Inspectors forced to intervene three times to help patients during ERI visit HOSPITAL inspectors had to ­intervene during ward visits after becoming concerned about the way patients were being cared for, a damning report has ­revealed. NHS Lothian issued an apology yesterday after an inspection of Edinburgh Royal Infirmary (ERI) uncovered failings in its care for older patients. The unannounced inspection of ERI by Health Improvement Scotland (HIS), which focused on care for elderly ­people, ­particularly with dementia, found shortcomings in the way staff treated patients and a lack of planning for individual needs. In the report, HIS said that issues were also found with the way staff maintain patient dignity, how meals are organised and with "unhelpful" ward ­environments. Failings were noted in nutritional care and hydration, with inspectors saying assessments were "not being carried out within the correct timeframes." The report also said the layout wards inspected were not helpful for people with dementia and cognitive impairment. Other weaknesses highlighted included a lack of care plans for individual patients. Inspectors had to intervene three times during their visit because of their concerns about the way patients were treated, the report said. HIS said that NHS Lothian must now make 23 ­improvements. Setting out areas where action was needed, inspectors said: "We are concerned about how staff are making sure patients" dignity and comfort are maintained at all times in the combined ­assessment area. This is a mixed-sex area and patients can be there for a number of days before being discharged or transferred to a ward. We had to intervene on three occasions whilst inspecting this area of the hospital. Concerns were also raised that during meal-times the most vulnerable were losing out: "Patients who needed help with their meals were waiting for a long time before that 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 meal times. Melanie Hornett, nurse director at NHS Lothian, said: "NHS Lothian is committed to providing high-quality, safe and person-centred care and I am extremely disappointed in the findings of this report. I would like to apologise to patients who have experienced care that was below the standard we expect. She said there were a number of policies and procedures in place to improve care for older people, but added it was "clear that we need to do more" to ­ensure they were being carried out, and that in response to the report, a detailed action plan was now in place. Royal College of Nursing (RCN) Scotland director Theresa Fyffe said: "While the report makes clear that patient feedback on care was largely positive, it also reveals a number of serious issues that amount to a picture of unacceptable standards in care for older people at the Royal Infirmary of Edinburgh." Ms Fyffe said staffing numbers appeared to be one contributory factor to the situation, but said that the RCN was offering support to ERI staff and management to help improve the ­situation.