A SHOCKING report into the state of Kirkcaldy’s Victoria Hospital has been sent to the Scottish Government after inspectors discovered a catalogue of problems.
Wards were said to be over capacity, safety issues from overcrowding were uncovered and the independent inspection team from Healthcare Improvement Scotland evaluated patient care and dignity levels as being compromised in some cases.
The report of the inspectors’ announced visit to the hospital on May 14-16 highlights 15 areas for improvement and just two areas of strength. Unsavoury notes include patients being wheeled to the toilet on commodes rather than wheelchairs, not having their hands washed at mealtimes, being moved wards in the middle of the night, having blood taken whilst eating and rooms with a fifth bed abandoned in the centre when they are only suitable for four.
A patient also reported their help buzzer being unanswered for three hours and at one mealtime inspectors felt compelled to intervene as a patient could not see their fork so was eating their meal with their knife.
The inspection, which focussed on the care of people with dementia and cognitive impairment and nutritional care and hydration, did however highlight there was a good psychiatric liaison service specifically for older people and that there was a good relationship between the wards and kitchen for requesting extra meals and snacks.
Staff were also given praise from patients, with 65 out of 67 surveyed feeling they provided a good quality of care.
However senior inspector Ian Smith, who led his team around 12 areas of the hospital, said he expected NHS Fife to address problems noted as a matter of priority.
He said: “Several hospital staff expressed concerns to us about capacity and how patients were moved through different services within the hospital.
“As a result, we looked at these issues as part of the inspection on all wards we visited and we found a number of examples that compromised patient safety, dignity and care. We escalated our concerns to the NHS Fife executive team and notified the Scottish Government of these concerns.”
John Wilson, chief executive of NHS Fife, said he welcomed the report.
He said: “The visit took place at a busy time for the hospital ... the issues referred to regarding capacity of the system were well known to us and under active management at the time of the visit. We did not attempt to hide or diminish them during the visit.”
Mr Wilson added an extra investment of £2.7m in acute services to manage capacity issues has been announced and recruitment to additional medical and nursing posts is well in hand.
Community services initiatives are also being expanded, so people not requiring medical treatment can be cared for elsewhere, and 22 beds are to open on a permanent basis at Victoria Hospital.
An all-too familiar problem
From comments throughout the 24 pages of the report it appears the biggest problem comes from overcrowding.
During April 2013 nine wards had an occupancy rate of between 101 per cent and 112 per cent of their identified capacity.
Overcrowding, and having too many patients for the number of staff, isn’t a new issue though.
However the way it is being dealt with at Victoria Hospital is concerning.
Inspectors said in the report there was “a significant risk to patients” of having five beds in rooms only suitable for four.
As the extra beds are not in a designated place they do not have oxygen or suction points or an electrical supply.
Staff claimed this was a “systemic problem” and expressed concern there could be safety issues if they were unable to get the necessary staff or equipment to a patient’s bed due to the extra bed getting in the way.