NHS Tayside has been told to improve its care of the elderly after serious failings were identified at Perth Royal Infirmary.
Inspectors from the watchdog Healthcare Improvement Scotland discovered a “significant” number of problems at the hospital following an unannounced inspection in July.
In all, 14 individual areas for improvement were identified, with the health board called on to take urgent steps to address the issues.
Inspectors uncovered instances where management of patient flow had compromised the safety, care and dignity of patients.
NHS Tayside has described the findings as “disappointing” and has pledged to overhaul policies and staff training if required.
Mid Scotland and Fife MSP Liz Smith said it was important to note the report’s praise for much of the work at PRI, but “concerning” to find that “the standard of care for older people in acute care was not acceptable”.
“There is already a concern amongst many elderly citizens when they are going into hospital and it is vital that we are able to reassure older people that they will receive the first class care as well as the compassion, dignity and respect we all expect when we go into hospital,” she said.
Ms Smith added that she would be raising the issue with health chiefs at “the earliest opportunity” and would seek a timetable for action to be taken.
During the visit to PRI, inspectors spoke extensively to staff and observed them during their working day and, in particular, their interaction with patients.
They also carried out patient interviews and a mix of carer, visitor, family and friend questionnaires, together with reviewing patient health records.
The team discovered a number of areas of good practice, but particular attention will now have to be given to those areas in which PRI is failing to meet national standards.
Some patients were found not to have been assessed within recommended timescales, while there were no care plans in place to ensure vulnerable patients received the correct food, fluid and nutrition.
Boarding – where patients are moved from one ward to another to meet the needs of the service (usually due to overcrowding) and not the patient’s clinical needs – was also widespread.
Head of Quality of Care Jacqui Macrae said: “Our inspection acknowledged areas where NHS Tayside is performing well.
“However, we identified a significant number of areas where NHS Tayside needs to improve the care provided to older people.
“Not all older people are assessed within the national standard recommended timescales and there is a lack of person-centred care planning.”
Ms Macrae also questioned the legibility and completeness of nursing and medical documentation, together with the quality of record-keeping vital to ensuring arrangements are made for future and ongoing care.
She added: “This inspection resulted in 14 areas for improvement and we expect NHS Tayside to address the areas for improvement we have identified.”
NHS Tayside chief executive Lesley McLay accepted improvements could be made to the care of the elderly in its hospitals.
She said steps would be taken to ensure that care of the elderly improved.
“Our frontline staff work hard every day to ensure person-centred, safe and effective care for all our patients and their families.
“Clearly, some of the observations noted by the inspectors on the day are disappointing and therefore we are reinforcing policies with staff and providing additional training where necessary.
“We recognise that the care of older people in our hospitals is an area that we can make improvements in.
“Last year we established an Older People’s Board consisting of a senior leadership team with clinicians and managers who care for older people, to look at the challenge of transforming the patient pathway and delivering modernised older people’s healthcare.
“We know it is essential that we keep striving to improve on what we do every day to ensure we get that care right for every patient every single time.”