2.1: Review arrangements to transition residents from Owenacurra
The Chair acknowledged that briefing notes and correspondence had been circulated in advance of the meeting regarding the closure plan for the Owenacurra Centre and the placement plans for residents. Further documentation was made available shortly before the meeting which set out the process undertaken in relation to the transition of residents.
The Chief Officer Cork Kerry Community Health Care Organisation noted that the decision to close the Owenacurra Centre took account of the standard of services and the current environment in which they are provided, the condition of the building, the need for it to comply with the Regulations (which are inspected by the Mental Health Commission) both now and into the future. It was advised that the centre could not remain open and be refurbished while the residents lived in it, and that the works required would be so extensive that the centre would need to be re-built rather than refurbished.
The Committee noted there were 19 residents in Owenacurra when the closure decision was made in June 2021 and currently six residents remain living there. A project implementation group comprising of multi-disciplinary members is in place to support the appropriate placement of residents. The multi-disciplinary team have been working with each resident and their families to match their assessed needs to their placement, in each case taking account of the person’s will and preference, their physical and mental health, their independence and preferred activities, and the level of support needed now and into the future. In addition, there are also ongoing Patient Advocacy services in place to discuss and support any resident’s concerns.
The Clinical Director Cork Kerry Mental Health Services provided the Committee with an overview of anonymised information in relation to the 13 residents that have moved to date, including the type of facility and accommodation that they have been transferred to, the average number of family meetings for each resident, the aftercare they are receiving and the assessment of post transfer of care.
The Committee was advised that the residents had been consulted on their preferences in terms of alternative locations to live and that some residents requested to be moved to locations that were near their family. It was advised that two individuals had moved further away from the Centre, at their own request, for this reason. All residents who have moved are currently in single rooms except one who is the sole occupant of a double room at present, though it is possible that this may change in the future.
The Committee agreed that both the health and safety of the residents, as well as their will and preference, must be prioritised in seeking appropriate alternative placements.
The Committee raised concerns regarding placements to St Stephen’s Hospital, Glanmire and St Catherine’s Ward in St Finbarr’s Hospital Cork as these centres had received lower Mental Health Commission inspection compliance ratings than the Owenacurra Centre. Concerns were expressed that these environments are congregated settings that are campus based, isolated, away from the community in contravention of the Convention on the Rights of Persons with Disabilities, Government policy and HSE policy as set out in Time to Move on from Congregated Settings - A Strategy for Community Inclusion. The Chief Officer acknowledged that there are ongoing challenges with St Stephen’s hospital but noted that there are ongoing service improvement plans in place to address compliance and cultural issues as highlighted by the Mental Health Commission Reports. He also confirmed that the most recent report from the Mental Health Commission was more favourable in this regard and that work remains ongoing to address the issues raised.
The Committee discussed with the Clinical Director the consideration that had been given to support residents to integrate in their new community settings. The Committee agreed that this was extremely important and that each individual must be supported in living their life and sustaining their connection with family and friends. The Committee was advised that it is standard procedure for a rehabilitation team to work with the individual who has moved, to address both their clinical and social needs to ensure individual care plans and therapeutic services are provided in line with best practice.
The Clinical Director also provided information on current plans and discussions regarding potential places for the remaining six residents noting that the priority is to work with these residents to meet their needs as assessed by medical experts along with their own will and preference. The Committee noted the multi-disciplinary team of mental health professionals continue to work with residents and families in this regard.
One potential option for three of the remaining Owenacurra residents is a house in Midleton. It is hoped that purchase of this house will be confirmed shortly. This is in addition to single rooms available in the Community Hospital in Midleton and St Catherine’s ward in Cork City. The Committee was also briefed on future commitments in Midleton and East Cork and the strategic medium to long term plans developed by Mental Health Services Cork.
The Committee acknowledged that the closure of the centre has had a significant effect on the residents for whom it was their home, and that a number of the residents were opposed to the closure and would prefer that the centre remain open. The Committee recognised the work that has been carried out to date with each resident noting that the assessed needs, and will and preference of residents, has been prioritised as much as possible in the context of their relocation to other appropriate settings. Some members of the Committee expressed dissatisfaction with the need to transfer the residents away from the Midleton area contrary to their expressed wishes. Others were of the view that the transition process, necessitated by the decision to close the centre, was considered and measured and made in good faith.
The Chair confirmed that she would report back to the Board on the transition of residents from the Owenacurra Centre and the concerns expressed and discussed by the Committee.
2.2: Correspondence from Individual Resident of the Owenacurra Centre
The Committee noted that the correspondence from the resident raised a number of significant issues that need to be addressed fully with the individual resident.
The Committee agreed to recommend to the Board that the Chief Officer, Cork Kerry Community Healthcare be requested to nominate a senior clinical consultant to meet with the resident and family to discuss the concerns raised and to address such concerns directly with the resident.
A report will be provided to the Committee following the meeting and a further response will be issued at that stage. A letter should be sent now to inform the resident that the concerns raised were being followed up on behalf of the Board.