Inspectors call for urgent change at Dundee hospital

Monroe House.

Inspectors have ordered a Dundee hospital to make urgent improvements to its system for giving medication to patients.

They found it was possible for residents of Monroe House to be prescribed drugs without staff having full details of all the medicines they were taking.

The Healthcare Improvement Scotland (HIS) team uncovered the problem during their fifth visit to the hospital so far this year.

The 26-bed unit on Americanmuir Road looks after adults with learning disabilities, mental health problems and challenging behaviour.

Earlier this year several members of its staff were suspended amid allegations of failings in care. A police investigation resulted in one woman being reported to the procurator fiscal.

The HIS inspectors made a surprise visit to the hospital on May 8.

Their report said: “During the inspection we found that some people who use the service had a separate sheet for ‘homely remedies’ prescribed by the GP.

“There was no record of what had been administered, by whom and when. We were told by staff that it would be recorded in the nursing notes.

“It was not clear on the prescription sheet what homely remedies were being given. This means staff could be prescribing medication without full knowledge of what the service user has been taking.”

The inspectors said a policy must be put in place for the use of such “homely remedies”, although they praised other aspects of medicines management at the hospital.

They were also checking to see what action had been taken to make improvements they had demanded at their previous visits. They found the work had not been completed and gave managers extra time.

Chief Inspector Susan Brimelow said: “While the requirements from the previous inspections have not been met, we were able to see that progress has been made to meet these.

“However, our inspection resulted in one new requirement and one new recommendation.

“We will continue to carry out rigorous inspection to monitor Monroe House’s progress in addressing these issues and have made it clear to the provider that the requirements must be addressed as a matter of priority.”

The HIS inspectors gave the management and leadership of the hospital a “weak” rating, although they judged staffing to be “good” and the quality of care and support of patients to be “very good”.

However, they said staff at Monroe House still had concerns.

“Staff we spoke with during the inspection told us that although there has been some improvement recently, they still do not feel supported by the management team,” the inspectors’ report said.

Monroe House is owned by Castlebeck Care, which went into administration in March.

Chief operating officer Simon Harrison said: “Our team at Monroe House is committed to the safety and well-being of every patient cared for at the hospital and their top priority is always to provide the highest possible quality of care for patients.

“This latest inspection report on Monroe House, with its high rating of our quality of care and support, of staffing and our medicine management, exemplifies that commitment in action.

“Since the inspection positive progress has been made to meet the recommendations of the report.

“We always work closely with our regulator, Healthcare Improvement Scotland, and other stakeholders as part of our effort to make our commitment reality.”