The Healthcare Environment Inspectorate visited Raigmore Hospital in Inverness in May, raising concerns about the cleanliness of both patient equipment and the environment.
But even after they were told to act urgently to resolve the situation, a follow-up inspection a few days later found issues remained with the cleanliness of equipment, which was found to be contaminated with blood.
Inspectors said they found “significant amounts of thick, grey dust” on high and low-level surfaces in the A&E department.
“We also found a number of worktops in clean, empty cubicles had a gritty residue,” the HEI report said.
“There were also a number of stained ceiling tiles in several cubicles.”
Inspectors also found poor standards of cleaning of patient equipment in A&E.
This included thick grey dust on the tops of equipment trolleys and dressing trolleys used for the storage of IV pumps, syringe drivers and warming blanket equipment.
They also found blood contamination on some patient equipment, including the base of a blood pressure machine stand and on the lids of two clinical waste bins.
At a return visit to A&E a few days later, inspectors found improvements to the environments and were told contaminated mattresses had been replaced.
But concerns about the cleanliness of equipment continued.
Inspectors found blood contamination on various items of patient equipment including bed rails on two patient trolleys, a blood gas analyser, a work top, clinical waste bins, one cubicle sink and three equipment trolleys.
Inspectors issued the hospital with eight requirements and two recommendations to improve standards.
Susan Brimelow, HEI Chief Inspector, said: “We have identified a number of areas where Raigmore Hospital must make immediate improvements.
“During inspection on 13 and 14 May, we were not satisfied with the standard of cleanliness in the accident and emergency department, where we found patient equipment was not clean and a poor standard of environmental cleanliness.
“As a result, we escalated these concerns to senior management at the end of our first day of inspection.
“On May 20, we carried out an unannounced follow-up inspection to the accident and emergency department.
“During this inspection, we found improvements to the standard of environmental cleanliness.
“However, issues with the cleanliness of patient equipment remained.”
Linda Kirkland, interim director of operations at NHS Highland, said: “All staff in Raigmore are committed to the improvements laid out in our action plan.
“I would like to reassure everyone that I will be leading the team to ensure we maintain the expected high standards.
“It is disappointing to have these short-comings pointed out to us but that is the job the HEI team and I would like to thank them.
“The report does highlight areas of good practice which is positive. The majority of patients spoken to on the day were also very complimentary with the care including the standard of cleanliness in the hospital.”