Health / Nursing director defends hospital room described as ‘bleak’ by inspectors
NHS SHETLAND’S director of nursing has defended the Gilbert Bain Hospital’s low stimulus room after it was described as “bleak” and “not fit for purpose”.
An inspection from Mental Welfare Commission Scotland found the room, which is used to temporarily accommodate patients with mental health needs, had no windows and no alarm system for staff to summon help.
Inspectors also found that patients awaiting a mental health treatment plan in the room had no access to outside space or fresh air.
However Kathleen Carolan defended the room, saying it had provided a “vital place of safety for patients who have required it” since it was established in 2017.
She said it had only been used four or five times.
“The low stimulus room is deliberately sparse so that we can safely provide care in the room where multiple staff might be needed,” Carolan said.
She said there were “multiple staff present when a patient is in this room – so the possibility that a member of staff could not leave the room if needed is assessed as a low risk.”
“Wherever possible, the patient will be able to get fresh air and leave the room in the company of the staff who are supporting them.
“They are not confined to this area.”
Inspectors also found that a team of senior staff were trained in the management of aggression, who would be called on if a patient became aggressive.
But they heard these staff “could live up to an hour or more away” and would not be able to provide immediate assistance.
Carolan said, however, that this team would be identified before a patient was transferred so staff not living close to the hospital was “not a key risk”.
“The low stimulus room is not an inpatient setting,” she said.
“The purpose is to create a calm environment for a patient whilst a treatment plan and/or a plan to transfer them to a more suitable specialist facility can be identified.
“This is typically Cornhill Hospital and the duration of time a patient will spend in the low stimulus room should be less than eight hours (subject to air ambulance availability).”
Carolan said the NHS had already been in the process of trying to improve the environment in and around the low stimulus room before inspectors visited last September.
“There are a number of changes we have made since then, including using space in an adjacent department to give the patient, their family if present, and the staff working in that area more privacy and access to natural light,” she added.
“We are committed to making the places of safety in the hospital as optimal as they can be in an older building, but we will also need to continue to take a risk-based approach as our nearest psychiatric hospital is in Aberdeen, and we cannot replicate these facilities locally.
“How we design spaces for people in need of acute psychiatric care will be a key consideration in the planning of a new hospital.”
NHS Shetland’s director of nursing and acute services added: “I want to assure everyone in our community that ensuring we offer compassionate, trauma-informed care when people present at hospital in a crisis is our priority and the staff ensure the environment is safe and comfortable.”
Mental Welfare Commission Scotland made four recommendations to NHS Shetland for future visits, one of which related to the low stimulus room.
NHS Shetland said it had considered the recommendations in the report and was “actively progressing them”.
“The recommendations made are on track for completion within the timeframe,” it said.
“The Mental Welfare Commission is returning in 2025 to follow up on these actions.”
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