Western General Oct 17

“During our latest inspection of the Western General, we noted the commitment by the hospital to improve compliance with the Care of Older People in Hospital Standards and the Standards of Care for Dementia in Scotland.

“Additionally, patients were positive about the care they received whilst in the hospital as well as the food, snacks and drinks available to them in hospital. However, throughout the inspection we identified examples of poor completion of documentation, which is an important part of a patient’s care which ensures that patient care is person centred. We will continue to follow up on the issues we have identified at future inspections.

Ian Smith, Head of Quality of Care for Healthcare Improvement Scotland

Western General Hospital

Older people in acute hospitals unannounced inspection

Inspection dates: 15-17 August 2017

Summary of inspection

We carried out an unannounced inspection to the Western General Hospital from Tuesday 15 to Thursday 17 August 2017 and we inspected the following areas:

  • acute medical assessment unit
  • ward 24 (colorectal)
  • ward 50 (medicine for the elderly)
  • ward 51 (medicine for the elderly)
  • ward 54 (respiratory), and
  • ward 55 (medicine for the elderly/stroke).

We also inspected the following areas in the Royal Victoria Building, which is part of the Western General Hospital:

  • ward 71 (acute medicine for the elderly), and
  • ward 74 (acute medicine for the elderly).

Areas of good practice

We noted areas where NHS Lothian was performing well in relation to the care provided to older people in acute hospitals.

  • The majority of patients and visitors we spoke with were positive about the care given in Western General Hospital.
  • Patients we spoke with were positive about the food, snacks and drinks available to them during their stay in hospital.
  • Using the role of volunteers in ward areas to improve the patient experience.
  • Good input by Team 65 for managing the care of older people.

Areas for improvement

We found areas where further improvement is required.

  • The electronic patient health record system in place must be improved to ensure accurate and accessible patient health records. We were unable to report the numbers of patient assessments correctly completed within the nationally required timeframes and we were unable to see whether patient outcomes were improving or not. Due to the system only logging the date and time of previous changes that staff made, it is not possible to see the outcome and dates of previous assessments.

  • Throughout the inspection, we identified examples of poor completion of documentation. Documentation is an essential part of a patient’s care; it is a legal requirement and ensures that patient care is safe. It is important to stress that poor documentation does not mean that the care is also poor. 

This inspection resulted in 10 areas of good practice and 15 areas for improvement. A full list of the areas of good practice and areas for improvement can be found in Appendices 1 and 2, respectively on pages 31 and 33. We expect NHS Lothian to address all the areas for improvement.

The NHS board must prioritise those areas where improvement is required to meet a national standard.

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Published Date: 25 October 2017


Western General Hospital overview

Find out more about this hospital, including the latest inspection report, on the Western General Hospital overview page.

Types of inspections

Inspections may be announced or unannounced and will involve physical inspection of the clinical areas, and interviews with staff and patients. We will publish a written report 8 weeks after the inspection.

  • Announced inspection: the service provider will be given at least 4 weeks’ notice of the inspection by letter or email.
  • Unannounced inspection: the service provider will not be given any advance warning of the inspection.
  • Follow-up inspection: the NHS board and hospital may or may not be given advance notice of the inspection. A safety and cleanliness follow-up inspection will take place no later than 26 weeks from the publication of the initial report.