NHS Highland told to make 13 improvements at Raigmore Hospital in Inverness after Healthcare Improvement Scotland carries out surprise inspection
Raigmore Hospital has been told to make improvements in 13 areas after a surprise inspection highlighted a number of issues - including failures to report infection outbreaks correctly.
But despite the need for more than a dozen improvements and “significant pressures” on the hospital’s capacity, the inspection team also found many strengths and a dozen examples of “good practice”.
Issuing the report this week, Healthcare Improvement Scotland’s chief inspector, Donna Maclean, said: “Despite significant pressures on hospital capacity, during our inspection of Raigmore Hospital, patients and families were complimentary about the staff and care provided. We saw teams working closely to provide safe and effective care and staff described supportive management.
“The majority of wards were calm and well organised with good leadership. We identified strong support for newly qualified nurses and assistant practitioners.”
But the added: “We raised concerns to senior managers regarding the use of additional beds and oversight of infection control risks. We also found instances where infection outbreaks had not been reported in accordance with guidelines.
“Further areas for improvement included ensuring staff are trained in fire evacuation, staff compliance with infection prevention precautions and ensure all patients have access to call bells and toilet and shower facilities.”
The Raigmore Hospital inspection resulted in 12 areas of good practice and 13 requirements - the latter of which the inspectors said are instances where “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”.
They added: “We expect all requirements to be addressed and the necessary improvements implemented.”
An improvement action plan has been developed by NHS Highlands to meet the requirements, and Healthcare Improvement Scotland said it will seek assurance that improvement actions are progressed through future inspections.
The 13 requirements identified for improvements were:
• Ensuring all staff are train to ensure safe fire evacuation.
• All patients must have access to a call bell.
• All staff must comply with hand hygiene the correct use of personal protective equipment (PPE).
• NHS Highland must ensure all staff comply with safe storage of linen.
• Safe sharps management must be complied with by all staff.
• The hospital environment must be maintained to "facilitate effective cleaning".
• Cleaning products must be stored safely and securely.
• Risk assessments must be completed when prioritising patients for single room accommodation.
• All infection incidents must be reported in line with accepted guidance.
• NHS Highland must ensure appropriate staffing levels that are "reflective of the number and care needs of patients".
• Processes must also be in place to "support the consistent application fo the common staffing method".
• All staff must be able to access training required for their role.
• And patient dignity must be maintained at all times, adding: “This includes… access to suitable toilet and shower facilities for patients requiring mobility aids”.
Meanwhile, the 12 areas of good practice identified were:
• The emergency department has developed processes ensuring patients "receive the right care in the right place using signposting and redirection guidance",
• The health board has developed "innovative ways" to share education about falls with patients.
• The leaders of the emergency department had "good oversight" of the risks and challenges arising from patients being delayed in A&E.
• High staff training compliance in immediate and paediatric immediate life support.
• Staff described "supportive leadership" from their managers.
• Emergency department and intensive care unit staff "have developed peer support networks".
• The spiritual care team provides extra support to staff awaiting counselling services.
• Meal times were "well organised" and patients were given help with hand hygiene before eating.
• New qualified nurses and band four assistant practitioners were offered "good support".
• Staff were supported to develop quality improvement projects.
• Staff were seen to be "kind and caring".
• And a range of activities have also been developed by staff for patients to take part in whose discharge is delayed.
