NewsBreakingOnline

Care Quality Commission finds ‘truly appalling and shocking’ levels of dignity and provision of nutrition during spot visits Twenty hospitals in England broke the law by failing to protect the dignity of older patients and ensure they got sufficient food and water, spot checks by NHS watchdogs have found. Thirty-five others subject to unannounced visits between March and June this year also needed to make improvements, with just 45 of 100 involved satisfying the Care Quality Commission.Too often staff did not treat patients with kindness and compassion, according to its highly critical report . Amanda Sherlock, director of operations delivery at the commission, called the results “truly appalling and truly shocking”, saying there could be no excuses from the hospitals involved. “Care should not be a lottery. It should be consistently meeting essential standards,” she told the BBC’s Today programme . Health secretary Andrew Lansley put the “unacceptable” failings down to failings in nursing leadership and promised more spot inspections, which he said were a better weapon on ensuring standards than a “top-down target culture”. The minister, who had asked the commission to carry out the research, said poor care needed to be identified and stamped out. “Everyone admitted to hospital deserves to be treated as an individual, with compassion and dignity. We must never lose sight of the fact that the most important people in the NHS are its patients. The CQC saw some exemplary care, but some hospitals were not even getting the basics right. That is simply unacceptable.” In future the planned new local HealthWatch organisations should be able to carry out their own unannounced inspections, he suggested. Age UK’s charity director, Michelle Mitchell, said: “This shows shocking complacency on the part of those hospitals towards an essential part of good healthcare and there are no excuses.” At Sandwell general hospital in West Bromwich, inspectors witnessed an incontinent patient remaining unwashed for 90 minutes, despite requesting help. The hospital later shut the ward concerned and replaced it with two other specialist wards. John Adler, chief executive of the hospital trust responsible, said it had “many excellent wards and one or two not up to the required standards”. The behaviour of staff at Alexandra hospital in Redditch, Worcestershire, prompted inspectors to decide there were major concerns about its levels of care, though improvements were then made. The CQC identified moderate concerns about nutrition and dignity at James Paget university hospitals foundation trust in Great Yarmouth, Norfolk. On a follow-up visit the commission found some patients were not receiving enough support with eating and drinking and that some who needed intravenous fluids were not getting it. The regulator warned the trust to make urgent improvements or risk being prosecuted or having restrictions put on its operating licence. In hospitals where essential standards were not being met, inspectors found patients’ call bells being put out of reach or not responded to quickly enough, staff talking to patients in a condescending or dismissive way, and patients not receiving help to eat or being interrupted and not finishing meals. Dame Jo Williams, the commission’s chair, said: “Too often our inspectors saw the delivery of care treated as a task that needed to be completed. Those responsible for the training and development of staff, particularly in nursing, need to look long and hard at why the focus has become the unit of work rather than the person who needs to be looked after – and how this can be changed. Task-focused care is not person-centred care. Often what is needed is kindness and compassion, which cost nothing.” The entire NHS needed to ensure that it made big improvements to end the scandal of poor care, she added. Poor leadership in NHS organisations had let “unacceptable care … become the norm”, while the attitude of some staff resulted in “too many cases where patients were treated by staff in a way that stripped them of their dignity and respect”, said the report. Inspectors also found unacceptable care on well-staffed wards and, equally, excellent care on understaffed ones. Age UK wants the commission to undertake more spot checks and for ministers to force hospitals to publish accessible information showing rates of malnutrition on their wards. The 20 worst offenders, according to the commission, were: Alexandra hospital, Worcestershire acute hospitals NHS trust Barnsley hospital, Barnsley hospital NHS foundation trust Bedford hospital, Bedford hospital NHS trust Colchester general hospital, Colchester hospital university NHS foundation trust Conquest hospital, East Sussex hospitals NHS trust Darent Valley hospital, Dartford and Gravesham NHS trust Eastbourne general hospital, East Sussex hospitals NHS trust Great Western hospital, Great Western hospitals NHS foundation trust Ipswich hospital, Ipswich hospital NHS trust James Paget hospital, James Paget university hospitals NHS foundation trust John Radcliffe hospital, Oxford Radcliffe hospitals NHS trust Norfolk and Norwich university hospital, Norfolk and Norwich university hospitals NHS foundation trust Ormskirk and district general hospital, Southport and Ormskirk hospital NHS trust Royal Preston hospital, Lancashire teaching hospitals NHS foundation trust Royal Free Hampstead hospital, Royal Free Hampstead NHS trust Sandwell general hospital, Sandwell and West Birmingham hospitals NHS trust South Tyneside district hospital, South Tyneside NHS foundation trust Stepping Hill hospital, Stockport NHS foundation trust University Hospitals Bristol site, University Hospitals Bristol NHS foundation trust Whiston hospital, St Helen’s and Knowsley NHS trust NHS Health policy Public services policy Nursing Older people Denis Campbell James Meikle guardian.co.uk