“Cause for concern”- Midland Regional Hospital found non-compliant with regulations

Midland Regional Hospital Portlaoise is under scrutiny following their annual report from the Mental Health Commission (MHC). The hospital's psychiatric department was found to be non-compliant with regulations surrounding the use of restraints, the lack of patient privacy, and the premises' state of disrepair.

The hospital was also found non-compliant in the reduction efforts of ligatures accessible to patients.

According to the annual inspection report, the hospital failed to record the amount of time a patient was left in restraints. It also failed to identify those responsible, determine the compliance with the regulations, produce a report on the following meetings, or provide a plan to improve patient care.

They were also found non-compliant as they did not determine if there was compliance with the rules on the use of mechanical restraint for each episode reviewed, or the approved centre's own policies and procedures relating to mechanical restraint.

The report stated that the hospital premises non-compliance risk rating is high;

"The approved centre was not kept in a good state of repair externally and internally. Floors were heavily pitted. Cigarette butts and litter were evident in the gardens. Some windows were dirty on the outside.

Walls were marked by wear and tear and needing painting. However, it was noted that there were plans in place to resolve most of the issues observed."

Picture: Midland Regional Hospital Portlaoise

Only 48% of centres comply with national regulations on restraining. The CAMHS sector reported the highest number of physical restraints, accounting for 19.77% of all reported episodes in 2023.

There are four different codes of practice regarding the use of restraints, and compliance with all four codes averaged just 57% in 2023. 

The report found that less than three fifths of centres achieved this minimum standard. The CAMHS sector reported the highest number of physical restraints, accounting for 19.77% of all reported episodes in 2023.

"There are rules covering restrictive practices, seclusion and mechanical restraint,”  said Prof Jim Lucey MD, who oversaw inspections of the mental health centres.

“Sixty-six approved centres were inspected in 2023. These therapeutic locations are dedicated to the acute care of people with serious mental health difficulty in a residential setting.

My inspection found that less than two fifths (39%) of these approved centres were more than 90% compliant with regulations, and only five centres achieved 100% compliance. 

MHC regulations represent minimum standards. They are based upon legislation which came into effect in 2006. And yet, still, after 18 years in operation, only a small minority of approved centres regularly achieve full compliance.

The continued failure to achieve compliance with minimum standards is a cause for concern," he said.

A corrective action plan has been put in place to ensure the hospital meets required standards.