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Eleven acute trusts fail dignity and nutrition inspections, says CQC


At least 11 hospital trusts have failed to meet essential standards for dignity and nutrition in a Care Quality Commission investigation, it has been revealed.

The organisation’s chief executive Cynthia Bowyer gave the NHS Confederation conference the most detailed results so far of the dignity and nutrition inspections.

With results in from 68 of the 100 acute trusts to be investigated in surprise inspections, only 57 were compliant with both outcomes. Out of the 11 in which compliance sanctions were required, she said two had “quite serious issues”.

Ms Bowyer revealed that “non-foundation trusts were worse than foundation trusts”.

Giving a typical example of the type of problems uncovered, she said: “Staff didn’t respond to patients and call bells were out of patients’ reach.”

Asked what made the biggest difference between those who failed and passed, she added: “The biggest difference was simply people being kind.”

Professor Rowan Harwood, consultant geriatrition at Nottingham University Hospitals NHS Trust, said of nursing in the sort of acute environments covered by the report: “This are very high pressure working environments. People not answering call bells is often because of patients who ring them all of the time.”

A series of reports have been issued into the issue by the CQC over the summer. A full report giving complete results from the programme of inspection will come out in September.


Readers' comments (17)

  • 'People being kind?' Is she being serious? Does she have any concept of what it is like to work on a busy acute ward?

    I would like to know however exactly what these compliance sanctions entail, what the CQC are doing to enforce them, if anything, and how many of the trusts are doing so. I would also like to know - since there are no specifics here in this article - if these remarks and sanctions raise the real issues of lack of staff, too many highly dependent patients, too much paperwork, etc, or what about the often inappropriate use of the emergency call bell for example, or if they are simply taking the 'easy out' and saying Nurses need to do more, which is the usual spiel.

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  • Mike, for the first time ever I think I am going to disagree with you and what you said. Nurses are kind and compassionate, that is something that makes us stand out from everyone else. Yes, you work on a busy and acute ward. So what. So do I, and so do many others. This should not stop you actually showing some humanity and kindness, even if you can't deliver compassion. I manage to deliver those even with people having GI Bleeds and people becoming regularly aggressive and violent due to encephalopathy and such like, or in most cases because they want a cigarette and we say no.

    I think you actually need to take a long hard look at the way you actually practice and decide whether nursing is for you. You do not appear happy and are constantly demanding strike action. I usually respect what you say but this time I am afraid you go too far worrying more about paperwork then human beings.

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  • Patients have always rung the bell a lot. They have always been demanding. There are reasons why they do that though...sometimes we forget.

    I agree that paperwork has taken its toll on the time spent doing this task but I have just had a personal experience that made me come home and sob.
    I agree that there are peole out there who should be questioning if nursing is for them. The people I have just come across need to move out pretty quick. I am a good nurse but what I saw made me ashamed.
    I still work hard, I still see patients and I still have mounds of paperwork to do- (it gets done when it gets done)
    The problem is that we dont stand together to say no when we need to.

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  • michael stone

    mike, I 'specialise' in logic. Not being a clinician, I cannot comment on most clinical stuff. I am willing to accept that patients can be annoying, and feel they need more attention than nurses sometimes are able to provide. And that nurses are over-worked, hampered by paper-work, stupid managers (perhaps), and are human beings like everyone else, etc.

    But: Giving a typical example of the type of problems uncovered, she said: “Staff didn’t respond to patients and call bells were out of patients’ reach.”

    If the bell is out of reach of an old and infirm patient, then the patient cannot ring it whether or not doing so is necessary/appropriate or would even potentially save the patient's life - there cannot be an argument, about that piece of logic. Only afterwards, could ringing the bell be judged inappropriate !

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  • Anonymous | 8-Jul-2011 12:43 pm especially, and to others, I think you misunderstood what I meant, or I did not put it across very well, one of the two.

    When I said 'is she being serious', I actually meant that Nurses ARE kind, they DO show humanity, regardless, but often it is the working practices that are enforced on us, ward, community or otherwise, which prevents these traits from coming through, and it is often these issues that need to be adressed rather than questioning the 'kindness' of Nurses.

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  • If it was not for patients we would not have a job. We choose to do the work we do if the condition are too difficult for us to give kindness and compassionate. Then please find a job with less busy, where you can do your work and deliver the milk of human kindness. Having said that, I would like to know what the CQC will do about what they found out? they say a lot but do nothing. We need actions not words

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  • I do my very best to maintain patents dignity and deliver high standard nursing care, but I am not a one man band. Whilst I am recording patients observations, doing my drug round which includes numerous IV antibiotics, answering the phone to relatives, social workers, ward rounds ( we have to do our own doctors wards round - our nurse in charge role got scraped, a cost cutting exercise to cut back on staff ) and then the ever increasing paperwork. There are not enough staff to answer the buzzers immediately. I love my patient care but I grieve for the nursing of old when we had more time. Paperwork needs an urgent review - by someone who works in the real world! Mike gets my vote he understands the pressures of nurses.

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  • Sandy, you are wrong. By your account we should all just get up and quit then shall we? Lets just all walk out, then who would look after the patients?

    And yes, I admit there have been days when I have thought Nursing as a profession was no longer worth it, there have been days where I have thought about changing professions because the stress, the workload and the bad working conditions have got to me. I'm sure many of us have. WE ARE ONLY BLOODY HUMAN!!!!

    But you know what? I would rather carry on and try to fight and change those conditions. I will continue to call for strike action and call for better staffing levels, better pay, etc. And you know what, that does not make me any less of a Nurse. That does not mean I have bad practice (Anonymous | 8-Jul-2011 12:43 pm)!!!! Quite the opposite in fact! It means I still have enough passion to give a crap! I just understand in those trusts where buzzers may not have been answered immediately or whatever rubbish the CQC is spouting, that is NOT because the Nurses were any less kind or caring than the rest of us, that those things happened more likely due to the fact that the Nurses were run ragged trying to deal with half a dozen emergencies, the med round, the Doctors round, drip feds, PEG feeds etc whilst a dozen buzzers were going at the same time!!!

    On your other point Sandy, I do agree, it is about time the CQC started ACTING, instead of just talking.

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  • michael stone

    Anonymous | 8-Jul-2011 12:43 pm

    Anonymous | 8-Jul-2011 1:59 pm

    You have helped to persuade me that many nurses do still retain some humanity - but 'The people I have just come across need to move out pretty quick. I am a good nurse but what I saw made me ashamed.' is worrying, if one might be a patient.

    I was going to add, for mike (who I think has addressed this point - I am not up-to-date yet, since my own first post) that I do NOT think that mike lacks humanity - I think, he gets carried away by his 'doctors and nurses are equal' hobby-horse (as I do with my 'the CPR guidance is wrong' hobby-horse).

    But, nurses are not the ONLY people within a hospital, who are 'stressed' - patients, who presumably would often prefer to not be ill enough to be in hospital, and the relatives of very ill or dying patients, are ALSO stressed, and NOT USED TO THE SITUATION. Some of you, judging from your posted comments, do not seem to get that, as much as others do. The second and third posters, clearly do get it - but 'only we nurses are having a hard time' implies some of you, have forgotten it !

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  • michael stone | 9-Jul-2011 11:51 am

    you need to work full time as a nurse on a hectic ward before making some of these judgments as yours come from a different perspective.

    " ...many nurses do still retain some humanity"
    as you put it.

    With very few exceptions, I don't believe that these nurses would have chosen this career or have been selected for training (although sometimes errors of judgement can be made) or been permitted to qualify without the ability to care for others and the necessary qualities required of a nurse, apart from sad few who suffer from the 'wounded helper syndrome'.

    I believe that some nurses started out with the right qualities and have lost them due to disillusionment and pressures from the system but may not be in a financial position, in the days of job shortages, to get out and leave or fear losing face if they give up. like many who stay in a bad marriage, they simply feel safer and possibly more financially secure than if they were to take the plunge and make a change so sadly they stay and are detrimental to patient care, to their team, to the organisation and for the reputation of the profession.

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