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A STUDY into the mental health services in the county has highlighted a number of shortcomings, most notably the need to get patients and clients more involved in their own care plan.

The annual report by the Mental Health Commission also pointed to some improvements in the service, while highlighting previous recommendations that remain unchanged.

Across all the services in the Clare area the commission has recommended that each patient have an individualised care plan that contains a social, psychological, occupational, nursing and medical needs assessment, including a risk assessment, and a documented set of goals collaboratively developed by the patient and the multidisciplinary team. It also recommended reviews of the care plan.

“There must be documented evidence that the patient has been involved in developing his or her care plan, and the patient must have a copy of the care plan. The care plan must be co-ordinated by the patient’s key worker.”

Referring to the acute psychiatric unit in Ennis, it criticised the practice of patients sleeping in other facilities due to bed shortages in the service.

“When bed occupancy is high, some patients area transferred to other units, through new arrangements has just been implemented to cease this practice.”

There is no multidisciplinary care plans in place in the 40-bed unit it emerged. The report recommends that the unit be self staffed to ensure continuity of care, that patients should have access to make drinks an snacks and the bed capacity in the high observation area be reduced.

“Alterations should be made to the seclusion room to ensure adequate ventilation, communication and sanitation,” said the report.

The high observation area currently has no toilet and no communication facility. A shortage of staff was highlighted at Unit Five in St Joseph’s Hospital, which meant some patients cannot be accompanied into town.

“Five of the patients leave the unit unaccompanied to attend church or go to the shop.”

In both Units Five and Six, a shortage of space was recorded.

There is also “no access to a garden for people who spend so much time indoors.”

A UNIT on the grounds of Our Lady’s, which was last year described as in urgent need of closure, has shown improvement in the most up to date Mental Health Commission report, although a number of shortcomings remain.

In 2004, the commission was particularly critical of St Anthony’s Unit in Ennis, “urgently” requiring that the unit be closed.

“All residents must have full multidisciplinary assessment of their future care and accommodation needs and be transferred to more appropriate community facilities,” it said.

The 2005 report shows that just one patient has had a “functional needs assessment carried out and it is planned that the other patients will have a needs assessment.

“There are no formal risk assessment tools in use within the unit,” the report states.

The document also reports that there are two people who have “moderate intellectual disabilities within the unit”.

In 2004, the commission criticised the unit for having “no input from the intellectual disability services”.

In the most up to date report, there is still no mention of such a service being provided.

The unit, which was used to take some of the long stay patients from Our Lady’s Hospital when it closed, did show “considerable” improvement in its environment.

Patient numbers have been reduced from 19 to 11 in the 12-month period and the empty bedrooms converted into an activity area, a visitor’s room and a games area.

“The number of toilets had increased to a more appropriate level and there were toilets outside,” the report said.

“The garden area was considerably improved.”

The unit’s records, however, do not support staff reports that a named system of nursing is used in the hospital.

“The nursing staff interviewed by the Inspectorate reported they are keen to implement evidence-based practice within the unit but needed some support and guidance on how to do this.

“It is also evident that the staff need training in the process of care planning.”

“Access to therapy monthly meetings are held within the unit and all disciplines attended. However, it was reported that none of the nursing staff from the unit attended these meetings.”

There does not appear to be any training in the management of violence or debriefing “after serious untoward incidents”.

The report recommends that a policy “on risk management, incorporating training for staff and for debriefing” following such incidents should be implemented.

Other recommendations included an individual care plan be provided for each patient developed by a multidisciplinary team with the assistance of the patient.

THE people of Lahinch have been left in a constant state of fear with some even considering taking the law in their hands following last weekends rioting now in the town.

People in the town suffered almost 5 hours of torment on Saturday July 1, when a large group of drunken youths went on a rampage through the towns streets.

“The fear is very real,” said Donogh O’Loghlin, Chairperson of the Community Council. “There was a 90-year-old woman who had to ring the guards three times and she was scared, I can tell you. They were spinning the wheels of their cars up around her house and there were three houses beside her which all had their windows broken.

“There are not that many people left living in Lahinch. The people who can get out are going out.”

One possible solution, according to the community council is the enforcement of the long promised by-laws for anti-social behavior in Lahinch.

“We received a message from Ger Dollard apologising for the delay in getting the by-laws in,” said Mr O’Loghlin.

“The message I got said that they are sitting on the Minister’s desk just waiting to be signed into law.

“They are putting in every law you can think of about dogs and horses, but they are holding up the one law that we have been campaigning for 4 years.”

In a statement to The Clare People , the community council said that they would be organising a public meeting in the next couple of weeks to decide how best to tackle the problem. They also said that the council rejected the calls from some locals to put civilian protection in place saying that the gardaí were the best people to tackle the problem.

“People blame the gardaí but I don’t blame them,” continued Mr O’Loghlin. “You are talking about 1,100 people coming out of the three club venues, not to mention about 1,000 people from the pubs.

It’s not possible for four guards to deal with that. It’s not possible to police to have that volume of people in the village.”

The statement went on to make four specific demands; that the anti social by-laws be enforced; that the local gardaí be supplied with better equipment and more man power; that the granting of late licences to night clubs must be better controlled; and that the ‘irresponsible letting’ of local holiday homes for stag nights and party’s be put to an end.

A VERDICT of medical misadventure has been returned in the inquest of a 54-year-old woman, who died at Ennis General Hospital, after attempts were made to insert a central vein line into her neck.

Ennis Coroner’s Court heard that Barbara Canavan, a retired nurse, of Church Street, Ennistymon, was admitted to hospital on June 29, 2004, having had abdominal pain associated with vomiting. She died there on the morning of July 2.

Some time after admission, she was operated on and her condition was reviewed a number of times.

Consultant Surgeon, Dr Denis Ó Ceallaigh, said she was “confused, disorientated and agitated.”

Some time before 9am on July 2, arrangements were made to have the central line inserted, so that medication could be given.

He said the insertion of the line was unsuccessful and she was confirmed dead at 11.15am.

He said “deterioration in her condition really occurred at 10pm the previous day.”

Consultant Anaesthetist, Dr William O’Brien – who, like Dr Ó Ceallaigh was not involved in inserting the central line – told the inquest that from his “contemporaneous records, the patient was expected to die.”

“When I saw the patient initially in ICU, despite her failure to respond to standard treatments administered for these situations, I knew she was a young woman. I took a slight chance that the patient might survive,” he said.

“A chance is worth a chance, in preference to being dead, even though she might die in the effort. Without intervention the outlook was fatal. The patient never stabilised satisfactorily post-operation. Her blood pressure was always temperamental. Her pulse rate was always racing,” he added.

The deceased’s sister Mary Healy, was at the Intensive Care Unit on the morning in question. She stated, in her deposition, “In my opinion I feel Barbara arrested while they were trying to insert the central line.”

Pathologist, Dr James O’Driscoll, said Ms Canavan’s death was due to cardiac failure, associated with an extensive haemorrhage to the right side of the neck.

“I believe the haemorrhage to the right side of the neck was the final event in this woman’s illness,” he said, adding that he believed that damage to the vein in the neck caused the haemorrhage.

“I would conclude they [the injuries] came in a critically ill woman, during an attempt to insert a central line,” he added.

County Coroner Isobel O’Dea and Inspector Tom Kennedy expressed sympathies to Ms Canavan’s family.

SPIRITS were high in the Kilrushbased Western Yacht Club this week as its two ships that took place in the Round-Ireland Yacht Race came first and second in the large ship category.

Limerick’s Atlanta Chieftain, whose crew came from the Kilrush Yacht Club, came in first in the Super Zero class, with Clare’s only yacht in the race, The Spirit of Kilrush, coming in second place.

Skipper of ‘The Spirit of Kilrush’, Tom Whelan, was overjoyed with the result and adamant that the crew never dreamed of such success.

“Kilrush never had a ‘Super Zero class’ boat before and this year we had two and won the category,” he told The Clare People .

The Kilrush crew sailed around Ireland in an impressive 116 hours. The overall winner, Cavatina, completed the sail in 153 hours, but when the handicaps were applied it was deemed the overall winner.

Mr Whelan said there were many high points for the crew along the way. One of the biggest highlights was when The Spirit of Kilrush came in ahead of the professionallymanned New Zealand yacht, Konica Minolta Zana. The New Zealand boat later finished third behind the two Western Yacht Club yachts.

The elated businessman said the crew hoped to get home first but that was before they learnt that the Konica Minolta Zana was entering.

The Spirit of Kilrush is a Volvo 60 yacht. The Volvo 60 is a 19.5m ocean racing yacht and is capable of 35 knots, which is helped by a 5,000 litre of water ballast.

The only other Volvo 60 yacht in the race was sailed by the yacht’s designer, Roy Heiner, who last year sailed around the word in a similar yacht.

“When we saw him entering, we were nervous but then we passed him in Tory Island,” said Mr Whelan. This was another highlight of the trip for the amateur Kilrush crew.

The Spirit of Kilrush was sponsored by local business people who wished to raise the profile of the West Clare capital.

“This costs a lot of money but they supported us so well,” said the Kilrush yacht’s skipper.

Among the local sponsors were Shannon Ferries, Whelan’s Garage, Kilrush Credit Union and 3Ps solutions. Starting in Wicklow, the 704mile round-Ireland race began on Saturday, July 1, with the contenders sailing clockwise around Ireland, keeping all islands to Starboard.

THE much-anticipated Kilrush Autism Unit is in doubt two months before it is due to open.

The specialised unit planned for the grounds of St Senan’s Primary School in the West Clare capital is currently in the planning process. It was hoped that planning would be received for at least temporary accommodation within the next two months.

But Clare TD Pat Breen has warned that the unit in Kilrush looks very doubtful for this September, because there are no qualified personnel available.

“Meanwhile the establishment of an Ennis-based learning centre of excellence for children with autism has still not been sanctioned by the Department (of education),” he said.

The Fine Gael TD also accused Education Minister Mary Hanafin of disregarding children with autism, following her decision to cut home tuition grants for such cases.

Last week The Clare People highlighted the plight of parents of children with autism who struggle to receive essential services for their children, and the added suffering the removal of this service would have on their children.

One family from Carrigaholt told how the service was withdrawn from their eight-year-old child without any warning. Little Isabelle Séquin is now facing primary school without the extra tuition, having already lost her speech therapy.

Speaking in the Dáil on behalf of Minister Hanafin, Junior Minister Tim O’Malley said the newly established National Council for Special Education was working across the country to ensure that new services were put in place where needed.

“The decision to discontinue the home tuition grant was on the basis that the educational needs of these pupils can be best met in their individual schools,” Minister O’Malley added.

Deputy Breen accused the Minister of having an institutional approach to the issue.

“That family has been in contact with me and it is clear that not all the supports can be provided in a school setting. The schools do an excellent job with their limited resources. But they do not have the specialised personnel to cope with a child with autism in the midst of a classroom of 30 children” he said.

The deputy added it was a disgraceful indictment of the Department’s performance that it had spent €11.7 million on legal costs and settlements relating to educational provision for children with special needs in the three years to 2005.

The vast majority of the cases relate to children with autism.

THE population of Inagh looks set to double in the next ten years, with a €1million sewerage system upgrade opening the door for the construction of some 150 new houses.

The funding, which was announced last week by Environment Minister Dick Roche, will see his department foot the bill for 40 per cent of the cost of upgrading the existing sewage system.

A number of private and commercial developments have been held up in the area in the last number of years, because of the lack of capacity in the current system.

“It is a fantastic development,” said the newly elected Mayor of Clare, Inagh Councilor, Flan Garvey (FF).

“Houses were being held up in places that have been zoned. €945,000 is a lot of money for a small place like Inagh.

“It is a perfect place for people to come and live because of its proximity to Ennis as well as places like Ennistymon and Lahinch.”

The 2002 census listed the population of the Inagh/Ballyea area at just 617 people, but this new development could see that figure rise dramatically in a relatively short space of time.

“There will be a big increase very quickly as people have been waiting to build for some time,” continued Mr Garvey. “People are ready to go.”

The upgrading works will increase the capacity of the existing wastewater treatment plant in the village and provide sewers to service new residential development. It’s envisaged the scheme will open up 35 acres of land for the development of 146 new houses.

The Minister said that the scheme was very important for the area, as it would provide for Inagh’s development needs for the foreseeable future.

“In particular, by opening up 35 acres of land for 146 new houses, it will allow home ownership in their own locality to become much more accessible and affordable to the local community,” said Minister Roche.

“We will be asking Clare County Council to complete the detailed design work as soon as possible.”

The sewage system currently in operation in Inagh was put in place in 1995 and has been operating at maximum capacity for the last two years.

A GROUP of 50 very special mums of sick and disabled children converged on the mid-west last week for a relaxing break away organised by the Share a Dream Foundation.

The group included women who lost their children through serious illness and others with children, suffering from chronic and severe illnesses such as leukaemia, muscular dystrophy.

They came to the area from Dublin, Waterford, Cork, Galway, Limerick County, Laois, Wicklow, Wexford, Westmeath, Longford, Roscommon, Monaghan, Tyrone and Down.

The Share a Dream Foundation has been making dreams come true for sick and disabled children from all over Ireland for the past 15 years. During this time, they have helped more than 17,000 children.

The group were accommodated in the lap of luxury in the Clare Inn hotel at Dromoland, courtesy of the Lynch hotel group and enjoyed a night of feasting, fun and song at Bunratty Castle, courtesy of Shannon Heritage.

They also visited a folk park and had dinner and music laid on in The Clare Inn.

Founder and Director, Shay Kinsella, said, “It’s really only when you get to know these children and their families that you begin to understand what amazing people they are.

“The children are battling illness and disability with everything they have and then you meet the parents – they are truly amazing.

“For them it is a 24 hour a day, seven day a week, 52 weeks a year commitment and yet they are full of love and good humour.

“And while Share a Dream Foundation does everything we can to make the very special dreams of the children come true, we couldn’t help but see how their parents never had any time out.

“That’s what made us think of organising a special weekend away for these amazing people – and what better place to bring them than to the beautiful mid-west.

“I know they are really going to enjoy the exciting city of Limerick and the lovely countryside of Co Clare,” he said.

“The people of Limerick and Clare are so welcoming and have always been so supportive of the work of the Foundation.”

MORE than a year after hundreds of customers signed up for a new broadband service in County Clare, it has emerged that subscribers will now have to wait until next year for the high-speed connection which they should have had last September.

In June 2005, Smart Telecom enticed customers to sign up for their alternative service, offering special deals including free line rental for life. Smart offered the package for just €35 a month including VAT, undercutting Eircom by almost €50. Smart also told those who signed up that they would have their connection by the following September (2005). Ten months later, the company now says that it could be 2007 before they can finally roll out broadband in Ennis but has not offered any explanation for the delay.

Smart continues to blame “unreasonable terms and restrictions imposed by Eircom, including access to its national network” for the delays in its roll-out to new areas.

Eircom has described these claims as “disingenuous” and says, “We have offered broadband to customers in Ennis since spring 2003. Eircom already provides access to our exchange in Ennis to other operators. A number of competitors avail of this access and also offer DSL broadband in Ennis so there is nothing stopping Smart Telecom from offering broadband there.”

According to Smart, “Our roll-out is based around the Government’s

Metropolitan Area Networks pro gramme. The reason the MAN’s came into existence is because Eircom would not offer reasonable terms on its network for national access.”

The government has invested €27m in its MAN’s programme in an effort to address the infrastructure deficit by building high-speed open access networks in 120 towns and cities nationwide, on a phased basis, in association with the local and regional authorities. It has emerged that Ennis is not included in either Phase I or II of the project which means, if Smart Telecom’s roll-out of broadband in Ennis is dependent on MAN’s, the company’s Ennis customers will have to wait until 2007.

According to the Department of Communications, Marine and Natural Resources, “We are well aware of the need for MAN’s for some of the larger towns like Ennis. However, the government decision was to target those towns which in 2003 did not have any broadband infrastructure at all. Ennis had DSL at that time.”

AN POST has further deferred controversial plans to relocate mail sorting services from Sixmilebridge and Newmarket-onFergus post offices to nearby Shannon Town, a move which staff and local politicians are vehemently opposed to.

The company had notified delivery staff at both post offices that they should report for duty in Shannon on February 20 and that they would be operating from that centre in future. That move was later postponed “in the short term” by An Post, without offering any explanation to workers, while a second planned move, which staff were not even informed about, has also been deferred.

An Post now says, “It is expected that this change will be made, in co-operation with our staff, later this year.” Workers claim, however, that they were not notified of the original move. The Communications Workers Union has since become involved and has met with the company but no agreement on a move has been reached.

At present, letter and parcel post for the villages of Newmarket-on-Fergus and Sixmilebridge is sorted on site at the respective post offices. Ten delivery staff are employed between the two offices. Moving them to Shannon would see a doubling of staff at that sorting centre.

Local Councillor John Crowe says he is “totally opposed to any plan which would see a dilution of services in either village. Sixmilebridge and Newmarket are expanding all the time and, if anything, An Post should be upgrading facilities and services here. The population is growing in these areas and what we need are more, not less, services.”

Others have expressed concerns that An Post plans to close the post officers at Sixmilebridge and Newmarket-on-Fergus.

An Post has said that neither post office is at risk of closure.

“Any changes to mail collection and delivery arrangements that may result have no bearing whatsoever on post office operations in those areas,” the company has said.

In a statement this week, An Post confirmed that “in order to improve both our delivery service to business and private customers and our operational efficiency, it is planned to operate delivery services for the Shannon, Newmarket and Sixmilebridge areas out of the Shannon Delivery Services Unit.”