Kilkenny psychiatric unit records slight improvement amid ongoing issues in new report
St Gabriel’s Ward at St Canice’s Hospital in Kilkenny received a slightly higher rating than the previous year in the annual Mental Health Commission report despite multiple high-risk non-compliances.
The unannounced inspection took place from 24-27 June last year and identified seven areas of non-compliance, a reduction from eight in 2024.
High-risk problems in therapeutic services, admissions practices and the use of mechanical restraint were detailed in the report, but also highlighted were “many encouraging findings during the inspection” and that “feedback from relatives of residents indicated high levels of satisfaction with care and treatment provided.”
The rise in compliance from 74% to 77% over the year will be a welcome reversal after an alarming drop from 97% in 2023.
A key problem identified by inspectors was the lack of an occupational therapy programme in the ward as the OT was on maternity leave and no short-term cover could be sourced.
This led to St Gabriel’s lacking compliance in ensuring that programmes and services provided were directed towards restoring and maintaining optimal levels of physical and psychosocial functioning of residents.
Another issue was found in how service users were admitted where one clinical file observed did not have a documented risk assessment as part of its admission assessment.
In the area of rules around the use of mechanical restraint, a mishandled incident was described in the report.
An instance of a lap belt and bed rails being used to restrain a resident for enduring risk of harm to themselves or others was not ordered by a registered medical practitioner under the supervision of the consultant psychiatrist responsible for the care and treatment of that person.
A risk assessment of the restraint later did not take place and was not updated and reviewed, at least quarterly, in line with the person’s individual care plan.
Even with several high-risk non-compliances the report surmised that “there was strong commitment to provide an excellent service to residents and family members confirmed that every effort was made to ensure their relatives were well cared for.”
Some quality initiatives observed included a new cinema room, hairdressers room and common area in the facility along with an orientation board and a dedicated end-of-life bedroom.
Since the previous inspection, toilet and shower areas had been upgraded with significant investment in infection prevention and control facilities.
The unit outlined how it would address all instances of non-compliance in its Corrective and Preventive Action Plan.