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CQC finds older people not assisted at meal times

Some patients were not given physical assistance to eat their meals, the Care Quality Commission (CQC) has found.

The CQC was reviewing Barnsley Hospital Foundation Trust and Whiston Hospital, part of the St Helens and Knowsley Teaching Hospitals Trust.

One patient at Barnsley Hospital, South Yorkshire, also had an empty urine bottle placed on their table while they were eating.

The criticism levelled at the trusts was revealed as part of the CQC’s England-wide review of care for older people in 100 hospitals.

Last week, it emerged doctors had to prescribe drinking water for patients at one NHS hospital because they were not given enough while others were left unfed.

The latest batch of reports released by the CQC found that some patients at Barnsley Hospital were not given help with eating - with staff unsure about which patients had specific nutritional needs.

The CQC review also expressed concern about the way older people were fed at Whiston Hospital.

Inspectors raised “moderate concerns” about the two trusts, in the CQC’s latest batch of 14 reports - meaning there was good practice on some wards, but not others.

A further two trusts have been told they are meeting standards but must do more to maintain them while 10 hospitals passed inspections.

The two trusts told to maintain their standards were St George’s Healthcare NHS Trust in south London and Sherwood Forest Hospitals NHS Foundation Trust.

The 10 trusts that met all the standards were: University College London Hospitals Foundation Trust, Lewisham Healthcare Trust, Heatherwood and Wexham Park Hospitals Foundation Trust, Kettering General Hospital Foundation Trust, Kingston Hospital Trust, Taunton and Somerset Foundation Trust, Nuffield Orthopaedic Centre Trust, Calderdale and Huddersfield Foundation Trust, North Middlesex University Hospital Trust and York Hospitals Foundation Trust.

A national CQC report on the full audit will be published in September.

Readers' comments (15)

  • Here's an idea then, DO SOMETHING ABOUT IT!!!! Until the CQC start backing Nurses up when we complain about things like staffing levels etc, until they start coming in and ENSURING managers/homes/etc are complying with best practice by FORCING practice to change instead of just coming out with the usual 'standards are not being met' press release, then they are simply losing credibility with every statement they make.

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  • Is the CQC fit for purpose?

    Sadly, I think this says more about the CQC than it does about the healthcare.

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  • good comments.

    it seems a very annoying total waste of money. i get fed up to reading the same old reports which cost a lot to produce only to be filed away in the archives before all the appalling stories hit the press.

    Why is this body only there to investigate and write reports. why do they not act on their findings? What is the point?

    i suppose it is quite nice to travel round the countryside spending an hour or two looking round a home and ticking all the boxes, one wouldn't even need to think, and then going off for a good lunch somewhere before perhaps doing another visit in the afternoon and then going back to the office to write a report and then going home to put one's feet up, probably all for a good salary which could be better spent on front line staff and meeting financial needs towards the shortfalls in patient care for which they are always saying there is no money! I expect even the reports follow a set format which does not require much thinking or time to produce, especially when they always repeat the same information!

    Apologies, I expect my comments are just as obvious and repetitive as the investigations and resultant reports themselves!

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  • Apparently the CQC are short staffed too! Should give them an insight of compassion and understanding perhaps?

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  • Speaking as a member of staff at St Helens and Knowsley NHS Trust and working on a care of the elderly ward I am totally appauled at the results of the report by the CQC, all patients on the ward where I work have their intake monitered, this highlights patients that refuse to eat and those that are unable to eat, we are constantly striving to increase nutrition in these patients, we have protected meal times and all staff regardless of rank assist with feeding, we are totally commited to ensuring our patients intake is as good as it can be, I myself look at each patient as if they were a member of my own family regardless of any opinion I may have of them, after all if my parents were to come into hospital I would expect them to be treated with dignity and respect even if the staff looking after them disliked them. The moment I enter the ward for my shift I know I am 100% commited to delivering the best quality care I can to the patients in my care .I am totally saddened by this report and can only hope that things improve.

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  • we are not there to judge whether we dislike our patients or not and I am not sure why this has been mentioned by a professional nurse. there is no obligation to like or dislike somebody to do a good job as there is any obligation for others to like us. important is to develop a professional therapeutic, empathetic caring relationship. like and dislike should not be part of the agenda but assisting individuals who are difficult may be a challenge which needs to be accepted. we cannot choose which patient are admitted to our wards on the grounds of personality, nor can the patients choose who will look after them and they may also dislike whoever this is! it works both ways.

    judgement leads to stereotyping which in turn leads to labelling, discrimination, stigmatisation, bullying and potential ostracising - a sad state of affairs for both the perpetrator and for the victim.

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  • Anonymous | 4-Jun-2011 2:27 am that was my point, things won't improve until the CQC get some teeth, and probably a backbone, and start doing MORE than simply writing reports on the obvious, and going after the people who are really responsible (managers/trust directors/government) for failings in care instead of simply blaming frontline staff.

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  • michael stone

    Not helping patients to eat, is nothing new and turns up in a report every few years !

    My dad was basically starving, after an operation in 1995, until, we complained and got a dietician invovled - then, because it became detailed as part of their job, the ward staff checked tha the was eating.

    But, that should be routine - people do need food !

    Most 'complaints bodies' are fairly useless, in my own experience, and most 'new enquiries' only throw up things, previously discovered in earlier enquiries.

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  • Anonymous | 4-Jun-2011 2:27 am

    When was the last time your hard work and dedication was the subject of a report? Probably never. Of course we should always strive to give the best care. We are nurses after all. But I'm sure that most people are unaware of the barriers you and your colleagues have to overcome daily, ( staff shortages, poor resources, unrealistic expectations, etc), whilst giving the 100% that you do.

    Anonymous | 4-Jun-2011 9:59 am

    In my time, I have nursed some absolute horrors, who I have disliked intensely. People don't suddenly become nice and woolly when they are ill. However, they have never known that I dislike them; because I have treated them with the same respect and care I would any patient. I am a nurse who takes her job very seriously, but I am also a human being. It is a shame that you chose to focus on this aspect of the previous commenter's post, and not the fact that he/she is obviously a deeply caring individual. But of course, you were passing a judgement, because you too are human.

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  • To anonymous 4th June 2011 9.59am

    Thank you for your comment which I believe was focused on me,(anonymous 4th june 2011 2.27 am) I was not trying to judge anyone as you understood.There is no place for judgement in nursing I am aware of that, I was just trying to make the point that we are all human and it is normal to dislike people but regardless of the fact I would never treat anynone differently, i'm sorry if anonymous 4th june 2011 9.59am thought I was un-professional,I never intended to give that impression I was just trying to make the point that I know I give 100% and that I felt upset at the CQC report. More staff is what is obviously needed but this is never going to happen,I do honestly believe that if staff who obviously lack commitment were replaced with staff that are commited things would improve drastically.

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  • from anonymous 4th June 2011 9.59am

    This general comment was not intended as a personal attack on Anonymous | 5-Jun-2011 0:44 am and i am sure that 'judging' by your comments you provide highly professionalized care and respect your patients. but since you bought this topic up and it is probably related to a lot of the poor care recently reported in the press, and especially to patients who have been classified in particular groups and then been judged by these, I wished to follow up this comment with some general remarks which you will note I did not direct to anybody in particular. where possible, except in direct answer to somebody, or for the sense of my comments, I tend to try and avoid the second person singular and referring to other commentators personally as i note in some comments this is accusatory and judgmental and in my opinion general comments are more acceptable.
    Although fortunately i have never witnessed such poor care I have heard a few nurses and doctors, even in senior positions, express their likes and dislikes of patients in public and even seen this written in nursing notes. i find this unprofessional, distasteful, and unfair and totally senseless to pronounce such personal judgments in public in a ward report, ward round or in notes. even though it may not, hopefully, affect the standard of care it can and sometimes does influence and set a bad example to junior and untrained staff which can affect their attitude towards the patient.
    All humans have likes and dislikes of other personalities some with whom we get on and others we would prefer to avoid altogether but with patients we do not have this choice and nor do they with those who care for them. there are so many different personal reasons underlying difficult behaviour presented by patients which you know as well as I do. these can be driven by fear, anxiety and stress at what they may have left behind at home, may be caused by their own prejudgments they may have formed about the care or treatment they may receive, the staff, the strange environment they have suddenly found themselves in, changes in lifestyle or self-image brought about by illness and they have extreme levels of anxiety and stress for any other reason, they may even have a mental health, behavioural or personality disorder or hundreds of other personal reasons. As nurses, and I am sure you do not need telling, we need to be highly sensitive to these psychological queues and try and ameliorate the patients encounter with the health services. Although we hope that they will accept and adapt to their new situation as smoothly as possible, as the majority of patients do, it is more up to us to help bring about these positive changes.

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  • Let's be clear here. The reasons for lapses in care of the elderly are systemic. There is an extremely dangerous habit of laying the blame for any and all the ills in patient care at the door of the Nursing staff. Worse still, there are Nurses who jump on this band-wagon, believe it must be true and wade in with fatuous lectures to their highly trained and more socially intelligent colleagues. To state that not liking a patient is .." probably related to a lot of the poor care recently reported in the press".. is outrageous.

    Until we approach this subject with more intelligence and maturity, there will be no change to the status quo. Proper and realistic staff/patient ratios (qualified and HCAs) should be embedded in law; Managers should listen to and act upon concerns raised by their frontline staff; Nurses need to stop propping up the NHS for free (by not taking their breaks and working unpaid extra time); appropriate use of budgets and better targeting of resources; and most importantly, the Nursing profession must stop asking nicely and DEMAND action. Our patients, likeable or not, at the very least, deserve that.

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  • CQC - what a useless spineless bunch, They report that older patients are not being assisted to eat. Anyone who has spent time in our hospitals already knew this and have done for some time. (Culture, custom and practice in some hospitals) I recieved a call from CQC last week in regard to the care of my grandfather, I pointed out that i documented his sub standard care in a diary. Do you think the person on the phone had the sense to ask me for a copy of that diary - NO.

    A disgrace there really is very little protection for our most vulnerable.

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  • why is there a cqc when nurses are capable of observing and reporting any problems? they seems they are better qualified for this.

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  • michael stone

    Fiona bell | 7-Jun-2011 10:07 pm

    I am interested - did you complain to the institution failing to care properly for your grandfather at the time ?

    I assume you did - but it is complaining as things happen, which is the only way this will ever get sorted. And, if you get the brush off at ward level, promptly complaining higher up (most people don't do this, but complaining to CEs sometimes gets a response, at any rate, from most organisations).

    Complaining afterwards - which tends to happen - does not, in my experience, and apparently in yours, tend to work very well.

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