Closure of Laois mental health facilty on hold but HSE says it's 'unsuitable'

The closure of residential high support mental health care centre in Rathdowney has been put on hold to allow a number of options, including closure or major refurbishment, to be considered.

Laois Offaly Minister of State Seán Fleming has published a letter to his colleague Minister Mary Butler in which the HSE's Head of Mental Health Services sets out the alternatives for the service after reports emerged that Erkina House would be closing with staff and residents moving to Tullamore.

Dervilla Eyres begins the letter by apologising "sincerely" to Minister Butler that she was not briefed in advance of media statements which reported that the service would be relocated to Silver Lodge Tullamore.

However, while she said it is one option, the HSE manager insists that the building is unsuitable and major investment would be needed to make it fit for purpose. The manager also indicates that a move out of Rathdowney would have a 'positive impact' on the recover of individuals.

"This proposal is one option that will be discussed with residents and their families along with political representatives," said the letter.

Ms Eyres says that the Housing Agency and the HSE have drawn together best practice in home design for people living with enduring and life altering mental health conditions. She says the long term aim for the service is to provide a consistent and quality approach across all community residences. 

"To realise this aim a funding application and business case was submitted prior to Covid-19 under capital spending to build a new 10 bed community residence in Portlaoise," the Minister was told.

The official outlines the status of the Rathdowney Centre

"Erkina House is considered unsuitable in contemporary mental health service provision. 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 (which increased to 12 residents in 2011)," she said.

The official told Minister Butler that emergency measures were put in place to ensure that there was only one bed per room. She added that all bedrooms, except one, are upstairs and shower and toilet facilties are shared and would be considered "less than adequate". She adds that there is an industrial style kitchen which renders it out of bounds for residents.

Ms Eyres says there is limited access to community services and public transport in Rathdowney.

"It is widely accepted that the number and quality of amenities can have a positive impact on individual recovery," said the memo.

The Head of Mental Health Services said that Silver Lodge in Tullamore 'a modern building' was purchased in June 2020. She said the purchase of the building is one part of the Laois Offaly mental health service development and reform plan to modernise residential services.

"The long term plan for Silver Lodge is to function as a high support 24 hour nurse supervised community residence. This will provide suitable modern accommodation for intensive rehabilitation and recovery," she wrote.

She added that due to the urgent refurbishment of the Maryborough Psychiatry of Later Life centre in Portlaoise, the Tullamore centre has facilitated temporary accommodation for residents of the Portlaoise facility. Maryborough's refurbishment is due to be completed by June 2022 which Ms Eyres says will free space in the Offaly centre.

The Minister was also briefed on consultation and planning. She was told that the Laois / Offaly Rehab and Recocovery Consultant Psychiatrist and Rehab and Rehab Assistant, Director of Nursing have discussed the needs of service users and the available accommodation with the Executive Clinical Director and Area Director of Nursing.

"The outcome was a proposal that Silver Lodge could be suitable for use as a staffed community residence to re-provide  for the service currently delivered in Erkina House," Minister Butler was told.

Ms Eyres added that over the coming months a number of consultative approaches were in preparedness for the transfer of services.

"However, these are now on hold until a full option appraisal is completed," said the memo.

The Head of Mental Health Services gave the options for this appraisal.

• Status quo remains - no change to Erkina House.
• Transfer of residents from Rathdowney to Tullamore.
• Engagement with estates on the cost of refurbishment of Erkina House to single room ensuite with adequate kitchen facilities. Capital request for funding for refurbishment and the timeline for approval of major capital investment.
• Wait for capital approval for new build in Portlaoise.
• Any other option by stakeholders.

Ms Eyres also outlined the next steps in the memo. She said the residents of Erkina House would be contacted by staff and informed of the Tullamore transfer option and given the opportunity to visit Silver Lodge. She said their views will be considered.

Their Psychiatrist will have regard for their clinical needs should they be transferred to Silver Lodge while the multi-disciplinary team will also engage, with service users consent, with relatives to discuss options.

The HSE manager says informal discussion has begun with staff representatives and will continue. 

The Minister was also told that cost estimates for the refurbishment of Erkina House to an appropriate standard would be obtained alongside timelines for funding. Ms Eyres added that the cost estimate for a new building in Portlaoise will be prepared similarly.

Ms Eyres concluded with a commitment that herself, Anne Kennedy, Acting Chief Officer, Antony Coyne, Area Director of Nursing, will make themselves available to meet TDs in Tullamore and Portlaoise on Thursday, April 21 to discuss the proposal, gather their views and view the Tullamore facility for themselves.

In a statement, Minister Fleming claimed Erkina House, Rathdowney has been "saved" following "his direct intervention" with the Department of Health and the HSE. MORE BELOW PICTURE.

He added however, that proposals for the transfer of services are now on hold until a full option appraisal is completed.

"I spoke directly with the Minister for Mental Health, Mary Butler T.D. and senior HSE officials who have now confirmed this in writing," he said.

He said he looked forward to all these options being fully explored including the purchase of a site in Rathdowney which the HSE previously considered for a new Erkina House.

"Everybody accepts that residents in Erkina House are entitled to the best level of accommodation and this must be the top priority. It is essential that the personal wishes of all residents and their families be fully respected and implemented as part of any new arrangements.

"I also wish to confirm that it was never or could never have been the intention to move staff from Rathdowney to Tullamore due to the normal transfer rules in the HSE that would have prevented any such forced transfer.

"I am now calling on the HSE to engage with all interested parties to ensure a plan to improve the facilities for residents of Erkina House is put in place.

"I understand and empathise with the residents, their families and staff for the unnecessary upset and worry caused by a pre-emptive announcement on Erkina House. My message is clear:  If anyone has concerns about the withdrawal of services from a Government funded facility they should contact me as a Minister of State in Laois to have the matter examined and truthfully explained," he said.