There are too few nurses on wards to provide basic, safe care to older people, nursing leaders have claimed.
The Royal College of Nursing (RCN) said the elderly are being let down by low staffing levels across the NHS.
It is calling on the Government to implement a patient guarantee, setting out the minimum number of nurses on older people’s wards.
While its own research shows one nurse currently cares for about nine elderly patients, the RCN said one nurse to seven patients should be the maximum ratio for providing basic, safe care.
Ideally, there should be at least one registered nurse for between five and seven patients, it added.
A survey of almost 1,700 nurses, including 240 working on wards for older people, found 78% said comforting and talking to patients was not done or done inadequately on their last shift due to low staff numbers.
Some 59% said promoting mobility and self care was left undone or unfinished, while 34% said they could not patients with food and drink.
A third (33%) said they were unable to fully help patients to the toilet or manage incontinence.
In a new report today, the RCN also highlighted an “inappropriate” mix of registered nurses to lesser-trained healthcare assistants (HCAs).
The RCN has said the NHS is too reliant on untrained HCAs who are asked to pick up nursing skills as they go along.
It has previously called for much tighter regulation and mandatory training.
However, the Government is not in favour of statutory regulation and has unveiled plans for a “code of conduct” and voluntary training for HCAs.
The RCN said today that hospitals are leaving too much in the hands of HCAs and recommends a ratio of 65% nurses to 35% HCAs.
Senior nurses should be able to decide their own levels locally depending on patient need, it added.
The RCN said the number of nurses on elderly wards compares poorly with other wards, such as adult general wards (6.7 patients per nurse) and children’s wards (4.2 patients per nurse).
RCN chief executive, Dr Peter Carter, said: “Patients on older people’s wards are being let down by systemic failings in our hospitals.
“Despite working tirelessly to provide patients with high quality care, nurses in these settings have repeatedly told us that they are unable to do this because of pressures caused by short staffing.
“It is unacceptable that there are not enough nurses on older people’s wards.
“This is an outdated historic disadvantage dating back to ‘geriatric’ wards of the past and must be urgently addressed.”
A spokeswoman for the Department of Health said: “Staffing levels should be set by the people who have local knowledge of the individual needs of patients, their levels of acuity and dependency, and the nature of the clinical care they require.
“There is a variety of guidance available to inform decisions about staffing levels, from expert bodies like the RCN.”
Care services minister Paul Burstow added: “We welcome the RCN’s work.
“The ratio of nurses to beds is already improving.
“We know from CQC inspections that good nurse leadership on the ward is essential to delivering high quality care.
“Through the Nursing and Care Quality Forum, we are working with the RCN and others to make sure that more nurse time is freed up for front line care.”