Report on an unannounced follow up inspection of Tumanako Inpatient Mental Health Unit
Excerpt: Inspection approach
From 25 to 29 September 2023, a team of three inspectors, whom I have authorised to carry out visits to places of detention on my behalf, made an unannounced five-day visit as part of my follow-up inspection of Tumanako Inpatient Mental Health Unit (the Unit), Whangārei Hospital.
This inspection was to follow up on the 13 recommendations I made following my previous inspection in 2019. The Northland District Health Board had accepted 12, and partially accepted one of these recommendations.
Inspectors gathered and assessed a range of information, including reviewing documents, interviewing a number of people, and observing facility activities. Before leaving the facility, inspectors met with Unit management to outline their initial observations.
The Unit is a 29 bed acute inpatient unit, providing assessment, treatment and stabilisation for tāngata whai ora experiencing acute mental health issues, who are unable to be cared for safely in a community environment. The Unit contained a general ward (Pumau), a High Dependency Unit (HDU) that was divided into two pods (Aroha and Manaaki), and a psychiatric ward for older people (Pono).
On the first day of inspection, 27 beds were occupied. Fifteen tāngata whai ora were in Pumau, seven in the HDU and five in Pono. The total occupancy varied over the week of inspection, from 24-25 beds. Unit management advised that in the last six months refurbishment had resulted in fewer beds available and a fluctuation in occupancy numbers. At the time of inspection, there was one voluntary tangata whai ora in the Unit and 26 tāngata whai ora admitted under the Mental Health (Compulsory Assessment and Treatment) Act 1992 (the MHA).
Voluntary tāngata whai ora are under no legal compulsion to remain within a facility to receive mental health services. However, where there is a risk that arrangements in place could effectively mean voluntary consent is not given (including to treatment) or they are not free to leave at will, voluntary tāngata whai ora come within the scope of my OPCAT function.
As a result of this follow up inspection, I consider that five of my recommendations were progressing but not yet achieved and eight recommendations were not achieved. I am disappointed that no action had been taken to achieve most of my recommendations, in particular in the areas regarding tāngata whai ora safety. However, I acknowledge there has been a change in Unit leadership and was pleased to hear from staff (at all levels) that a positive shift in the Unit culture was being led by the Clinical Nurse Manager (CNM).