Highlands’ New Craigs Hospital issued with several recommendations following surprise inspections
Health inspectors have issued several recommendations for improvement at New Craigs Hospital following surprise inspections of two of its wards.
The unannounced visits to the Inverness hospital's Morlich and Bruar wards were follow-up inspections following previous visits in in 2022 and 2023 respectively.
And despite highlighting many positives on their latest inspections, the Mental Welfare Commission made several recommendations too.
After visiting the Morlich Ward, which is a 12-bed mixed-sex inpatient ward for older adults with mental illnesses other than dementia, as well as early-stage dementia.
The inspectors said they met with six of the individuals in care and a relative, as well as nursing staff and managers, with the inpatients praising the "approachable" nurses, and giving "positive" feedback about the staff team.
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The inspectors also "observed warm and respectful interactions between staff and individuals" and "saw that physical health care needs were being addressed and followed up appropriately".
They also said there was evidence of regular reviews of patient care plans, but that details in these were "variable" and they "look forward to seeing improvement in this area when we next visit".
And while there were many positives with the standards of care and staff interactions, the commission did make four recommendations for improvements.
Top priority among them was the need to ensure "that all prescribed medication is legally authorised, where appropriate". This came after they noted during inspections that although medications prescribed were duly noted in patient files, the documentation did not always include an authorised signature and that this meant the forms were not "legally compliant".
They continued: "More work needs to be done to ensure forms are legally compliant and could be improved by following the good practice found elsewhere in the service.
The inspectors said this improvement should be regarded as a priority as it had also been spotted during the previous visit in 2022.
Elsewhere, recommendations also included that staff display in the ward a programme of patient activities available that they could take part in and so that "individuals are aware of what is available daily".
They also stressed that although the Morlich Ward is a "pleasant environment" with a "well-maintained" secure garden, there were no manual or hydraulic hoists to help nurses support patients who required bathing assistance. There were also only overhead showers in the en-suite bathrooms, and overly complicated lighting controls in bedrooms, and recommended that "managers should arrange to provide the necessary equipment and make alterations to ensure the environment is suitable for older adults".
The final recommendation was that managers review "the bed capacity and designation in each specialty to better meet the needs of the individuals being referred" after noting that although the ward as designated as an older adult functional assessment unit, some of those present during the inspection were either well under 65 years old, or had dementia diagnoses or a learning disability. The team said this was "clearly putting additional pressure on nursing staff to meet such a wide range of needs".
The inspection of the Bruar Ward, meanwhile was held to review progress of previous recommendations made during an earlier visit in May 2023.
The ward, which has eight beds and serves as a mixed-sex, locked rehabilitation unit,
Again, as with Morlich, feedback from those receiving care was positive, with "all those that we spoke with" being full of praise for the staff - with comments such as "non-judgemental", "helpful" and "sound" mentioned.
The inspectors also noted that they found "a good standard of recovery-focussed care being delivered to individuals with varying and complex needs".
Another positive was that recording of individual and staff engagement "had significantly improved" since their previous visit when they had been "unable to see evidence of one-to-one engagement" between staff and ward users.
However, there were also several recommendations.
They said that although the ward was "bright" and the bedrooms "appeared homely though some were in need of re-decoration" there were issues with the tap water supply, and those using the ward, as well as staff, were having to drink bottled water instead.
They recommended that "every effort is made to complete the water surveillance as quickly as possible".
They also recommended that managers monitor care plan reviews “to ensure adequate information is provided" after some of the reviews inspectors looked at "merely state 'no change'", and they felt that "there could have been more information provided as to why this was the case".
The final recommendation, as with the Morlich ward, was for staff to ensure treatment given "is legally authorised" after inspectors found "a few cases of medications prescribed" which were not correctly authorised on the relevant form.
