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Care for older patients at Great Western Hospital only a “moderate” success

Despite praise from its older patients.  Swindon’s modern Great Western Hospital, which serves Marlborough, was found to be wanting when a team from the Quality Care Commission made a secret visit in April.

The inspection of 100 acute hospitals in England showed that one in five of them are breaking the law in their treatment of older people.

The Great Western is not one of them.  The commission has credited the hospital with “moderate” success and given it 10 days to respond with details of the action it will take to improve nursing in Neptune and Jupiter wards.

The Commission was looking at two elements of the care of the elderly in hospitals: “respecting and involving people who use the services” and “meeting nutritional needs.”

The report points out: “A modern concern means that people who use services are safe but are not always experiencing the outcomes relating to this essential standard and there is an impact on their health and well-being because of this.”

Detailing the inspection, the report says:  “Many of the patients on these wards were older people and we were told that some people had dementia.  On each ward we observed how patients were being cared for, talked with people, and looked at some patient records.  We spoke individually with 13 patients and six members of staff.  We met with other patients, their relatives and staff during the visit.”

“Our inspection team was joined by a practising, experienced nurse and an ‘expert by experience’ -- a person who has experience of using services, either first hand or as a carer, and who can provide the patient perspective.”

The report continues: “Patients we spoke with made some very positive comments about the staff.  They described staff as ‘very kind’, ‘lovely’ and as treating them ‘like a friend’.  We were told that staff were busy and worked hard, and some patients said that more staff were needed.”

“Patients told us that staff took an interest in how they were feeling.  However, they had not always been asked for information which would help staff to get to know them as people, with their own likes and dislikes.”

“We were told about the layout of the wards, which included a number of single rooms with en-suites, and other rooms for four patients.  Patients liked the privacy and the facilities that these areas provided.”

“However, we also met patients who said that their privacy and dignity was not being respected.  One person described themselves as a ‘trolley patient, the fifth person in a four bedded room', as they were accommodated in an extra bed.”

And it adds: “People should be treated with respect, involved in discussions about their care and treatment and able to influence how the service is run.  Overall, we found that improvements were needed for this essential standard.”

On the provision of food, the inspection team found that the hospital was meeting essential standards but again suggested improvements needed to be made.

Responding to the report on aspects of patient dignity and nutrition, a GWH spokeswoman told Marlborough News Online: “We were disappointed that on the day there were some areas of our care which the Commission felt needed to be improved and we took that feedback very seriously, as we do with all other types of feedback we receive.”

“Following the inspection, we formed an action plan to address the issues raised, which was submitted to and approved by the Commission.  Since then they have informed the Trust that they are reassured by the actions we have been taking.  This is supported by a more recent inspection by the Commission in July which showed no significant concerns.”

“We are now working to make sure the action plan is fully implemented and to ensure that wherever a patient is cared for in the Trust they receive the same high standard of care.”

“We continue to work hard to provide the best care for patients and service users and encourage feedback so that we can  always look for ways we can do things better.”

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