Inspectors left a Moray community hospital “impressed” with the care offered, despite staffing issues.
Seafield Hospital is a 32-bed medical facility providing palliative care, with an eight-bed unit dedicated to older adults suffering from dementia.
Inspectors from the Mental Welfare Commission visited the unit, the Muirton Ward, in May.
Now they have published their report, which notes that although they were unable to have detailed conversations with patients, they appeared “relaxed and content” within the environment.
Speaking to managers, inspectors discovered – like many facilities – Seafield is facing recruitment challenges and is using agency nurses to ensure continued care.
Managers say that while the issue is nationwide, facilities in rural areas are most hard-hit when recruiting staff to fill vacancies.
The report said: “We were impressed to see and hear that the staff have continued to provide a quality service despite the numerous challenges presented to them, including staff shortages.
Feedback from relatives about the ward staff was positive, saying that the staff were “very caring and kind”.
During a recent outbreak of Covid-19, staff kept patients in regular contact with relatives.
In dealing with stressed/distressed behaviour, most ward staff have received training to support patients when needed.
Inspectors found that care plans were not detailed enough concerning stress/distress.
More activities needed
The report said: “Many care records indicated the use of non-medical strategies to support patients, however, these were not specifically identified in the care plan, nor were the triggers that were noted to cause the patient’s distress.
“We, therefore, found that some patients were given as required medication to reduce symptoms of stressed and distressed behaviours, rather than first utilising nonmedical interventions.”
On their previous visit, inspectors recommended revised care planning, with this visit indicating little was done to improve this issue.
The report said: “Managers should re-introduce regular auditing of the patient’s notes, including the care plans to ensure that they reflect and detail interventions which support patients towards their care goals, along with regular reviews and summative evaluations.”
On inspection day, no activities had been planned due to the absence of an activities coordinator, with the task falling to nurses, who often have other priority tasks.
Inspectors found it “disappointing” that there were no activities listed in patient files given the positive effect on patients, while reducing the need for medication.
However, describing the ward itself as “bright and spacious”, inspectors were impressed with the physical environment, while utilising dementia-friendly signage.
However, the outdoor space was inaccessible due to broken glass from the outdoor shed, caused by a previous storm which hadn’t been fixed yet.
The report offered four recommendations for Seafield Hospital, including auditing patient notes, increased activities and repairs to the outdoor space.
While recognising the pressures due to the lack of available staff, inspectors were impressed with the indoor space and staff attitudes towards patients.
Simon Bokor-Ingram, chief executive of Health & Social Care Moray, said: “We welcome the publication of the Mental Welfare Commission’s report on Muirton Ward and note the many areas of good practice identified, including the quality service the team has continued to provide throughout the many challenges of the Covid pandemic.
Significant progress has already been made on improving the garden area to enhance patient safety and wellbeing.
“Along with the required repairs, the garden has been given a fantastic transformation with painting, planting and artificial grass laid.
“We are very grateful to the Friends of Seafield Hospital which funded the work, to the volunteers from Finechty Men’s Shed which carried out the work and the local companies involved.”
Conversation