Published Date: 19 November 2013
Older people in acute hospitals announced inspection
Inspection dates: 24-26 September 2013
Summary of inspection
We carried out an announced inspection to Raigmore Hospital from
Tuesday 24 to Thursday 26 September 2013.
We inspected the following areas:
- ward 2A (stroke/rehabilitation)
- ward 3A (orthopedics)
- ward 4A (surgical admissions)
- ward 4C (surgical)
- ward 5A (medicine for the elderly)
- ward 6A (acute medical admissions unit, with medical high
- ward 6C (medical admissions), and
- ward 11 (medical/respiratory medicine).
We focused the inspection on the care of people with dementia
and cognitive impairment, nutritional care and hydration, and
preventing and managing pressure ulcers.
Areas of strength
We noted areas where NHS Highland was performing well in
relation to the care provided to older people in acute
- We saw good examples of warm, caring and friendly interactions
between staff and patients. Patient care was carried out in a way
that maintained patient dignity and respect. Healthcare Improvement
Scotland Announced Inspection Report (Raigmore Hospital, NHS
Highland): 24-26 September 13.
- Dementia champions and the Alzheimer’s nurse consultant are
working together to improve the care of people with dementia.
Nursing assistants have also carried out the ‘best practice in
dementia care’ training course. This has a positive impact on
- Some wards have appointed a mealtime co-ordinator to provide
clear direction to staff, to ensure that patients receive the meal
they had ordered and were given appropriate help when necessary.
Other wards have appointed a housekeeper who makes sure that menus
are given out, completed and returned to the kitchen in a timely
Areas for improvement
We found that further improvement is required in the following
- There is no routine screening for cognitive impairment taking
place when older patients are admitted to hospital.
- The ward and hospital environment needs to be made more
suitable for people with dementia and cognitive impairment.
Raigmore Hospital needs to ensure that signage is appropriate to
meet the needs of all patients and helps them to find their way
around the hospital.
- Although we found that care delivered to patients appeared to
be appropriate and of a good standard, we were not assured that
patients, identified as having a cognitive impairment, had a
personalised care plan in place. This care plan should identify the
specific needs of the patient and how staff will meet these
This inspection resulted in six areas of strength, 13 areas for
improvement and one area of continuing improvement. A full list of
the areas for improvement can be found in Appendix 1 on page
We expect NHS Highland to address all the areas for improvement.
Those areas where improvement is required to meet a recognised
standard must be prioritised.
The improvement action plan for this inspection has now been
removed from the Healthcare Improvement Scotland website, as the
inspection took place more than 16 weeks ago. Please
contact NHS Highland Board for further information on
progress against this action plan.
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