A hospital patient was left on a bedpan for a 'prolonged period' while another was left on a soiled sheet, a shocking inspection has found. Healthcare Improvement Scotland said improvements are required in the 'provision of the fundamentals of care' at Perth Royal Infirmary.
Distressing Incidents
One patient became very distressed after being left to sit on a bedpan for a 'prolonged period of time', with inspectors adding the person concerned suffered 'avoidable' pressure damage as a result. Healthcare Improvement Scotland (HIS) staff highlighted the incident as they told how improvements are needed at the PRI.
A report published after an unannounced visit in February said there were 'delays in assisting patients to use the bathroom', and also delays in administering medication and carrying out observations. It also revealed there was an incident where a patient was left on a soiled sheet - with inspectors saying there were 'two gaps in healthcare support worker availability for that shift'.
Staffing Pressures
The report highlighted 'several reported incidents relating to staffing pressures, with staff describing being unable to provide timely assistance to patients'. It added this 'impacted on patients significantly', with 'one patient being left on a bedpan for a prolonged period of time'. This, it said, had 'resulted in the patient experiencing distress and sustaining avoidable pressure damage'.
Inspectors said they had 'raised concerns regarding the impact of reduced staff availability upon delivery of care with senior managers', adding managers 'were aware of the incidents and acknowledged this had not met the required standards for safe, effective and person-centred care'.
Requirements Issued
HIS issued six new requirements after their visit, with these covering areas where the hospital has 'not met the required standards and the inspection team are concerned about the impact this has on patients using the hospital or service'. There was also one requirement carried over from a previous inspection in 2021.
HIS also made an unannounced visit to Ninewells Hospital in Dundee in February, with inspectors highlighting concerns with the storage of clinical waste and cleaning products. While they said the areas they inspected were 'clean and well maintained', the hospital 'must ensure that clinical waste is stored in a designated safe, lockable area whilst awaiting uplift'.
In addition they found chlorine-based cleaning products being stored 'incorrectly' in store rooms which were 'unlocked and had doors wedged open', saying as a result these could be accessed by either patients or members of the public. The inspectors stressed this was not in line with regulations which set out such products 'must be kept in a secure area such as a locked cupboard'.
Chief Inspector Comments
HIS chief inspector Donna Maclean said: 'During our follow-up inspection of Perth Royal Infirmary we observed staff working to provide compassionate and responsive care, which was also reflected in patient feedback. The hospital was clean and well-maintained, wards were calm and well-organised, and staff were clear on their responsibilities.'
'However, several areas required improvement including the provision of fundamentals of care. These include delays in helping patients to use the bathroom and the recording of medication.' She added the previous visit to the hospital had revealed 'poor compliance' with hand-hygiene practices, saying inspectors 'found this remains an area requiring improvement'.
Ms Maclean said inspectors found Ninewells Hospital to be 'calm and well-organised', with patients 'consistently treated with kindness, compassion and respect'. While she said Ninewells had made 'significant improvements' in areas such as the safe storage of medications and completion of paperwork, she added: 'Some areas of improvement remain, such as the safe storage of clinical waste and the safe storage of hazardous cleaning products.'
NHS Tayside Response
Lynn Smith, chief officer for acute services at NHS Tayside, said the reports 'provide important feedback for our multi-disciplinary teams and highlight areas for improvement and the opportunity for learning across our services'. She stated: 'I am pleased to see that today's reports highlight areas of good practice and standards of care.'
'Staff were recognised by inspectors for providing compassionate and responsive care, treating patients with kindness and respect, in clean and well-maintained environments. Patients also shared positive experiences and spoke highly of the care they received from staff.'
'Our clinical teams have developed a comprehensive action plan and steps have already been taken to address the areas of improvement identified in the reports to ensure that all of the requirements are completed in a timely way.'
