Kilkenny psychiatry department’s compliance drops in watchdog report

Thirty-nine areas were evaluated in the unannounced annual survey, which took place in September 2024, with the department rated as compliant in 31, non-compliant in five, and not applicable in three. 

Although St Luke’s ranked in the top half of the 13 centres inspected across the country, its score has steadily dropped from 94% in 2020 when it had two areas of non-compliance.

St Patrick’s University Hospital and Lois Bridges in Dublin recorded the highest scores, each receiving 97% with the Central Mental Hospital, also Dublin, getting the lowest grade of 51%.

Of the five problem areas observed in Kilkenny, issues in individual care plans (ICPs), premises and staffing were deemed to be high-risk.

Ten individual care plans were reviewed as part of the inspection with a required assessment to address the residents’ goals and care needs not conducted by a multi-disciplinary team (MDT) in five of these plans.

One ICP was not developed by the MDT following a comprehensive assessment within seven days of admission while five plans were not reviewed weekly by all relevant members of the MDT in this acute setting. 

The premises were generally minimised of hazards, but some ligature points had not been reduced to the lowest practicable level, leaving a potential risk to residents.

The centre was kept in a good state of repair apart from a broken socket which was fixed upon discovery.

In staffing, the unit had two dedicated occupational therapy positions. One of the therapists was on statutory leave at the time of inspection without their position being backfilled.

There was evidence of cross-cover with nursing staff providing some activities where a reinstatement of the dedicated occupational therapy resources was required. Corrective and Preventative Action Plans (CAPAs) were provided by the unit for all but one of the five areas of non-compliance.

Some quality actions that were observed included several new training initiatives delivered by the unit’s psychologist. 

These comprised a trauma-informed care workshop for all staff of an inpatient mental health unit, training for non-consultant hospital doctors to improve their skills in assessing and supporting residents, and a ‘Managing Emotions’ open skills-based group for residents on Sycamore Ward.

In addition, St Luke’s secured funding for ‘de-escalation benches’ as a further step towards reducing potential restrictive practices and a library was installed to help residents learn more about recovery and read hopeful stories of other people who had improved their mental health.

Residents interviewed by the inspection team gave generally positive feedback with comments including, “food is fantastic with good options” and, “care and treatment is very good.”