A Fife community hospital has been urged to make improvements after concerns around patient mealtimes were raised during a recent inspection.
Staff at Cupar’s Adamson Hospital have been urged to ensure a “consistent approach” to mealtimes in all wards, co-ordinate meals appropriately and stop all non-essential activity when meals are being served.
Healthcare Improvement Scotland inspectors found the arrangements around mealtimes were “not well managed” during an unannounced visit to the hospital’s Tarvit Ward last October.
That was one of only a few recommendations to come out of the inspectors’ report, which overall gave Adamson Hospital – which provides services including physiotherapy, occupational therapy, podiatry, dietetics and speech and language therapy – a largely clean bill of health.
The report noted a very good standard of environmental cleaning, and that patients were treated with dignity and respect by staff who were attentive to their needs.
Inspectors also observed that patient’s relatives were kept up-to-date and patients were supported to keep in touch with by phone or by video call, as well as being able to have designated visitors in line with current Covid-19 guidance in place at the time of the inspection.
Ian Smith, Healthcare Improvement Scotland’s head of quality of care, said: “During our inspection we found the cleanliness of the environment was good and assessments for falls and pressure ulcer care were completed for all patients.
“However, we found the need for a consistent approach to mealtimes, where meals are co-ordinated appropriately.
“Moreover, equipment should be in a condition that ensures that it can be effectively cleaned.”
Inspectors suggested mealtime preparation appeared to be “limited”, which meant staff gave patients their meal but then had to help patients position properly to eat it.
Some ward staff were not aware that the meals had arrived on the ward, which meant only a small number of staff were helping with the mealtime, while some ward staff were leaving their ward duties for their break while not all patients had received their meal.
“We saw that those patients requiring assistance received staff support that was caring and dignified, however, staff did not encourage or prompt some patients who were not eating their meals,” the report noted.
Fluid balance charts were also in place for those patients who needed their fluid intake monitored, although overall completion of the charts was labelled “poor” by the inspectors.
“We saw that many did not state the reason for them being in place, previous day total of input/output and overall fluid balance,” the report continued.
An action plan has been developed to address these issues quickly.
Commenting on the report, NHS Fife director of nursing, Helen Buchanan, said:
“We are pleased that the report published today by Healthcare Improvement Scotland recognises the high standard of cleaning within Tarvit Ward, and notes that staff were attentive to the needs of the patients in their care.
“Furthermore, I am also pleased that the report recognises the efforts made by staff in supporting patients to use technology to remain in regular contact with relatives during a particularly difficult period with visiting restrictions in place.
“We note also the improvement actions contained the inspection report. NHS Fife is committed to continually improving the standards of care we provide and work is well-underway to address the action points as quickly as possible.”
