Psychiatric unit's compliance rates with regulations continue to fall

Compliance with national standards continues to fall at the psychiatric unit at Roscommon University Hospital, according to the latest inspection report by the Mental Health Commission (MHC).

The report found that residents’ privacy and dignity were not maintained at all times, and that not all staff involved in physical restraint were appropriately trained.

Furthermore, as keyworkers were not in place to coordinate all stages of a resident’s stay, there was no point of contact for the resident, their family, carer or chosen advocate, the report concluded.

The unit has a bed capacity of 24, which was restricted to 22 at the time of inspection, July 22nd to 25th 2025.

Published recently, the MHC report found that the centre’s compliance with the regulations governing mental health facilities had fallen to 72 per cent, the lowest score since 2017 when just 46 per cent compliance was recorded.

There were nine areas of non-compliance, with one, ‘Use of Seclusion’, again deemed a critical risk. Inspections from 2024 and 2023 also found this area to be a critical non-compliance. Six non-compliances were found to be of high risk and two of moderate risk.

The report noted that the patients found staff kind, and helpful. They were also found to be professional, engaging, compassionate, and discrete. Residents also made a number of suggestions including improvements to charging facilities for devices so they could stay in contact with friends and loved ones. This was acted on immediately after the inspection, the report said.

The report found that the unit’s seclusion facilities were not maintained and cleaned in such a way that ensured a person’s right to personal dignity and privacy.

“A section of the flooring and the inside of the seclusion room door were heavily marked and stained,” it said.

Three episodes of seclusion in relation to three different individuals were reviewed by the MHC. In one episode, an individual placed in seclusion was topless for twenty three and a half hours.

“There was no proof that the individual was offered a top or a refractory top based on a risk assessment.” It was also not possible for staff to clearly monitor the person within the seclusion room using sound, the report found.

“The ability to hear when someone was speaking through the existing monitoring system was not there, given that in the seclusion room the sound quality was unintelligible at a normal volume and tone of speaking. While a written record of the person was made by a registered nurse at least every 15 minutes, these written records did not consistently record the person’s level of distress.” 

In terms of addressing this critical non-compliance, the HSE said that all relevant staff received a memo in August 2025 regarding the requirement to repeatedly risk assess the need for ongoing extensions to seclusion . All staff were reminded that if a patient does not wish to wear their own clothes, alternative clothing must be offered and documented.

Regarding lack of privacy, the HSE said that measures have been put in place but the “ultimate resolution will be via a purpose built new build”.

This new 40 bed premises has been approved by the HSE. The aim will be to have a design team for the new unit appointed by February 2026, to commence the preliminary design phase for the new facility, the HSE said.