Portlaoise mental health unit gets good report despite ‘high-risk’ failings

THE Maryborough Centre in St Fintan’s Hospital, Portlaoise, was found to be non-compliant in three key areas of care, in a report by the Mental Health Commission (MHC).

The report, published on 4 February, found three high-risk and one moderate-risk non-compliances in the centre, which provides continuing care and psychiatry for older people in the Laois/Offaly area.

The unannounced inspection took place over a four-day period in early July 2025. The inspection team’s findings were positive, with the centre deemed 84 per cent in compliance with the rules, regulations and codes of practice.

However, the report flagged concerns in four key areas, including ‘Regulations on Premises’, ‘Staffing’, ‘Risk Management Procedure’ and ‘The Use of Mechanical Restraint’.

The MHC report noted that staff at the centre comprised a vetted multi-disciplinary team of medical professionals. However, the numbers and skill mix of staff were ‘not sufficient to meet resident needs’.

Staffing numbers were found to be insufficient and an MHC review of the rota over an eight-week period showed that lower staffing levels were often in place after 5pm, with only two registered psychiatric nurses on shift. The centre was therefore deemed high-risk non-compliant in this area.

The report found that the centre ‘was kept in a good state of repair externally and internally’, with adequately-sized rooms and appropriate ventilation, heating and light.

However, a report from a fire specialist dated in May stated that three emergency doors failed an inspection. The centre was still awaiting costing to resolve the issue at the time of the MHC’s visit.

The centre was therefore deemed high-risk non-compliant as it ‘did not ensure that the physical structure and the overall environment was developed and maintained, with due regard to the specific needs of residents and the safety and wellbeing of residents’.

The centre was also found to be high-risk non-compliant in its risk management procedures as ‘not all health and safety risks were identified’.

The report states: ‘The registered proprietor did not ensure that the approved centre implemented its risk management policy throughout the approved centre.

‘The risk management procedures did not actively reduce identified risks to the lowest practicable level of risk, as the accuracy of the risk register and the identification of existing controls were incorrect.’ 

The Maryborough Centre was also found to be moderate-risk non-compliant in its use of mechanical restraint, used for patients who present ‘an enduring risk of harm to themselves or others’.

An annual report on the use of mechanical restraint at the centre had been completed. A multi-disciplinary review and oversight committee undertook a review to determine the appropriateness of the use of the restrictive practice.

The review outlined the arrangements that are in place at the approved centre to ‘reduce or, where possible, eliminate the use of mechanical restraint’.

The committee met quarterly to determine compliance with the rules on the use of mechanical restraint and with the approved centre’s own policies and procedures relating to mechanical restraint.

The committee, however, ‘failed to produce a report following each meeting of the review and oversight committee’.

As a result, no report was available upon request by the MHC team. The approved centre was therefore deemed moderate-risk non-compliant with this rule.

The MHC has published inspection reports for 10 approved inpatient mental health centres across Cavan, Clare, Dublin, Galway, Laois, Limerick, Roscommon, Waterford, and Westmeath. Each is available to read on the MHC’s website.

Inspectors found varying levels of compliance with the rules, regulations and codes of practice. Five centres were between 90-100 per cent compliant, a further three centres were between 80-90 per cent compliant, while two centres were between 70-80 per cent compliant.

The MHC requires corrective and preventive action plans (CAPAs) from all services where non-compliances are identified. The MHC monitors the implementation of these CAPAs on an ongoing basis and requests further information and action as necessary.