Nursing staff at Mid Staffs did not completely escape criticism in Robert Francis’ report on care failings at the foundation trust.
Despite mostly apportioning blame to managers rather than clinical staff, it found a culture at the trust where some staff provided unsatisfactory levels of care, and other staff tolerated this poor care.
“Although some members of staff were singled out for praise by patients, concerns were expressed about the lack of compassion and uncaring attitude exhibited by others towards vulnerable patients and the marked indifference they showed to visitors,” the report says.
Patients and their relatives told the inquiry of requests to use bedpans or go to the toilet that were ignored; patients being left on commodes for too long; and patients being left in sheets soiled with urine or faeces.
The report was told that the attitude of some nurses towards these problems “left much to be desired”.
Some families felt obliged or were left to take home soiled sheets or to change beds.
“Some staff were dismissive of the needs of patients and their families,” the report says.
The report says this evidence points towards a systematic failure of good care, and it says: “The causes of these instances of poor care included, in a small number of cases, staff who appeared uncaring. More often there were inadequate numbers of staff on duty to deal with the challenge of a population of elderly and confused patients.”
It adds: “It is difficult to believe that lapses on the scale that was evidenced could have occurred if there had been an adequately implemented system of nursing and ward management.”
The report also heard complaints about poor hygiene practice among staff, such as using a razor on more than one patient, and neglect of basics such as cleaning patients’ teeth.
The report says: “A wholly unacceptable standard was tolerated on some of the trust’s wards for a significant number of patients.”
Robert Francis’ report makes a number of recommendations that could affect nurses. They are:
|The trust, in conjunction with the nursing school at Staffordshire University, the royal colleges, and the deanery, should review its training procedures to ensure that high-quality professional training and development is provided at all levels|
|Audit in all clinical departments should be improved, and staff must be required to participate in audit processes|
|Staff must be involved in the complaints process from investigation to when any action is taken|
|The board must give priority to ensuring that any member of staff raising a concern is supported and protected|
|The board should review the management and leadership of nursing staff|
|The management structure of the trust must be reviewed to ensure that clinical staff and their views are fully represented at all levels of the trust|
|The trust should review its record-keeping procedures in conjunction with clinical staff|
|All nursing staff should have training in the diagnosis and management of acute confusion|
|The trust must ensure that its nurses work to a published set of principles, focusing on safe patient care|