S.I. No. 551/2006 - Mental Health Act 2001 (Approved Centres) Regulations 2006

STATUTORY INSTRUMENT

S.I. No. 551 of 2006

Mental Health Act 2001 (Approved Centres) Regulations 2006

PART 1: PRELIMINARY AND GENERAL

Preamble

I, Tim O'Malley, Minister of State at the Department of Health and Children, in exercise of the powers conferred on me by section 5(1) and section 66(1) of the Mental Health Act 2001 , (No. 25 of 2001) and the Health and Children (Delegation of Ministerial Functions)(No.2) Order 2004 ( S.I. No. 843 of 2004 ), after consultation with the Mental Health Commission, hereby make the following regulations:

1.

1. Citation

These Regulations may be cited as the Mental Health Act 2001 (Approved Centres Regulations 2006.

2.

2. Commencement

These Regulations come into operation on 1 November 2006.

3.

3. Definitions

In these Regulations:-

“Act” means the Mental Health Act 2001 ;

“Individual care plan” means a documented set of goals developed, regularly reviewed and updated by the resident's multi-disciplinary team, so far as practicable in consultation with each resident. The individual care plan shall specify the treatment and care required which shall be in accordance with best practice, shall identify necessary resources and shall specify appropriate goals for the resident. For a resident who is a child, his or her individual care plan shall include education requirements. The individual care plan shall be recorded in the one composite set of documentation.

PART 2: GENERAL CARE AND WELFARE

4.

4. Identification of Residents

The registered proprietor shall make arrangements to ensure that each resident is readily identifiable by staff when receiving medication, health care or other services.

5.

5. Food and Nutrition

• (1) The registered proprietor shall ensure that residents have access to a safe supply of fresh drinking water.

• (2) The registered proprietor shall ensure that residents are provided with food and drink in quantities adequate for their needs, which is properly prepared, wholesome and nutritious, involves an element of choice and takes account of any special dietary requirements and is consistent with each resident's individual care plan.

6.

6. Food Safety

• (1) The registered proprietor shall ensure:

• (a) the provision of suitable and sufficient catering equipment, crockery and cutlery

• (b) the provision of proper facilities for the refrigeration, storage, preparation cooking and serving of food, and

• (c) that a high standard of hygiene is maintained in relation to the storage preparation and disposal of food and related refuse.

• (2) This regulation is without prejudice to:

• (a) the provisions of the Health Act 1947 and any regulations made thereunder in respect of food standards (including labelling) and safety;

• (b) any regulations made pursuant to the European Communities Act 1972 in respect of food standards (including labelling) and safety; and

• (c) the Food Safety Authority of Ireland Act 1998 .

7.

7. Clothing

The registered proprietor shall ensure that:

• (1) when a resident does not have an adequate supply of their own clothing the resident is provided with an adequate supply of appropriate individualised clothing with due regard to his or her dignity and bodily integrity at all times;

• (2) night clothes are not worn by residents during the day, unless specified in a resident's individual care plan.

8.

8. Residents' Personal Property and Possessions

• (1) For the purpose of this regulation “personal property and possessions” means the belongings and personal effects that a resident brings into an approved centre; items purchased by or on behalf of a resident during his or her stay in an approved centre; and items and monies received by the resident during his or her stay in an approved centre.

• (2) The registered proprietor shall ensure that the approved centre has written operational policies and procedures relating to residents' personal property and possessions.

• (3) The registered proprietor shall ensure that a record is maintained of each resident's personal property and possessions and is available to the resident in accordance with the approved centre's written policy.

• (4) The registered proprietor shall ensure that records relating to a resident's personal property and possessions are kept separately from the resident's individual care plan.

• (5) The registered proprietor shall ensure that each resident retains control of his or her personal property and possessions except under circumstances where this poses a danger to the resident or others as indicated by the resident's individual care plan.

• (6) The registered proprietor shall ensure that provision is made for the safe-keeping of all personal property and possessions.

9.

9. Recreational Activities

The registered proprietor shall ensure that an approved centre, insofar as is practicable provides access for residents to appropriate recreational activities.

10.

10. Religion

The registered proprietor shall ensure that residents are facilitated, insofar as is reasonably practicable, in the practice of their religion.

11.

11. Visits

• (1) The registered proprietor shall ensure that appropriate arrangements are made for residents to receive visitors having regard to the nature and purpose of the visit and the needs of the resident.

• (2) The registered proprietor shall ensure that reasonable times are identified during which a resident may receive visits.

• (3) The registered proprietor shall take all reasonable steps to ensure the safety of residents and visitors.

• (4) The registered proprietor shall ensure that the freedom of a resident to receive visits and the privacy of a resident during visits are respected, in so far as is practicable, unless indicated otherwise in the resident's individual care plan.

• (5) The registered proprietor shall ensure that appropriate arrangements and facilities are in place for children visiting a resident.

• (6) The registered proprietor shall ensure that an approved centre has written operational policies and procedures for visits.

12.

12. Communication

• (1) Subject to subsections (2) and (3), the registered proprietor and the clinical director shall ensure that the resident is free to communicate at all times, having due regard to his or her wellbeing, safety and health.

• (2) The clinical director, or a senior member of staff designated by the clinical director may only examine incoming and outgoing communication if there is reasonable cause to believe that the communication may result in harm to the resident or to others.

• (3) The registered proprietor shall ensure that the approved centre has written operational policies and procedures on communication.

• (4) For the purposes of this regulation “communication” means the use of mail, fax email, internet, telephone or any device for the purposes of sending or receiving messages or goods.

13.

13. Searches

• (1) The registered proprietor shall ensure that the approved centre has written operational policies and procedures on the searching of a resident, his or her belongings and the environment in which he or she is accommodated.

• (2) The registered proprietor shall ensure that searches are only carried out for the purpose of creating and maintaining a safe and therapeutic environment for the residents and staff of the approved centre.

• (3) The registered proprietor shall ensure that the approved centre has written operational policies and procedures for carrying out searches with the consent of a resident and carrying out searches in the absence of consent.

• (4) Without prejudice to subsection (3) the registered proprietor shall ensure that the consent of the resident is always sought.

• (5) The registered proprietor shall ensure that residents and staff are aware of the policy and procedures on searching.

• (6) The registered proprietor shall ensure that there is be a minimum of two appropriately qualified staff in attendance at all times when searches are being conducted.

• (7) The registered proprietor shall ensure that all searches are undertaken with due regard to the resident's dignity, privacy and gender.

• (8) The registered proprietor shall ensure that the resident being searched is informed of what is happening and why.

• (9) The registered proprietor shall ensure that a written record of every search is made which includes the reason for the search.

• (10) The registered proprietor shall ensure that the approved centre has written operational polices and procedures in relation to the finding of illicit substances.

14.

14. Care of the Dying

• (1) The registered proprietor shall ensure that the approved centre has written operational policies and protocols for care of residents who are dying.

• (2) The registered proprietor shall ensure that when a resident is dying:

• (a) appropriate care and comfort are given to a resident to address his or her physical, emotional, psychological and spiritual needs;

• (b) in so far as practicable, his or her religious and cultural practices are respected;

• (c) the resident's death is handled with dignity and propriety, and;

• (d) in so far as is practicable, the needs of the resident's family, next-of-kin and friends are accommodated.

• (3) The registered proprietor shall ensure that when the sudden death of a resident occurs:

• (a) in so far as practicable, his or her religious and cultural practices are respected;

• (b) the resident's death is handled with dignity and propriety, and;

• (c) in so far as is practicable, the needs of the resident's family, next-of-kin and friends are accommodated.

• (4) The registered proprietor shall ensure that the Mental Health Commission is notified in writing of the death of any resident of the approved centre, as soon as is practicable and in any event, no later than within 48 hours of the death occurring.

• (5) This Regulation is without prejudice to the provisions of the Coroners Act 1962 and the Coroners (Amendment) Act 2005 .

PART 3: CARE OF RESIDENTS

15.

15. Individual Care Plan

The registered proprietor shall ensure that each resident has an individual care plan.

16.

16. Therapeutic Services and Programmes

• (1) The registered proprietor shall ensure that each resident has access to an appropriate range of therapeutic services and programmes in accordance with his or her individual care plan.

• (2) The registered proprietor shall ensure that programmes and services provided shall be directed towards restoring and maintaining optimal levels of physical and psychosocial functioning of a resident.

17.

17. Children's Education

The registered proprietor shall ensure that each resident who is a child is provided with appropriate educational services in accordance with his or her needs and age as indicated by his or her individual care plan.

18.

18. Transfer of Residents

• (1) When a resident is transferred from an approved centre for treatment to another approved centre, hospital or other place, the registered proprietor of the approved centre from which the resident is being transferred shall ensure that all relevant information about the resident is provided to the receiving approved centre, hospital or other place.

• (2) The registered proprietor shall ensure that the approved centre has a written policy and procedures on the transfer of residents.

19.

19. General Health

• (1) The registered proprietor shall ensure that:

• (a) adequate arrangements are in place for access by residents to general health services and for their referral to other health services as required;

• (b) each resident's general health needs are assessed regularly as indicated by his or her individual care plan and in any event not less than every six months, and;

• (c) each resident has access to national screening programmes where available and applicable to the resident.

• (2) The registered proprietor shall ensure that the approved centre has written operational policies and procedures for responding to medical emergencies.

20.

20. Provision of Information to Residents

• (1) Without prejudice to any provisions in the Act the registered proprietor shall ensure that the following information is provided to each resident in an understandable form and language:

• (a) details of the resident's multi-disciplinary team;

• (b) housekeeping practices, including arrangements for personal property mealtimes, visiting times and visiting arrangements;

• (c) verbal and written information on the resident's diagnosis and suitable written information relevant to the resident's diagnosis unless in the resident's psychiatrist's view the provision of such information might be prejudicial to the resident's physical or mental health, well-being or emotional condition;

• (d) details of relevant advocacy and voluntary agencies;

• (e) information on indications for use of all medications to be administered to the resident, including any possible side-effects.

• (2) The registered proprietor shall ensure that an approved centre has written operational policies and procedures for the provision of information to residents.

21.

21. Privacy

The registered proprietor shall ensure that the resident's privacy and dignity is appropriately respected at all times.

PART 4: PREMISES

22.

22. Premises

• (1) The registered proprietor shall ensure that:

• (a) premises are clean and maintained in good structural and decorative condition;

• (b) premises are adequately lit, heated and ventilated;

• (c) a programme of routine maintenance and renewal of the fabric and decoration of the premises is developed and implemented and records of such programme are maintained.

• (2) The registered proprietor shall ensure that an approved centre has adequate and suitable furnishings having regard to the number and mix of residents in the approved centre.

• (3) The registered proprietor shall ensure that the condition of the physical structure and the overall approved centre environment is developed and maintained with due regard to the specific needs of residents and patients and the safety and well-being of residents staff and visitors.

• (4) Any premises in which the care and treatment of persons with a mental disorder or mental illness is begun after the commencement of these regulations shall be designed and developed or redeveloped specifically and solely for this purpose in so far as it practicable and in accordance with best contemporary practice.

• (5) Any approved centre in which the care and treatment of persons with a mental disorder or mental illness is begun after the commencement of these regulations shall ensure that the buildings are, as far as practicable, accessible to persons with disabilities.

• (6) This regulation is without prejudice to the provisions of the Building Control Act 1990 , the Building Regulations 1997 and 2001, Part M of the Building Regulations 1997 the Disability Act 2005 and the Planning and Development Act 2000 .

23.

23. Ordering, Prescribing, Storing and Administration of Medicines

• (1) The registered proprietor shall ensure that an approved centre has appropriate and suitable practices and written operational policies relating to the ordering, prescribing storing and administration of medicines to residents.

• (2) This Regulation is without prejudice to the Irish Medicines Board Act 1995 (as amended), the Misuse of Drugs Acts 1977, 1984 and 1993, the Misuse of Drugs Regulations 1998 ( S.I. No. 338 of 1998 ) and 1993 ( S.I. No. 338 of 1993 and S.I. No. 342 of 1993 ) and S.I. No. 540 of 2003 , Medicinal Products (Prescription and control of Supply) Regulations 2003 (as amended).

24.

24. Health and Safety

• (1) The registered proprietor shall ensure that an approved centre has written operational policies and procedures relating to the health and safety of residents, staff and visitors.

• (2) This regulation is without prejudice to the provisions of Health and Safety Act 1989 the Health and Safety at Work Act 2005 and any regulations made thereunder.

25.

25. Use of Closed Circuit Television

• (1) The registered proprietor shall ensure that in the event of the use of closed circuit television or other such monitoring device for resident observation the following conditions will apply:

• (a) it shall be used solely for the purposes of observing a resident by a health professional who is responsible for the welfare of that resident, and solely for the purposes of ensuring the health and welfare of that resident;

• (b) it shall be clearly labelled and be evident;

• (c) the approved centre shall have clear written policy and protocols articulating its function, in relation to the observation of a resident;

• (d) it shall be incapable of recording or storing a resident's image on a tape, disc hard drive, or in any other form and be incapable of transmitting images other than to the monitoring station being viewed by the health professional responsible for the health and welfare of the resident;

• (e) it must not be used if a resident starts to act in a way which compromises his or her dignity.

• (2) The registered proprietor shall ensure that the existence and usage of closed circuit television or other monitoring device is disclosed to the resident and/or his or her representative.

• (3) The registered proprietor shall ensure that existence and usage of closed circuit television or other monitoring device is disclosed to the Inspector of Mental Health Services and/or Mental Health Commission during the inspection of the approved centre or at anytime on request.

PART 5: STAFFING

26.

26. Staffing

• (1) The registered proprietor shall ensure that the approved centre has written policies and procedures relating to the recruitment, selection and vetting of staff.

• (2) The registered proprietor shall ensure that the numbers of staff and skill mix of staff are appropriate to the assessed needs of residents, the size and layout of the approved centre.

• (3) The registered proprietor shall ensure that there is an appropriately qualified staff member on duty and in charge of the approved centre at all times and a record thereof maintained in the approved centre.

• (4) The registered proprietor shall ensure that staff have access to education and training to enable them to provide care and treatment in accordance with best contemporary practice.

• (5) The registered proprietor shall ensure that all staff members are made aware of the provisions of the Act and all regulations and rules made thereunder, commensurate with their role.

• (6) The registered proprietor shall ensure that a copy of the Act and any regulations and rules made thereunder are to be made available to all staff in the approved centre.

PART 6: RECORDS

27.

27. Maintenance of Records

• (1) The registered proprietor shall ensure that records and reports shall be maintained in a manner so as to ensure completeness, accuracy and ease of retrieval. All records shall be kept up-to-date and in good order in a safe and secure place.

• (2) The registered proprietor shall ensure that the approved centre has written policies and procedures relating to the creation of, access to, retention of and destruction of records.

• (3) The registered proprietor shall ensure that all documentation of inspections relating to food safety, health and safety and fire inspections is maintained in the approved centre.

• (4) This Regulation is without prejudice to the provisions of the Data Protection Acts 1988 and 2003 and the Freedom of Information Acts 1997 and 2003.

28.

28. Register of Residents

• (1) The registered proprietor shall ensure that an up-to-date register shall be established and maintained in relation to every resident in an approved centre in a format determined by the Commission and shall make available such information to the Commission as and when requested by the Commission.

• (2) The registered proprietor shall ensure that the register includes the information specified in Schedule 1 to these Regulations.

29.

29. Operating Policies and Procedures

The registered proprietor shall ensure that all written operational policies and procedures of an approved centre are reviewed on the recommendation of the Inspector or the Commission and at least every 3 years having due regard to any recommendations made by the Inspector or the Commission.

PART 7: OTHER PROVISIONS

30.

30. Mental Health Tribunals

• (1) The registered proprietor shall ensure that an approved centre will co-operate fully with Mental Health Tribunals.

• (2) In circumstances where a patient's condition is such that he or she requires assistance from staff of the approved centre to attend, or during, a sitting of a mental health tribunal of which he or she is the subject, the registered proprietor shall ensure that appropriate assistance is provided by the staff of the approved centre.

31.

31. Complaints Procedures

• (1) The registered proprietor shall ensure that an approved centre has written operational policies and procedures relating to the making, handling and investigating complaints from any person about any aspects of service, care and treatment provided in, or on behalf of an approved centre.

• (2) The registered proprietor shall ensure that each resident is made aware of the complaints procedure as soon as is practicable after admission.

• (3) The registered proprietor shall ensure that the complaints procedure is displayed in a prominent position in the approved centre.

• (4) The registered proprietor shall ensure that a nominated person is available in an approved centre to deal with all complaints.

• (5) The registered proprietor shall ensure that all complaints are investigated promptly.

• (6) The registered proprietor shall ensure that the nominated person maintains a record of all complaints relating to the approved centre.

• (7) The registered proprietor shall ensure that all complaints and the results of any investigations into the matters complained and any actions taken on foot of a complaint are fully and properly recorded and that such records shall be in addition to and distinct from a resident's individual care plan.

• (8) The registered proprietor shall ensure that any resident who has made a complaint is not adversely affected by reason of the complaint having been made.

• (9) This Regulation is without prejudice to Part 9 of the Health Act 2004 and any regulations made thereunder.

32.

32. Risk Management Procedures

• (1) The registered proprietor shall ensure that an approved centre has a comprehensive written risk management policy in place and that it is implemented throughout the approved centre.

• (2) The registered proprietor shall ensure that risk management policy covers, but is not limited to, the following:

• (a) The identification and assessment of risks throughout the approved centre;

• (b) The precautions in place to control the risks identified;

• (c) The precautions in place to control the following specified risks:

• (i) resident absent without leave,

• (ii) suicide and self harm,

• (iii) assault,

• (iv) accidental injury to residents or staff;

• (d) Arrangements for the identification, recording, investigation and learning from serious or untoward incidents or adverse events involving residents;

• (e) Arrangements for responding to emergencies;

• (f) Arrangements for the protection of children and vulnerable adults from abuse.

• (3) The registered proprietor shall ensure that an approved centre shall maintain a record of all incidents and notify the Mental Health Commission of incidents occurring in the approved centre with due regard to any relevant codes of practice issued by the Mental Health Commission from time to time which have been notified to the approved centre.

33.

33. Insurance

The registered proprietor of an approved centre shall ensure that the unit is adequately insured against accidents or injury to residents.

34.

34. Certificate of Registration

The registered proprietor shall ensure that the approved centre's current certificate of registration issued pursuant to Section 64(3)(c) of the Act is displayed in a prominent position in the approved centre.

35.

35. Enforcement of Regulations

• (1) These Regulations shall be enforced by the Mental Health Commission.

• (2) The Commission shall satisfy itself as to the compliance of an approved centre with these Regulations, having regard to any reports of the Inspector and any reports requested from the approved centre concerned.

36.

36. Closure of an Approved Centre

• (1) The registered proprietor of an approved centre in which it is intended to cease the provision of care and treatment of mental illness or mental disorders shall inform the Mental Health Commission in writing not later than 3 months before the intended date of cessation of provision of mental health services.

• (2) Prior to closure, the registered proprietor shall arrange for the transfer of each voluntary resident who continues to require treatment to an alternative approved centre capable of providing care and treatment appropriate to the voluntary residents' needs and in accordance with his or her individual care plan.

• (3) When a voluntary resident is transferred from an approved centre to another approved centre due to the closure of an approved centre, the registered proprietor of the approved centre from which the voluntary resident is being transferred shall ensure that all relevant information about the voluntary resident is provided to the receiving approved centre.

• (4) The registered proprietor shall continue to provide care and treatment for mental illness or mental disorders for a period of not less than 3 months from the date of serving notice of intention to cease the provision of these services pursuant to subparagraph (1) unless agreed in writing with the Mental Health Commission to cease the provision of these services at some earlier date.

	GIVEN under my hand,
	1 November 2006. Tim O'Malley Minister of State at the Department of Health and Children.

SCHEDULE 1

Information to be included in the register of residents in respect of each resident:

• (a) Full name

• (b) Address

• (c) PPS number

• (d) Gender

• (e) Date of birth

• (f) Country of birth

• (g) Ethnic or cultural background

White

• Irish

• Irish Traveller

• Roma

• Any other White background

Black or Black Irish

• African

• Any other Black background

Asian or Asian Irish

• Chinese

• Any other Asian background

Other, including mixed background

• Other, write in description

• (h) Next-of-kin or representative

• (i) Admission date

• (j) Discharge date

• (k) Diagnosis on admission

• (l) Diagnosis on discharge

• (m) Patient status, i.e. voluntary or involuntary

EXPLANATORY NOTE

(This note is not part of the instrument and does not purport to be a legal interpretation)

These regulations set out the minimum standards required in approved centres, i.e. hospitals or other in-patient facilities for the care and treatment of persons suffering from mental illness or mental disorder that are registered with the Mental Health Commission and for the proper conduct of such centres.