INSPECTORS have condemned a series of failings in elderly care at a major hospital which included a woman with learning difficulties being left partially naked in a mixed-sex ward.
Healthcare Improvement Scotland, which sent inspectors into Edinburgh Royal Infirmary unannounced, also raised concerns that mealtimes "seemed poorly organised" with patients who had difficulty feeding themselves frequently left alone while staff attended to other tasks.
Pressures on nursing staff also meant patients were sometimes abandoned halfway through treatment, while there was also criticism about a lack of routine screening for cognitive impairment among pensioners.
In their report, the inspectors said: "Due to the busy nature of the ward, we saw instances where nursing staff would start to care for a patient and then be called away before they were able to complete their tasks. Patients were interrupted on several occasions while treatment and care was given.
"Some mealtimes seemed poorly organised. Patients who needed help with their meals waited for a long time before help was provided. We had significant concerns about the provision of meals across several wards and how some patients were assisted to eat their meals. On a number of occasions, we had to intervene and ask staff to provide help for patients at mealtimes."
In total, they noted 23 areas for improvement and four areas of strength at the hospital during a three-day inspection on the hospital's stroke ward, elderly medicine, respiratory care and orthopaedic trauma wards.
The report added: "We had to intervene on three occasions to ask staff to help preserve patients' dignity. This included a female patient with a learning disability who was uncovered and exposed to other patients, staff and visitors in one of the bay areas."
Emergency call handsets were often placed out of a patient's reach so they would have difficulty calling a nurse for help.
However, the inspectors noted feedback from patients about their care was generally positive.
Ian Smith, acting chief inspector, said: "We observed areas where NHS Lothian is performing well, including the provision of a service to advise and support staff on wound care and preventing and managing pressure ulcers.
"However, we also identified a considerable number of areas for improvement."
A spokesman for Age Scotland said the failings "can't simply be attributed to general staff overstretch and financial pressures".
He said: "The snapshot given by this inspection report is of weak systems and processes, inadequate assessments, and ward environments that don't meet the needs of older people with dementia and cognitive impairment."
Theresa Fyffe, Royal College of Nursing Scotland director, said: "There are a number of factors behind this poor situation.
"Staffing appears to be one contributory factor,which is why we call for a minimum of one professionally qualified nurse per seven older patients in all hospitals, to reflect the complexity of the care required."
Melanie Hornett, nurse director, NHS Lothian, said: "We have reviewed the inspection team's findings and have a detailed action plan in place to address the issues raised."
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