INSPECTORS who paid a surprise visit to one of Scotland's leading regional hospitals found two confused dementia patients walking around a cluttered ward full of heavy medical equipment.

Four staff from Healthcare Improvement Scotland went unannounced to Inverclyde Royal Hospital, Greenock, in August, to assess the quality of care it was giving to vulnerable elderly people.

The report, published yesterday, drew attention to the incident when the inspectors came across the elderly patients walking around the machines.

It said: "Although wards were brightly lit, they were very cluttered. This was particularly noticeable in J North, the acute admissions unit.

"During our visit to the ward, we saw two confused patients walking around the ward. One patient was quite unsteady on their feet. As they were walking, they had to walk around a lot of equipment, including blood pressure monitoring machines and patient hoists. This can increase the risk of falling for people who like to walk around, particularly if they are confused."

As well as the cluttered wards the inspectors identified other significant areas where improvements needed to be made, including to the signage around the hospital, to the completion of charts recording patients' food and fluid intake and to the referral process and waiting times to see a dietician. Some 14 shortcomings were listed in the report.

However, despite the areas where improvements were needed, the inspection team also found many staff had a caring and positive approach towards the elderly patients.

"We found that patients' care was carried out in a way that maintained patient dignity and was respectful. Staff appeared to be engaged with their patients and attended to their requests for assistance. We saw many examples of positive interactions between staff and patients during the inspection," the report said.

"Patients appeared well groomed, comfortable and well cared for."

The programme of inspections of hospitals treating dementia patients was announced three years ago by ministers after a case of poor care emerged at Ninewells Hospital, Dundee. Rosslyn Crocket, NHS Greater Glasgow and Clyde board nurse director, said she was pleased to note the inspection team observed patients being cared for with dignity and respect by staff.

But she added: "I am extremely disappointed that in a number of areas, particularly record keeping and care planning, we are still falling short of the standards expected."