Three out of 12 hospitals fail to meet essential standards of care of older people, finds watchdog

Older patients in some NHS hospitals are being left to go hungry and thirsty, and are not being shown the respect they deserve, according to a series of damning reports by the Care Quality Commission (CQC).

The first 12 reports into care of older people by the CQC examine whether older people receive essential standards of care in NHS hospitals throughout England. They found that three hospitals were failing to meet the essential legal standards. CQC inspectors also had less serious concerns about three other trusts, but found the other six were performing as they should.

At Worcestershire Acute Hospitals NHS Trust, the Ipswich Hospital NHS Trust, and Royal Free Hampstead NHS Trust the commission found “a bleak story of people not being helped to eat and drink, with their care needs not assessed and their dignity not respected.”

Many older people were not being given the assistance they needed to eat, which meant that they struggled to eat, and in some cases were physically unable to eat meals. It also found that the nutritional needs of older patients were not being assessed and monitored making it impossible to determine if they were losing weight. If they had been identified as malnourished, no action plan was put in place to deal with the problem.

Older patients were also going thirsty with water either left out of reach or no fluids given for long periods of time. In one case, a member of clinical staff described having to prescribe water on medicine charts to ensure patients got enough to drink.

Health secretary Andrew Lansley said that the reports showed “appalling levels of care” in some hospitals.

“The inspection teams have seen some exemplary care, but some hospitals are not even getting the basics right. That is unacceptable,” he added.

Jo Williams, chair of the CQC, said that some of the inspections found situations that added up to “a failure to meet basic needs.”

She added, “People not spoken to with respect, not treated with dignity, and not receiving the help they need to eat or drink. These are not difficult things to get right—and the fact that staff are still failing to do so is a real concern.”

She said that every patient should be treated as an individual “not a nuisance to be ignored or a task that must be completed.”

Ms Williams said she would be writing to the chair of every hospital where poor care had been identified to ask what they plan to do to address the failings.

Commission inspectors also found that in some hospitals staff talked to patients in a condescending or dismissive way and failed to involve patients in their own care.

Keith Pearson, chair of the NHS Confederation, said: “The failings in this first batch of CQC Inspection reports are simply unacceptable.

“I’m afraid that failures damage the NHS as a whole. It should not be an option for any part of the service to provide anything but the highest standards of dignity and nutritional care to its patients. Getting it right for every patient, every time is a big challenge, but it can be done. There should be no excuses.”

Roger Goss, co-director of Patient Concern, commented, “Once again stories of inhumanity and uncaring staff on the wards of our hospitals hit the headlines. Once again managements seem unaware of the disgusting standards in their hospitals.

“The last thing we need in these circumstances is Lansley’s total reorganisation of the NHS. That will distract managers from the urgent need for reforming basic patient care focusing their attention on job protection and survival.”

He called for a system where managers’ pay is docked if they fail to supervise wards appropriately and a local inspection system along the lines of old community health councils.