€5.3 mill to overhaul Laois health facility found to 'fundamentally' not comply with guidelines

A facility in Rathdowney that the HSE wants to close, 'fundamentally' does not comply with guidelines designed to help overcome barriers to independent living experienced by people diagnosed with certain mental health conditions. 

That's according to a report on Erkina House commissioned by the HSE after it was forced to stall its plans to shut the facility in south Laois and rehome residents living there in Tullamore.

To bring it up to standard, the HSE has been told that an estimated €5.3 million would have to be spent on refurbishment and new extensions to the landmark property which was a Convent prior to becoming a Community Residence in 1996.

The architect's assessment report submitted to the HSE was prepared by Fitzgibbon McGinley Architects Ltd. It says the report was prepared to assess the compliance of Erkina house against the recommendations contained in the HSE Housing Design Guidelines “Design for Mental Health” published in 2016.

An inspection was also carried out in the property resulting in a 42-page report which has been seen by the Leinster Express / Laois Live.

It concludes that Erkina House fundamentally does not comply with the Design for Mental Health Guidelines under a number of headings

The architects say the split floor levels contained throughout the property conflict with the guidance contained throughout the guidelines.

They say the relationships between the bathroom accommodation and the bedrooms "directly conflicts" with the concept of personal care. They add that the guidelines note in relation to bathrooms that poor self-care is frequently associated with enduring mental health conditions and emphasises the design of bathrooms as being an essential part of design for mental health.

The report also finds that the current arrangement is such that residents have no facility to prepare any food/ beverages for themselves or to participate in any person-centred personal care that having access even to minimal facilities would promote.

The architects said that the Design for Mental Health Guidelines specifically identifies “creating an environment
that supports specific essential tasks” and in “maximising functional ability and minimising barriers so that people are empowered to live, with appropriate supports, where needed.”

Another conclusion is that the current living areas are the re-purposed Chapel and Altar and an original Institutional Day room does not comply with the requirement in the Design for Mental Health Guidelines. The architects say Guidelines recommends that due to reduced social opportunities, individuals with mental health conditions are likely to spend a lot of time in
living areas and it is important that these are “as pleasant as possible. 

The final finding covers the layout of Erkina House. The architects say it is not intuitive or easy to negotiate or to navigate. They say the existing layout is an institutional convent layout that has had its rooms re-purposed as required. The report finds that this is contrary to the type of layouts promoted in the Design for Mental Health Guidelines. They say that the Guidelines emphasise that easily read and understood layouts will give the person the cues they need to function.

"Erkina House fundamentally does not comply with the guidance contained in Design for Mental Health Housing Design Guidelines Manual," concludes the report.

The report also includes an Order of Magnitude Costs to overhaul the building. The architects do not go into detail as to how this can be achieved and whether it would result in a building that would be in compliance with the guidelines.

However, the estimates prepared by MJ Turley finds that the refurbishment of the 950sq mt house and the construction of a 50 sq mt extension would run to nearly €4 million. When professional and other costs are added the bill would run to nearly €5.3 million.

The HSE decided in April 2022 that it wanted to shut Erkina House and relocate patients to the Silver Lodge facility in Tullamore which itself has been criticised by the Mental Health Commission.

The HSE believes that Erkina House is considered unsuitable for mental health service provision. It reached its decision to close without informing the Minister of State, Mary Butler.

On foot of a public meeting protesting closure and the Minister's intervention, the HSE committed to carrying out an appraisal of options that would include a professional assessment of the building and an estimate of overhaul costs.

The HSE said in 2022 that prior to Covid-19 residents lived in shared dormitory-style bedrooms. In 2020, the bed capacity in Erkina House went from 17 to 11 residents.

The building is understood to date to the 1800s.