DAMAGED flooring, walls and ceiling tiles at Borders General Hospital are highlighted in a new inspection report which also raises concerns over patient hygiene standards.
Healthcare Improvement Scotland (HIS) carried out an unannounced inspection of the hospital on the outskirts of Melrose back in late 2022.
As well as noting six areas of good practice, a total of five requirements were made.
HIS returned to carry out an unannounced follow-up inspection on August 5 this year, to assess progress made against the actions contained within NHS Borders’ improvement action plan.
The follow-up inspection resulted in three areas of good practice, two new recommendations and four requirements.
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The new report, focused on ‘safe delivery of care’, highlights areas of good practice including excellent staff hand hygiene, appropriate use of PPE across all staff groups and well-coordinated patient mealtimes.
NHS Borders says these observations demonstrate the improvements made since the last inspection.
Additionally, inspectors commented on the positive feedback from both staff and patients relating to care.
However, the report finds that improvement is needed in the accurate and consistent completion of all patient documentation and for support assisting patients with hand hygiene at mealtimes.
The four areas of requirement are to ensure that the environment is in a good state of repair and maintained to support effective cleaning; ensuring all hazardous cleaning materials were labelled; to make sure that all patient care documentation is accurately and consistently completed and updated and ensuring that all patients have access to a call bell or a means to contact staff when they require assistance.
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The inspection report states: “A requirement in the inspection report means the hospital or service has not met the required standards and the inspection team are concerned about the impact this has on patients using the hospital or service.
“We expect all requirements to be addressed, and the necessary improvements implemented.”
The report raises concerns over the upkeep of the hospital building, stating: “In the majority of areas inspected we observed damage to flooring, walls, and ceiling tiles.
“In several wards, flooring was cracked, patched with tape, or coming away from the walls, impacting on the ability to effectively clean these areas.
“These include the emergency department, medical assessment unit, intensive care unit, high dependency unit, Borders stroke unit and wards 4, 5 and 14.
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“Senior managers provided us with information of a flooring replacement schedule. While we acknowledge improvements within some areas, with flooring replaced or overlaid in the hospital’s main corridor, intensive care corridor and wards 6 and 9, there continues to be numerous clinical areas with outstanding flooring replacement requirements.”
Cleanliness issues were also highlighted, with the report adding: “We also observed within several areas inspected the ventilation grills were not clean and contained visible thick dust.
“Cleaning of ventilation grates and other components is part of the routine maintenance expected under Scottish Health Technical Memorandum.
“Senior managers we spoke with described challenges in maintaining the healthcare-built environment due to the ongoing high occupancy within the hospital, which impacts on the ability to close patient areas to maintain and upgrade the environment. This requirement has not been met and will be carried forward.”
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Further areas for improvement identified during this inspection include assistance with hand hygiene for patients at mealtimes, correct labelling of cleaning products and risk assessments for patients placed in non-standard care areas.
Inspectors observed that the majority of mealtimes were well co-ordinated with patients receiving their meals in a timely manner.
Those patients who required assistance appeared to receive this with minimal delay. Due to these observed improvements, the requirement from the original inspection had been met.
The report adds: “However, we observed that the majority of patients were not offered or assisted with hand hygiene prior to meals. A new recommendation has been given to support improvement in assisting patients with hand hygiene prior to mealtimes.”
Inspectors observed that patients at BGH were “consistently treated with kindness, compassion, and respect”, with the report concluding: “Patients shared positive experiences, describing staff as friendly, patient, responsive and supportive, and confirmed they could access help when needed.”
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Sarah Horan, NHS Borders’ executive director of nursing, midwifery and allied health professionals, said: “I am immensely proud of our staff, who the inspectors overwhelmingly observed to be patient centred.
“We value the opportunity to review and improve our performance so that we can continue delivering high quality care to our patients.
“I would like to thank the inspectors for their report and everyone at NHS Borders who has been involved in this process.”
Philip Grieve, NHS Borders’ interim associate director of nursing, added: “The feedback provided from inspections is always welcomed, and the areas of improvement identified by the inspectors are detailed in our improvement action plan which we have begun to implement, with some of the actions already completed.
“I echo Sarah’s thanks to everyone who was involved in the inspection and extend my thanks to all staff across NHS Borders who continue to work incredibly hard to deliver care to the people of the Borders.”