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9 areas where Dunfermline hospital must improve according to inspectors

The Courier looks at the key findings of a Healthcare Improvement Scotland inspection at Queen Margaret Hospital.

Queen Margaret Hospital.
Queen Margaret Hospital in Dunfermline. Image: Kim Cessford/DC Thomson

Inspectors have demanded a series of improvements at a Dunfermline hospital.

Healthcare Improvement Scotland (HIS) made an unannounced visit to Queen Margaret Hospital in Dunfermline in February.

A report, published today, highlights a series of concerns, as well as some areas of good practice, in three mental health inpatient wards – one, two and four.

This includes two 18-bed older adult inpatient wards and an acute adult mental health ward for 22 adult inpatients.

One key area of improvement identified was staff training, after it was found just 19% of workers had completed child protection training.

Levels of staff training in other areas, like basic life support and infection prevention and control, were also found to be low – potentially leaving workers without the skills to provide  “safe and effective care” for patients on the three wards.

Unannounced inspection carried out at Queen Margaret Hospital in Dunfermline.
An unannounced inspection was carried out at Queen Margaret Hospital in Dunfermline. Image: DC Thomson

Inspectors further highlighted concerns about a high number of patient falls and damaged flooring.

The use of mixed sex and mixed-function wards was found to be “challenging for staff and patients with regards to privacy and dignity”.

A similar concern was raised in January after a Mental Welfare Commission inspection.

Inspectors also highlighted issues with high staff sickness and vacancy rates, while ligature reduction assessments and risk assessments designed to reduce the risk of patient self-harm were found to be incomplete.

Key requirements for improvement at Queen Margaret Hospital

Key requirements for improvement include:

  • Understanding and reducing the high number of falls
  • Ensuring staff comply with the locked-door policy and ensuring necessary signage and risk assessments are in place
  • Making immediate improvements to ligature risk assessments
  • Accurately completing all fire risk assessments
  • Ensuring wards are in a good state of repair to support effective cleaning
  • Managing used linen properly, in line with national guidelines, to reduce the risk of infection
  • Ensuring adequate staffing to enable meaningful activity to be provided to enhance recovery and promote wellbeing
  • Improving the audit schedule to ensure high-quality care is being delivered
  • Using data on incidents to improve how the service delivers care to patients

Two recommendations have also been made.

These are:

  • Improvements should be made to the outdoor area for patients within ward two  to develop a more therapeutic space
  • NHS Fife should ensure ward staff participation in meetings to support team discussion and information sharing

Inspectors said staff treated patients with care, compassion, dignity and respect, and communicated clearly and sensitively with them, including using “innovative” techniques to support patients.

Work to make improvements at Queen Margaret Hospital ‘a priority’

They also found “good management support at ward level”, and said care plans were complete and up to date.

HIS further highlighted an ongoing programme of redecoration and upgrades in the hospital.

Jillian Torrens, head of complex and critical care services with the Fife Health and Social Care Partnership, says she notes areas where improvements are required.

She said: “An extensive programme of refurbishments was already underway at the time of the inspection and has since helped considerably improve the hospital environment.

“As the report suggests, significant work has also been carried out across our mental services to reduce the risks associated with ligatures, and this project remains ongoing.

“Additional work is still required to address some of the remaining improvements identified in the report and this will continue as a priority in the coming weeks and months.”

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