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Southern General Hospital warned on elderly patient care Southern General Hospital warned on elderly patient care
(35 minutes later)
Health inspectors have found numerous problems with elderly patient care at Glasgow's Southern General Hospital.Health inspectors have found numerous problems with elderly patient care at Glasgow's Southern General Hospital.
They found some patients with cognitive impairment were being moved from ward to ward, against hospital policy, to help cope with new admissions.They found some patients with cognitive impairment were being moved from ward to ward, against hospital policy, to help cope with new admissions.
The inspection team also found dozens of cases of elderly patients being kept in hospital due to delays in finding a social worker to assess their needs.The inspection team also found dozens of cases of elderly patients being kept in hospital due to delays in finding a social worker to assess their needs.
Glasgow health board apologised for the failings, which it is addressing.Glasgow health board apologised for the failings, which it is addressing.
The unannounced inspection visit by Health Improvement Scotland (HIS) was carried from 18 to 20 February this year.The unannounced inspection visit by Health Improvement Scotland (HIS) was carried from 18 to 20 February this year.
Patient 'boarding'Patient 'boarding'
Inspectors found "a number of areas of strength" but also identified instances where care of elderly patients was below the expected standards.Inspectors found "a number of areas of strength" but also identified instances where care of elderly patients was below the expected standards.
They expressed concern "about the patient flow and capacity", especially in relation to the practice of "boarding", which is when a patient is moved around to meet the needs of the hospital and not the patient's clinical needs.They expressed concern "about the patient flow and capacity", especially in relation to the practice of "boarding", which is when a patient is moved around to meet the needs of the hospital and not the patient's clinical needs.
The inspection report said: "NHS Greater Glasgow and Clyde 'patient flow policy' states that patients with cognitive impairment are not boarded. However, we found this was not the case.The inspection report said: "NHS Greater Glasgow and Clyde 'patient flow policy' states that patients with cognitive impairment are not boarded. However, we found this was not the case.
"For example, a patient with known dementia and increased confusion had several ward moves."For example, a patient with known dementia and increased confusion had several ward moves.
"Although some of these moves were due to clinical need, some were documented as being due to capacity issues in the hospital.""Although some of these moves were due to clinical need, some were documented as being due to capacity issues in the hospital."
The inspector's report also found dozens of cases where patients planned discharge from hospital had been delayed and said this could be damaging to their wellbeing.The inspector's report also found dozens of cases where patients planned discharge from hospital had been delayed and said this could be damaging to their wellbeing.
"We noted that 48 patients were listed as delayed discharge," the report said."We noted that 48 patients were listed as delayed discharge," the report said.
"We were told that patients are waiting up to 54 days to be allocated a social worker to allow an assessment of needs to be carried out."We were told that patients are waiting up to 54 days to be allocated a social worker to allow an assessment of needs to be carried out.
"This is detrimental to the patients as it can lead to issues with cognitive impairment, increased risk of infection and impact on functional ability.""This is detrimental to the patients as it can lead to issues with cognitive impairment, increased risk of infection and impact on functional ability."
Elsewhere, the inspection team found: Elsewhere, the inspection team found examples of:
Jacqui Macrae, HIS head of quality of care, said: "During this inspection, we were particularly concerned about patient flow and capacity within the hospital.Jacqui Macrae, HIS head of quality of care, said: "During this inspection, we were particularly concerned about patient flow and capacity within the hospital.
'Friendly staff''Friendly staff'
"On the majority of wards inspected we found no evidence of care plans being used to inform and evaluate the care given to patients."On the majority of wards inspected we found no evidence of care plans being used to inform and evaluate the care given to patients.
"We did, however, observe friendly and polite interactions between staff and patients, with the most speaking positively about the quality of care received.""We did, however, observe friendly and polite interactions between staff and patients, with the most speaking positively about the quality of care received."
Ms Macrae added: "This inspection resulted in two areas of strength and 16 areas for improvement which NHS Greater Glasgow and Clyde must address as a matter of priority.Ms Macrae added: "This inspection resulted in two areas of strength and 16 areas for improvement which NHS Greater Glasgow and Clyde must address as a matter of priority.
"We will follow-up these concerns at future inspections.""We will follow-up these concerns at future inspections."
Rory Farrelly, NHS Greater Glasgow and Clyde's acute director of nursing, said: "We are pleased to note that the inspection team observed friendly and polite interactions between staff and patients, with the most of the patients interviewed speaking positively about the quality of care received.Rory Farrelly, NHS Greater Glasgow and Clyde's acute director of nursing, said: "We are pleased to note that the inspection team observed friendly and polite interactions between staff and patients, with the most of the patients interviewed speaking positively about the quality of care received.
"However, we are sorry that in a number of areas we are still falling short of the standards expected in all our hospitals."However, we are sorry that in a number of areas we are still falling short of the standards expected in all our hospitals.
"Clearly we need to reinforce some of our policies with staff and provide additional training where required."Clearly we need to reinforce some of our policies with staff and provide additional training where required.
"We have drawn up an extensive action plan to address the improvements highlighted in the report and some of these actions have already been implemented.""We have drawn up an extensive action plan to address the improvements highlighted in the report and some of these actions have already been implemented."