Inspectors find contaminated mattresses and holes in walls at IRH

The hospital came under the spotlight during a recent unannounced visit by Healthcare Improvement Scotland watchdogs.

NHS Greater Glasgow and Clyde has since put a compulsory action plan in place to address four 'requirements' made by inspectors around the risk of infections, decontamination and maintenance.

During an unannounced visit Healthcare Improvement Scotland watchdogs uncovered:

• worn and contaminated mattresses on beds and trolleys

• risks of infection around the use of catheters inserted in the arms of patients to allow intravenous treatments.

• concerns raised around the monitoring of water safety to reduce the risk of waterborne infections like Legionella

• wear and tear around the hospital including holes in the walls

In an official report inspectors said: "In one ward, we found several damaged mattresses that had been repaired with tape.

"This damage would not allow for effective decontamination and could allow ingress of contaminants to the inner foam.

"In another ward, we found some mattresses were contaminated on the inside cover and foam."

They added: "During our inspection, we found some wear and tear to the fabric of the building.

"This was mainly to walls, doors and doorframes.

"This damage would not allow for effective decontamination."

The list also included damaged kitchen and pantry cupboards, kitchen flooring, exposed wood behind toilets, broken sealant around toilet bases and damaged walls.

Inspectors also drew attention to the management of peripheral vascular catheters - the small flexible tubes placed into a vein in order to administer medication or fluids.

They concluded that existing procedures at IRH ran the risk of staff being unable to determine whether the devices had been in longer than the recommended 72-hour limit.

Accident and emergency, three general wards and two wards in the Larkfield Unit all came under the spotlight during the inspection.

Inspectors have made recommendations to guard against water infections.

Their report stated: "To reduce the risk of Legionella, there should be regular flushing of unused or less frequently used water outlets.

"We saw that water flushing was being carried out, however wards and departments had different methods of recording this."

The inspectors also outlined areas of good practice across wards, including praise for the overall cleanliness of the hospital, standards of the housekeepers and the response of the estates team.

In the end there were four 'requirements' placed on NHS Greater Glasgow and Clyde to be acted on immediately.

An action plan was drawn up which included replacing all contaminated or damaged mattresses on beds and trolleys.

Bosses say this has now been completed.

Repair of holes in walls throughout the hospital is now under way while a survey of walls, doorframes and doors has commenced.

A review of all ward kitchen/pantry areas has been carried out and work has been tendered to fix surfaces within patient toilets in the Larkfield Unit.

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RESPONSE STATEMENT FROM NHS GREATER GLASGOW & CLYDE:

"We welcome today’s unannounced inspection of safety and cleanliness at the Inverclyde Royal Hospital report which shows a number of positive findings.

"The inspectors highlighted that the standard of domestic cleaning was good.

"In all wards inspected, the majority of storage areas and domestic service rooms were found to be clean, uncluttered and well organised with equipment stored appropriately to allow effective cleaning.

"Our highly dedicated staff are committed to quality care and patient safety so it was especially encouraging that all 54 patients questioned stated that the standard of cleanliness on the wards is ‘always good’ and the equipment used by staff is ‘always clean’.

"Senior charge nurses also told inspectors they are happy with the level of domestic resources and the standard of cleaning.

"It was also noted that they spoke highly of the role of the housekeeper whose duties include ensuring cleaning schedules are completed.

Inspectors did find damage to some sections of walls and doorframes which is being addressed.

"They also saw damaged mattresses on one ward and a plan was already in place to have these replaced which has been done.

"Staff relationships with the infection prevention and control team were described as good, as were the regular visits to wards and departments by the team.

"Inspectors reported the adequate provision of personal protective equipment which was readily available for staff to use during patient care.

"They also praised good staff knowledge of standard infection control precautions and staff performing high levels of hand hygiene compliance at the appropriate times.

"Good precautions were also noted around infection control in isolation rooms including the appropriately individualised infection prevention and control checklists and risk assessments for patients in isolation.

Patient safety is always our absolute priority and all infection prevention and control team (ICPT) lead and senior nurses now have access to a Care Assurance and Improvement Resource dashboard and to both local standard infection control precautions (SICPs) and hand hygiene data.

"This data will be reviewed ahead of IPCT audits to identify any areas of focus."