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Too many hospitals 'fail' elderly patients

A “shocking” report has highlighted many hospitals are failing to meet the basic needs of older people.

The Care Quality Commission (CQC) carried out a series of 100 unannounced inspections of acute NHS hospitals in England and Wales between March and June 2011 as part of its Dignity and Nutrition Inspection Programme.

Over half of the hospitals visited gave the regulator “cause for concern” and 20 hospitals were said to be “not delivering care that met the standards the law says people should expect.”

In particular, Sandwell General Hospital and the Alexandra Hospital were seen to be offering care that put people at “unacceptable risk of harm”.

Twelve hospitals investigated were found to be non- compliant with standards relating to the respect of patients.

Upon visiting the non-compliant hospitals, the CQC reports instances where staff spoke to patients in a condescending or dismissive way; call bells were put out of patient's reach, or they were not responded to in a reasonable time; and curtains were not properly closed to give sufficient privacy to patients receiving care in bed.

Inspectors recall one instance of non-compliant practice:

“The patient constantly called out for help and rattled the bedrail as staff passed by…We noted that 25 minutes passed before this patient received attention. When we spoke with the patient, we observed that their fingernails were ragged and dirty.

“People were not taken to a toilet far away from their bad space, commodes were used for much of the time and the process could be heard throughout the bed areas.”

Fifteen hospitals out of the 100 visited failed to meet standards relating to nutritional needs, according to the CQC report.

Inspectors found patients were not given the help they needed to eat, and many patients were not able to clean their hands before meals.

CQC Chair Dame Jo Williams places the blame of such “alarming” failings with NHS leaders and managers.

“Those responsible for the training and development of staff - particularly nursing - need to look long and hard at why ‘care' often seems to be broken down into tasks to be completed,” she said.

“Task-focused care is not patient-centred care. It is not good enough and it is not what people want and expect. Kindness and compassion costs nothing.

“Holding doctors and nurses to account for every box they have or haven't checked sends the wrong message. Need to work against a system that puts paperwork over people.”

The Royal College of Nursing (RCN) calls upon all those in a position to deliver solutions that address “these examples of completely unacceptable care” and prevent them becoming entrenched. 

“There are some deeply troubling, indeed shocking examples of poor care in the CQC reports, which demand urgent and sustained action to improve care for vulnerable patients,” said RCN Executive Director of Nursing and Service Delivery Janet Davies.

“Every nurse is personally accountable for their own practice and must act promptly to raise concerns if staffing levels or other pressures are getting in the way of delivering good care. 

“Each trust board and chief executive must take responsibility too. Decisions about the numbers of staff employed, the availability of senior, experienced clinical nurses and the whole ethos of the hospital are not issues that can be delegated.”

Dame Williams warns the report “must result in action…if we are not to find ourselves here, yet again, a few years down the line.”

Care Quality Commission