Idmisalon tonnt- 1brR
were cIcIIr diJchJ,rae gllidetinet .... il.ble and t!lOW!! \0 Il1Il1Ift. Pltlellll
W\'I'e giv-en written infOnllllIlOll on rnediq,tiolllO lake borne wilb!be"
ud III appointment and telephoae number 01 the hoipttal _ ...,
J!Y1:. 10 IhI: ~timl 011 disdutTJl!- ~ . . fecdt-:t. fn:m ,.....
pneu~ on IhI: qulllily of ICtvXOe prorided 11 tha lIIIIuIll praI
pno;otbl!cr IcctIU"el and
from pIIDcntl &Od fImiIiIII 10 tbc
..
feed'**
quatiorllwre ~~ The
rim"" _
10 IIIe ~ were fIuIbk
"";(I~II poticy
for lhe order;n •• preKribma. lI00F Md admirutIllIlion CJI au 1Mdi.
tines wu in operation. 'The stOl1l&e llUlI were ItIllIfactory u .... lhe
II1I.nSport .ylt~m ilel1'l'1l:cn \IfIIts. The pbannacy reQWIIlioII boot for the
hoqIital required updlluna. There .... I 1mIIk.na policy in thr IIoIpital
Md !here 1'1'11:", deslpted unotlJll ....:I IICHIIIOkuI& ....... All are.
were appropmuely $iJnJQtcd. The QIIIbty of food for plltltllts ....
IoIIlisfactOtJ and men ... were reviewed ca I sU: weekly qde. Meals were
provided 11 wdlUy MX:cpllble lirroe. ....:I lllri pb)"Ul CQvironmeQt 01
dinina arcII and Qualily of t.bIc.......... oil hip order.
....:I !he facil,hQ .... ibblc for .... Ion weRAtWKtOry. A
A aofely committee had been Ippomled and IIIri IIIfcly SUlemrnl for
the hvlpilll Ind IoW uni""" wilh Ihe pn.a~fI. A ....,uen pobcy ....
lvailable in Ihe ~t&1 on mln""l bandllilt....:l '11ff h.t been tnlincd
OD liflin& ledtniquet. A rftOrd .... kept olllD tI1IWDc propanuna:
"'lIh lbe Rima of au those wbo Ineodcd. There .... ODe IcmIre pI"
~&r for au ruff 011
prcwlllioa ud tile . . . 01 IlD lid' wIto
11!CDded wcre recorded. A lot .... kept 0I1IIIID' oulbru.b 01 lire ....:I
of action latcn by Mall.
rITe
The pounds and thr buildlnp 01 tbc bo$potal ..,re maiataiMd t.o a
lap -.datd. 'Th::rc ...., hiah Quality RppoII'", bodI
ad
utmlally witb adequale facihtiel: for tile diIabkd ...:I fat:ilitiel for _
lITe activities. NotltClbIe in ttu. IIooIpital .... thr -..iDsI;,lulioul
~.1'&rI1;C of wards wiLb IU lrell be"" coadlIt:iw 10 aood ~
care. Access 10 . uppon dinialllCrvicaI ,..;1hlD the hoIpitallUdlll de ...
tQtry. pbysiotherapy &Dd cturopody .... 1tI~.
iDle,....,.
~ndiled by the Royal CoIkJc 01 Paycbiam.u for
media] traini", Ind .... Ipp!O"td by All Bard AllnlIIIiI for 11_
The hoIp.lll ...
II1I.lnin... 'There was onJOinI in-fCrvio::c tnIiaiftI for nursinJ, Qlmn, ....:I
other .wr and records were ktpl CJlIlD II1Iininc ((1W1CI.
There ... I n cthla mmmincc ill dUI ItoIpIIII &rid tbc l1li: IIIHtDrc
.... two ~b prior 10 !hit iDspeetloa. The proc:edare for rcpor1u., of
~n"lo palients .... ItItalactory IIId I q 01 au -unts and the
KTion luen _ kepi. There .... I n«d for ID -u11I reponin& polIty ineorpontina the Dcp&rtmCet 01 HeaItb Qulcku-. ~ IIWIIfC"
~I leam were wortiac l1li I poIiq for thr ....... 01 ~ R,.
lily Within the hoIPlII &Dd tM ~ li1liiii« rro... ~ 10 other
IMlI.pItals. 1'be Wedioa control policy _
II'OOrpOnUN .,thin the pr0cedure book. There ..... I policy rcpnlml paloenu' ~rty wbk:I._
utwactOl'J, 1'be code of professional c:ondur;t from An Bon1 A11tMaD
for nW'$a"" lvailable in the servitt.
ST JOIIN
or COD HOSPITAL. DUBUN _
1993
L~SPt:cnON
INSP£CT£D ON " DECEMBER, '993
GENEKAL DESCKIPTION
or TilE SEKVICt:
There were .pproximately 180 palienb .ccommodatN in the SI JohP
of God HOIpi\.lllon the day of inspection. tlliny of whom wc", ~III
Hullll 80ud patif:nts from the Ollll;n Mhui", servitt. 1'hc:re ftfC,-u·
ioUII departments in the l\oe.pItal IlICh as units for you.nl adokIanU.
the OI'pnic elderly and the flmalonal ddcrly.
Medicallllffinl CX>IlSisIN of the lMdieal director and IIlree IXlII&IIllUltt
M:~ the privtote hoIpital. The Eastcrn Heallb BotIrd palimll
wcre k:Iokcd dler by thell" own CXM\SUlllnts from the auain M/lu~
IICrviot. 'There WIS a wide range o f olher Ita" 5U<"b as IOdaI workcrs.
pI)'ChoIogiIts. occupalional the,.pisl& a nd housekeepin,llIff.
wbo
A full lour of the hospital .... tarried out Ind CYCrytlli1ll ..... found In
be iD OI"der. PIrti<:\tl.ar '"Clition WII pPd to the seclusion room whidI.
(IQ ID earlier inlp«tioa. CIOused _ m heause of !he
01_
obIe ......1MIa pancl. This problem lud been reo:::tificd by the ~
01 a ~ pancl wIUch provided vision iDto moll of the sed....
"'11«
-
..
ILOOMnELD IIOS'"AL. DU.UN - 199] INsncnON
INS'ECfED ON 14 J UNE, 1993
CF..NEIlAL D ESCRIJ'TION OFTHE SERVICE
BIoomf,eld HOipilal opcri.'jKd in \be: c::IlK cl ~natria aDd tile
acoornmodalion oonsi5ted or wily IWO beOf III AIIp. doable and IilI bed
unilt, all of whkh were 0Q0;Upied on \be: dIoy or inIpcctuI. In lllidirion ••
IWO ~orcy ronKMlIOf} ovcrloolullI tbc: Ittractlvely laid OUI IfOIlIIds
had been built sirw:e the last inspection. T'hi$ ..... In llIIo!cnily whicb_
obvioutly enjoyed by lhe patients ia the botpltal.,
Ther~ were I_nly five adrruuions. five cbdwJCI IIId lwenty .,.
dealt.. in 1992.. Twenly IWO pt.tienb adnull~ were a,ed hcrw.tn forty
and IilIly five yel", wh,le Ihr« ~re (Wtr sUay live )'CaBot . . 'lKre
were wily one pt.ticnts in lbe ho(pll.ll 011]1 [)eonnhcr. 1992, fifty.,.
cl whom were over IilIty five: )'Can ot . . wbilc lell were OB lAc fony
to IilIty fiH • IJOUp. Fifty lhm: ollhc pt.lXnl:l_r ....,y fM, yean
ot. _re volUlltary ud eiJIu wcre WardI of CoIIn. tWCllIJOIIC wct'C
privale pil;entJ IUId forty wen publiC pahtlllJ .'bo wtf1: iUb¥m1ed by
tbc: Eastern Heailb Board.
Mediall CO\Icr ..... prov;ded by !WO acncral prxIltlolor ... NUflUll flan
<:OnIi&led of • matron, tWO NOs. ..,vcn ltaft' ....,.., twenty cadel nunes
Ilded by one orderly and five domeIIia. Ni&hl IXIVCr .., provIdc<.I b)'
two ltaff nuT1C!l and four part-tilllo!c IIIIf nUf1Cl. Three malnlclII_ Itaff
were alIo employed and administralion _ anicd 0\It by. IleCJCwy
and two PJlrt.time lllittantl.. Ancillary tcrvita 1UCb .. dllIOpOdy. dca·
tiltry and physiotherapy were proftcIed 0II.1Cf.\iOnIJ btiis.
The lire prtMfClion ')'Item _ ..tillalory .ad led_OIl fire atId fife
drill_re c:arrioed OUI ~ yurly. Vo/llDtlf)' J108PI..u.ted moo.fitld
reJlLlarty 10 entertain liIe pt.timtl.. P.~nll lied ample _
10 1110:
IfO\IndI but they were !lOt aDowcd _
10 !he fl'Olll ollhe IXIlIIpiClI
boause 01 ill pnmnuty 10 tbc: rt*I and IIIe dIn&cr cl
off. Tbc MandardI of dc«Jr. b~ aDd .,.oml ~
!bar"""'"
were ",istKlOl)'.
BLOOMl-lELD IIOSPITAL, DUBLIN - I") INSPECl10N
INSP ECTED ON 16 DECEMBER, I")
GENERAL DF.SCRlmON OP THE SERVICE
Twenty nine mile and tluny femlle patienu wcre resideDt ill Bloomfield Hotpotll on the dlr of inspection.
SllfflllS eonJUted of the mltl'Oll, 1_ '''Ien, seve n Sllff nurses. twenlY
cadel nUQCI. one male o rderly, thrce IWlililry nul'Kl Ind thrce part.
lime nul'Kl. In addition. there were nine lM)U$Chold IIlff Inc1udi"lIMl
piln-ume Illff.
The RllI(b,rd of ac:oorrun<xblion &nd the level 01 patlelll o;:are wen:
Ahsflaory.
ST AUGUS'nNE'S, COUNTY MEATI1 _ 199) INSPECOON
INSPECTED ON 16 APRIL. tj9.l
CENEIlAL n F.SCRlmON OF nlE SER VICE
Fifty thru voIu.ntary palienlJ. all of whom were over siJlly five )'Can fA
.." _re aa:ommodIt~ in RatOllih Manor on the dly of lmpKDOL
F'lf'Ioca ~ticnu _re subvented by the Eulcm Health Boud- 1kR
...:re tHl 8dmiqioog &nd t...:1ve discharp dunnll991.
Mcdic&I rover na provided by
I vitJtin, COQSulIPt psyduatr.t pd
by , Fner&! pnlC\ltioec:r. Eithl nunln, Ind fony
IIlff wen: Mo
employed. DentIStry, cluropody and physiotbtTlPY _re pro>idcd (Ill'
'*"'
..............
The fire dclechon l)'Item "'.. salisf.a ory and the pIIlicnlJ wen: MUll
weU ... red for in Iltnctivcly furnished ICCOIIImodatloo.
lOO
sr AUGUSTINIE'S, COUI\TV MUTH -1'U "~'lEcnON
INS'IECTEO ON' OEct:M1E1t. 1"3
GENERAL DESCRIJ'110N OF THE SERVICE
FIll,. two pltients were ~tcd 111 Ratoath M~ on !he day
of 1Mpeetion. Tbcrc _re tWO~. two _
,",re bcm&dec:orIted. 'fhcre had been nine deaths and tbinttn ad~ to Ratoath
Minor in 1992. Finy two "arr were cmplo)'cd Ind mndiaI CO\'er_
provided by I local &cnertl practltlOMr.nd • _llatJl P')'dII.tnst
11$0 visited.
_re
AI uwal S, A1IJU'Une" ..as IflOIIca and 1III~lcly hp( and
P'llieOts
cvMkntly weD cared for. A rue proIfCtion ')'IIelll .. IIIc:h
... salisfllClOf)' _
in openlion.. The ryslel1l .... repLarty inI:ptCled
by tbe rue offio:er IDd fin: d:riDt were held repLarty
IUGlnlELD AND HAMJ'STf.AV HOSPITAL5
_1993 INSPECTION
INSPECTED ON If JUN£, 1"3
GENERAL DESCIUmON OfnlE SERVICE
llIcre
_re
Ihree ~1I1S 10 u.. Hiablklll IIId HampIIUd ~
C>JftIi1liat of HunpPcad, H'lhficld Md tile _ A1*oIMr'. U..I
lbe Hi&bf~1d C&II1pUI wIIich ... 1I5o tMwn.!be Care Centre.
0.
Thin,. four maJc and three femP: cldo'rly ,.Iienll wonw ~ted
in Hlmpslead on u.. cia,. of wpection, thRC of _"- ..,,"' Wlrds
or Court. Thll unit ..., 11I1¥li~1y d«orItcd with UICIISI~ pounds
JIrOvidu., I peaceful IIId tranquil KIliD&- ne fire 6et«l1OCl !)'Itcm
... satilfM:tol)' and tile 1Iandard1 of brJicM. (lire .nd dcg)r _re
cxecllcnt,
Thirty eiibl female pallents were aa:ornmoo;bled m Hi&hfldd l1li tile
dly 01 iNp«lIoa. One p'-l1ent who ..... , Ward 01 Cour1 .... lemp«.
lriIy ,blenl 11 she was hO$opltaliscd in lhe Mlter IIl11pllll. 1be staAdanh 01 CIte .were 01 the ~ order I!Id the unil ..... '1I1XIi~ty
.....,...
Twenly IWO pIIucnts were aorommodIlt(I in lhe AWlcimcr'l c.n: IIIIIit
on lhe dly of inspection. There had been ...
in ~ oecupucy.
OGly four paloc.n~ were IOXOIIImodalfil in the urul 'I the t,me 01 tile
Last inspection.
'neJe_
ru~ty mne admissi0n5 to the three u.nill in 1992. $lily IWO
dischlr~ Ind fourteen dealhs. The diagnoses Iltnaro from mbo:iml:r'1
There were
dileue and allied organic conditions. affectIve dilorders.lChil.opltnnil.
menlll b... d..:ap and Ikobol related iIIncact.
On Jbt Deambcr. 1992 there.were IOS paloc.nts aa:ommodltcd in ~
tiuft uni\l., of .'hom tcvtnty IIine we.e over Ji.l(ty live yurs 01 . .
lwenty ... ere: in the for1y to sUlly five •
VOUP and Ioi.J; were iD ....
twenty 10 fOft)'
IF VOUP. Twenty onc palients were subVenlnl "" ....
E.lem HeaJlh Board.
Mcdio;al cover .... proridcd by IWO _ltlnl psychialrim IJId by 0lIO
FIIC!IlII pnctilioner. There were twelve nunin, staff inl;:hxlllll 0lIO
m.lrOG, lwenty clibl nlllK-aidcs Ind twelve domeslk: NlfJ. Niabl ~IIB­
illl cover WIll proYidcd by Ji.I( Aaff nu!'$CI Ind c1ahl nurte-aXIc:I. Three
m.intenance Illff were Iba employed. SuppGl1 dinicll tcrvioel such.
denlislry. chiropody and ps)":hothelllPr were provided on • pari ~
"""
HIGIIFl ELD AND HAMPSTL\O HOSPITALS
-
I") INSPECIlON
L"IISPECTED ON 21 DECEMI£R.
'''J
GENERAL DESCltlmON OF TIlE SERVICE
T-«cnty lour wo!unllry patients. most or "ham ... ere femak .-ere
atton1IIIC)dIlnlln lhe thirty two bed AW>cimcr ..... c UOlI on lhe <by 01
inspec1ion. In Iddilion, four day~ paWnlS IUfnded the unil. Somoe
p!llifnt, rcqwinl m,iw ~ 'An to k ICCOIIIllXldltcd ID the l1li11
dllriq the Ouw_ holidays. Staff"" a.siIIed 0I1WO III1f'1iDa Jtatr
IIId IWO nlln.e.aides dllnna tbf day. WltlI IWO Dw.I 11 IIi&III- n..e.
staff were wppIe_nled by bouItbold aDd ~ IlafL hbnlS
'" tlIilwut were low do:pmdea<y, _
or aD 01 whom _re ambuIIIIt.
_,-,,-,tee!
Forty onc female YOIunllry pIOtirntI ~
ill HiJb&1d
Hoapital on the day of uupecuon. There _re ei&;ht ~ IlaIJ on
duty durin, the day and four.tIff II Di&bL Admilmtnuft w.ff were
Ibo employed.
Thirty volunlary femlle pIOtlenlS were ICCOII\IIIOCIIled ia HIIIIP'lcld
Ho.pilllon lhe day of ill$pU!ion. MOll of HIIII..leld ... been decor·
Ited Ind pIOintcd sine.: the list inspecboa and tbe pbysbl ' " ' _ t
WIll p1e_t. Apart from I small dormitory• ...:.I 01 the "Iienll Iiad
lbelr OWl! rooms whidl were briJbt IDd checrfl>l. El&b1CC1l1tatf '*"CtC
a.i&ned to thiI IWI. tJUrtc,ca of whom were I1IiDed nuna HId !be
n:1IIIindll:t _no Iides or onkrlil:s. Three IIL11K1 1-.1 IWO 1IIInC...m&
were on dUly 11 nipl .....1II two fwtbtr w.ff 1¥IiIIbk tor ....t duty. If
~lIued. In addilMllL eapl uc:iIlIry IUIf IIId IWO a-Iry w.ff .ere
IlIo employed.
The ph,..1 conditioN and SW'IdInb 01 can! do tbe AIzM_. Care
Unit. HilhrlCld Ind iUmplleld were Au.fICCOr}'UId tlte fiR prouc1tyStcm wu 1150 AlisfKlory.
ICYLIEMORE CU..... IC, COUNTY DU_UN -
Itt) L"iSPEC1l0N
INSPECTED ON 14 JUNt:. .,,,
GENERAL DESCRlmON OF m& 5UVlCE
Tllirty IICftn pIItoc:nll wetc tc$idml in Kykllll"lR 011 ~ day 01 ~
tloa, There wcre ninclCCn adm;-jont: in 1992, r.IYI! ~ and la
do:lu.. Foortcen 01 IhoJe admitted were <wcr tilLly lift yean 01 . '
three \llf:re III tbe forty to WIly five lac POUP Ind IWO were id tbe
213
I_nty to forty IF VOUP- Diaposes vamd from beh.avoounJ disturbance, orpnk: confuslonalstatcs. dementia and uni and bipolar atrcaM:
disorders.
On !he 31 Deoember. 1992 !here were thirty lit voIun...,- piltienl:$ resident in Kylemoft. thIrty five of whom _re O\'t':r suty Ii.... years 01. ...
Thlfl: residePII _re lulM:ntcd by tile Eutem Health ao.rd.
Medial CO\Icr was pnMdecl by two vitltin, oonJIIltant P')'thUl[mllpd
by a FnenJ prICIitioner wh o 1'I'a$ available on I lwen[y four how- beIiJ.
Numn, rover wu provided by a matron. OM NO. seven 1[111 nunes.
founun nurse-alcte. and four mile orderlies. NiJht duty COYer was ~
vided by onc: It.1f nurse Ind [hree nurse..idcs. Contl'kl clcltlCr1 IIId
kitchen ....If includina I d .d and I cooIt. were 1110 cmplo~ Ao;eII
to IUpport clinical serriI;:Q such u dentistry. chiropody and p/lysiolherapy _re provided on I scuional basis Ind OC'CUpiltional tberapf
ICSIion:!I were earned OUI twice ~kly.
Voluntary
aroupI
"';";tcd frequently. The fire .'ely lylIelD no
NIGfactory_
1bc entut ambience 01. [his facility ..... pleasant and lhe IJOUIIdI wen
IIIIact,",ly tept. "'lieoll had 951 _
10 these pn:lclll wlLic:h tber
,,,mly Ipprenated.
'The lI.ndard of e.re. decor and byr;icne were uctllent.
KYU!MOR E Cu.....
c. CO UNn' OU.UN _
1.,3 INsrEC11ON
INs r ECTEO ON 16 DECEM.ER. ,.,3
CENERAl m :S<;RJmON OFTHE SERVICE
Sil mlk Ind thony one female pilhenl$ were I(X(WlInlOdllcd in !lie
Kylemore Oink: on lhe day of illSp«tion. All o f the pillknll M'rt cw.
c.ly and the ,rul majority suffcrtd from orpnK brain o;,onkr aDd