Spot checks on 22 mental health wards across Wales
Spot-checks on 22 mental health wards for elderly patients found no evidence of systemic poor care or neglect.
But there was room for improvement in some areas, including making sure patients have daily activities and staff can get effective training.
The checks were ordered by the health minister late last year.
However, they did not find any repeat of the failings and "institutional abuse" at the former Tawel Fan unit at Denbighshire's Glan Clwyd hospital.
Relatives had described patients being treated like they were "in a zoo" in a report released this month.
An earlier Trusted To Care report looked at care of elderly patients at two hospitals in Bridgend and Neath Port Talbot.
That prompted a round of unannounced spot checks in 70 general wards treating elderly patients at 20 hospitals which found medicine management issues.
The latest review checked how older patients with dementia and mental illnesses were being looked after on specialist wards.
In the main, the checks found staff "were doing their best to provide good quality care in the face of a number of challenges".
Visits to 22 wards found "many areas of good and excellent practice" across Wales.
But they also showed room for improvement and "considerable variation in standards and practice".
Issues needing action involve:
- Ensuring older people have access to daily activities on wards
- Staff need to feel they can raise concerns easily; have effective training and understand the necessary legal safeguards
- The need for improvements to ward environments, in particular ensuring simple maintenance tasks and repairs take place promptly
- Flexible visiting hours should be encouraged on wards
The findings have already been raised with health boards and more than £5m a year will be invested in providing psychiatric liaison services in general hospitals to ensure daily activities are available on all older people's mental health wards.
Health Minister Mark Drakeford said: "These spot checks have provided us with assurance that poor care and neglect are not systemic features of the care of elderly mental health patients in Wales.
"They also highlight compassionate care provided by staff."
"However, the report does acknowledge there is room for further improvement. I expect health boards to continue to develop and improve services for older people with mental health problems both in hospitals and in the community."
As well as issues like nutrition, medicines and continence care, the checks also included how restraints were used, daily activities for patients and how relatives were involved.
Inspectors included mental health nurses, pharmacists and occupational therapists.
Dr Ruth Hussey, Chief Medical Officer for Wales, said immediate action was taken in some cases but there were also general themes emerging.
"As there are more people with vulnerability and dementia in the population, the environments we care for them in have to be develop too. So when we're refurbishing wards now we need to build in suitable, dementia-friendly environments.
"We need to be more flexible with meal times - involving families more but when you're very frail and elderly you may not have standard meal-times and want different arrangements."