INSPECTORS witnessed poor hand hygiene at a Borders hospital during an unannounced visit, with some staff seen “going between rooms and patients” wearing the same gloves.

Healthcare Improvement Scotland carried out the assessment at Hay Lodge in Peebles on December 8.

And although NHS Borders has described the report as “positive” overall, the watchdog said some staff members had worn personal protective equipment (PPE) “inappropriately”, adding that “not all patients could physically distance” from others.

In the 22-page findings, published this month, inspectors said: “There were six beds in each bay and limited space in the bays between patient beds.

“We raised this as an area of concern, mainly because not all patients could physically distance from other patients, notably when a patient used their chair.

“This lack of physical distancing is further compromised when a staff member or a visitor is at the bay. 

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“Additionally, domestic staff told us that cleaning the area was difficult.”

The report went on to say: “Some staff were seen not to decontaminate their hands at appropriate opportunities – for example, before donning (putting on) and after doffing (taking off) gloves.

“Gloves were worn inappropriately, and therefore hand hygiene was not carried out. 

“PPE should only be used for individual care episodes or tasks and should be donned immediately before the tasks and removed immediately after.

“Staff were seen going between rooms and patients wearing the same gloves.

“For example, nursing, domestic, and medical staff wore gloves when not required, such as when distributing drinks, during the drug round, and writing inpatient notes.”

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Healthcare Improvement Scotland said equipment and environmental cleanliness were both good and that staff said they were well supported and kept up-to-date during the pandemic.

It also highlighted “evidence of learning from falls reviews which have driven quality improvement work to reduce the number of falls” at the 23-bed hospital.

However, despite there being “a good provision of food, fluid and nutrition for patients”, inspectors thought the meal-time service was “not well managed”.

The report states: “Meal service was un-coordinated, resulting in patients in bays receiving their meals at different times and meals being left in the trolley for up to 20 minutes after meal service began.

“Staff were not available to provide a prompt or encouragement in a timely manner for those who required it.

“We also saw some staff leaving the ward for their break before all patients had received a meal.”

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Speaking following the publication of the report, Ian Smith, head of quality of care at Healthcare Improvement Scotland, said: “During our inspection we saw that the standard of both environmental and equipment cleanliness were good.

“There was also evidence of learning from incident reports which have driven a reduction in the number of falls.

"However, the use of person-centred care plans and assessments for food, fluid and nutrition must be improved, as well as ensuring a consistent approach to meal times.”

NHS Borders confirmed it has taken steps to address concerns after agreeing an action plan with Health Improvement Scotland.

The health board says “a meal-time co-ordinator role has been re-established and an education template for person-centred care planning has been developed which will now be used to deliver education in Hay Lodge Community Hospital”.

Suzie Flower, associate director of nursing and chief nurse for primary and community services at NHS Borders, said: “We are committed to learning from this inspection and ensuring the care we deliver to our patients in Hay Lodge is of the highest quality.

“I would like to take this opportunity to echo the inspectors’ thanks to all staff involved.”