NHS Borders told to clean up its act after an unannounced inspection

NHS Borders has been told to clean up its act after an unannounced inspection from a health watchdog.

The health body has been required to carry out a three-month action plan to prevent the risk of infection at its mental health units.

Representatives of Healthcare Improvement Scotland paid visits to NHS Borders mental health inpatient units on Tuesday, August 22.

The units inspected were East Brig adult mental health rehabilitation unit in Galashiels; Huntlyburn adult mental health acute inpatient unit; Lindean, an older mental health facility, and Melburn, an older mental health acute unit, all three based within Borders General Hospital at Melrose.

Inspectors viewed the ward and hospital environment, observed staff practice and interactions with patients, such as during patient mealtimes, spoke with patients and ward staff and accessed patients’ health records, monitoring reports, policies and procedures.

It was found that staff inspectors spoke with were knowledgeable about infection prevention and control and spoke highly of the support from the Infection Prevention and Control Team.

But although the environment appeared visibly clean on the day of inspection, staff told inspectors that “reported repairs were not addressed in a timely manner, potentially leading to continued deterioration of the environment and hindering effective cleaning”.

A lack of storage space was also an issue on most of the wards inspected.

The watchdog’s report states: “This meant that some storage areas were cramped and cluttered with equipment and products. This could make safe access and effective cleaning difficult.

“Domestic staff reported good support from supervisors. An e-learning training module had been implemented to support domestic staff with required water flushing processes. However, further training on the use of disinfectant cleaning products must be implemented to ensure these products are being used safely and effectively.”

The inspection found three areas of good practice and three with requirements for improvement.

The three areas of good practice were:

• The positive relationship between ward staff and the Infection Prevention and Control Team
• Senior managers being proactive in providing learning opportunities for all staff, including ‘bite sized’ on ward learning sessions and implementing specific learn pro modules for domestic staff
• Patient forums were used to update patients on any changes in guidance or ward issues in relation to infection prevention and control

The improvements required:

• NHS Borders must ensure the care environment is in a good state of repair to support effective cleaning
• Ensure that domestic staff are trained on the chlorine-based cleaning product used on site
• Ensure that specialist infection prevention and control advice is recorded within the ward-level patient care record to inform care planning

The report concludes: “We expect NHS Borders to address the requirements and recommendations.”

A spokesperson for NHS Borders said: “We welcome the opportunity to review and improve our performance so that we can continue delivering high quality standards to our patients.

“To do so we have worked with Health Improvement Scotland to agree an action plan, which we have begun implementing. Our Infection Prevention and Control team now have access to our electronic record keeping system (EMIS) and staff have been reminded about the importance of record keeping.

“Further actions to be undertaken soon are establishing a process for oversight and escalation of outstanding maintenance tasks and implementing some refresher training.”

Peter Lerpiniere, associate director of Nursing for Mental Health, Learning Disability & Older People, said: “I would like to take this opportunity thank all staff involved for supporting the Inspectors during their visit as well as their hard work every day.

“I am delighted that we have such dedicated staff who work well together to ensure high quality environments for our patients.”