Mr. Michael Fitzgerald:

Good afternoon. I am the chief officer for Cork Kerry community healthcare. I thank members for the invitation to meet with the Joint Sub-Committee on Mental Health to discuss Owenacurra centre in Midleton, County Cork. I am joined by my colleagues: Mr. Derek Chambers, general manager of mental health operations in the HSE; and, here in the room with me, Dr. Sinead O’Brien, executive clinical director, Cork mental health services, and consultant psychiatrist.

The Owenacurra centre is a mental health services continuing care unit in Midleton, County Cork. It is registered with the Mental Health Commission to provide a service for 24 people for psychiatry of later life, continuing mental health care and mental health rehabilitation. There are currently 19 people resident in the centre. Mindful of the fact that the current building and layout do not allow for the needs of a modern residential and day service, our mental health services planned for a refurbishment of the centre. We are very aware of the excellent work carried out by the team at the Owenacurra centre and the special place it occupies in Midleton town centre. Our aim was to bring the building to a standard where it matched the care being provided there. We were also acutely aware that the current building simply did not allow for the kind of care and recovery which a modern service should provide. Unfortunately, as we moved to the advanced planning phase for the centre, serious concerns emerged that any level of refurbishment could not bring the building to the standards required. Advice from construction experts has led the HSE to take the difficult but necessary decision to close the centre. We have reviewed all options for the centre and every option involves a complete demolition of the existing building, rather than a phased refurbishment.

While we were aware of the pressing need to bring the building to the standard which residents deserve, it was only when the fabric of the building was assessed for this work that we established that they only way to refurbish the building was to knock it. This was not our original plan for the valuable service at the Owenacurra centre, and while it was a difficult decision, there was no other option open to us.

Although there were no conditions attached to the registration or escalation or enforcement actions since the previous inspection in 2020, the Mental Health Commission completed an inspection between 16 and 19 February of this year, raising serious concerns with regard to persistent non-compliance with regulation 22, which relates to premises. On foot of this, Cork Kerry community healthcare committed to providing plans for the Owenacurra centre to work to address the non-compliance. These concerns echoed the ongoing concerns of local management about the condition and unsuitability of the current building to serve the needs of the people using the service.

On 23 June of this year, the HSE informed the Mental Health Commission that we would close the centre on a phased basis by the end of October 2021. On 28 June, the acting head of service in mental health wrote to the staff, residents, families and carers at Owenacurra centre to apprise them of the issues arising about the condition of the building. Local Oireachtas Members and health forum members were also informed at that time.

The immediate priority is the welfare of the 19 residents of the centre. We are working with each resident and their families individually to agree an appropriate alternative placement based on their assessed needs. Residents will move on a phased basis after detailed consultation and discussion. They will transfer to the most appropriate setting that will meet their needs, and with their expressed preference to the forefront in any such decision. Assessments with residents have been completed and consultation with families is under way at present.

The site will be reviewed by Cork Kerry community healthcare organisation to confirm what healthcare services are required in the area so as to maximize the use of the site to the benefit of the local public. A mental health day service is also located within the building. Services in the day centre have been affected due to Covid. Work is under way to identify an alternative location for this service, as close as possible to the current location and to recommence this service as soon as possible.

An implementation team has been tasked to manage the closure of the Owenacurra centre within the timeframe indicated. An initial step in the process was for the mental health multidisciplinary team in the area to formally assess the needs of each of the residents. All of the assessments have been completed at this stage. A full Camberwell assessment of need has been completed with each resident and an action plan has been developed, following on from the assessment. The team has been asked to use the housing preference and assessment survey assessment tool, developed by Cowman, Gough and Cunningham, or a similar tool for all residents prior to a decision being made on their place of transfer.

The multidisciplinary team within the Owenacurra centre continues to have ongoing discussions with all residents to offer ongoing support and assurances. In order to keep residents and families informed throughout the process, a key contact lead is available to support and act as a facilitator between residents, their families and the project team. Social work input has been increased to support residents and families through this period. Social work also has support from the housing co-ordinator to assist with any third-party agency interactions which may be required to assist residents in moving to new homes. There is increased consultant input from the clinical director to assist with the transfer of residents of the Owenacurra centre. A member from the independent Irish Advocacy Network is part of the project steering group, in addition to a mental health service user family member and carer engagement representative, to ensure the residents and families continue to have independent supports available throughout the process.

The closure of any centre, particularly one that provides residential care to service users, can cause concern and uncertainty for residents and families. We understand that the Owenacurra centre has provided a very valuable service to residents, in a unique location, for many years. The HSE is committed to working closely with the residents to find appropriate alternatives as close to Midleton as possible over the coming period. We are committed to making sure that residents have the same level of links to their community and loved ones in their new homes.