Dignity and nutrition for older people

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1 Dignity and nutrition for older people Review of compliance Calderdale and Huddersfield NHS Foundation Trust Huddersfield Royal Infirmary Region: Location address: Type of service: Yorkshire and Humberside Huddersfield Royal Infirmary Acre Street Huddersfield West Yorkshire HD3 3EA Acute Services Publication date: June 2011 Overview of the service: The Calderdale and Huddersfield NHS Foundation trust is an acute trust in West Yorkshire. It became a foundation trust in The trust has two main hospital sites; Calderdale Royal Hospital in Halifax which has 430 beds and Huddersfield Royal Infirmary in Page 1 of 15

2 Huddersfield which has 425 beds. Both hospitals provide a full range of day case, outpatient and inpatient services and have an accident and emergency department. Page 2 of 15

3 Summary of our findings for the essential standards of quality and safety What we found overall We found that Huddersfield Royal Infirmary was meeting both of the essential standards of quality and safety we reviewed. The summary below describes why we carried out the review, what we found and any action required. Why we carried out this review This review was part of a targeted inspection programme in acute NHS hospitals to assess how well older people are treated during their hospital stay. In particular, we focused on whether they were treated with dignity and respect and whether their nutritional needs were met. How we carried out this review We reviewed all the information we held about this provider, carried out a visit on 7 April 2011, observed how people were being cared for, talked with people who use services, talked with staff, checked the provider s records, and looked at records of people who use services. As part of the review, we visited the following two wards at Huddersfield Royal Infirmary: - Ward 6, which is a complex care and short stay unit. This ward had 23 beds, which consisted of two two-bedded bays, two four-bedded bays and 11 single rooms. Ward 7, which is a gastroenterology ward. This ward had 26 beds, which consisted of two eight-bedded bays and 10 single rooms. The inspection teams were led by CQC inspectors joined by a practising, experienced nurse. The inspection team also included 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. Page 3 of 15

4 What people told us The patients we spoke to told us that they were happy with the treatment they receive. The also told us that staff had explained why they were here and staff listen to them. The patients we spoke to told us that they did not have any concerns with the meals they were offered. They also told us that were given a choice of food of drink and staff asked them if they needed support. What we found about the standards we reviewed and how well Huddersfield Royal Infirmary was meeting them Outcome 1: 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 Huddersfield Royal Infirmary was meeting this essential standard. Outcome 5: Food and drink should meet people s individual dietary needs Overall, we found that Huddersfield Royal Infirmary was meeting this essential standard but, to maintain this, we suggested that some improvements were made. Page 4 of 15

5 What we found for each essential standard of quality and safety we reviewed Page 5 of 15

6 The following pages detail our findings and our regulatory judgement for each essential standard and outcome that we reviewed, linked to specific regulated activities where appropriate. We will have reached one of the following judgements for each essential standard. Compliant means that people who use services are experiencing the outcomes relating to the essential standard. A minor concern means that people who use services are safe but are not always experiencing the outcomes relating to this essential standard. A moderate 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 wellbeing because of this. A major concern means that people who use services are not experiencing the outcomes relating to this essential standard and are not protected from unsafe or inappropriate care, treatment and support. Where we identify compliance, no further action is taken. Where we have concerns, the most appropriate action is taken to ensure that the necessary improvements are made. Where there are a number of concerns, we may look at them together to decide the level of action to take. More information about each of the outcomes can be found in the Guidance about compliance: Essential standards of quality and safety. Page 6 of 15

7 Outcome 1: Respecting and involving people who use services What the outcome says This is what people who use services should expect. People who use services: Understand the care, treatment and support choices available to them. Can express their views, so far as they are able to do so, and are involved in making decisions about their care, treatment and support. Have their privacy, dignity and independence respected. Have their views and experiences taken into account in the way the service is provided and delivered. What we found Our judgement The provider is compliant with outcome 1: Respecting and involving people who use services Our findings What people who use the service experienced and told us The results from the latest adult inpatient and outpatient surveys relating to respect and dignity were mixed with some positive and some negative comments. The main negative comments related to not getting answers to questions they could understand from their doctor, when they asked important questions. The comments from the inpatient and outpatient surveys on the NHS choices website generally praised the staff involved and the care received at the trust, but would have liked more respect from the doctors. We spoke to four patients and they told us that they were happy with the treatment they receive. The also told us that staff had explained why they were here and that staff listen to them. We spoke to a relative of a patient, who told us that they are kept well informed by the ward staff. Page 7 of 15

8 Other evidence The information we hold about the trust shows that there is a low risk of non compliance with this outcome. The Patient Environment Action Team (PEAT) assessment data from 2010 rated the trust as much better than expected and excellent for privacy and dignity. The wards we visited consisted of a mixture of single rooms and bay areas. Each ward was split into a male and female side. The bay areas provided single sex accommodation. The patients were adequately spaced out in the bays with curtains around each bed. The director of nursing told us that the trust had implemented single sex accommodation across all of the wards at the two main hospitals. Each ward had dedicated male and female toilets and shower facilities. We did not observe patients having any problems accessing toilets or wash facilities. The male or female door signs were interchangeable so the ratio of toilet and wash facilities could be adjusted depending on the number of male or female patients present on the ward. We saw that each patient had a bed side locker for the storage of their belongings. During the visit, staff were observed treating patients with respect. Patients privacy and dignity was maintained. We observed staff talking to patients in a calm and polite manner, whilst also asking their preferences. Curtains were drawn around patients beds when necessary. We also saw signs in place stating please respect privacy, care in progress. On one occasion we could hear staff giving personal medical advice to a patient when the curtains were drawn, however, the majority of care was delivered in a way that promoted the privacy and dignity of the patients. We spoke to the ward manager for ward 6, who told us that a nurse normally accompanies the doctors during their ward rounds, to assist with communication and provide explanations to patients in a way that they would better understand. The ward layout, facilities and general environment contributed to patient privacy. During a brief period, ward 7 appeared to be noisy because there was a medical ward round, coffee round and a domestic cleaning at the same time. However, the majority of patients we observed across both wards generally appeared to be calm and relaxed. We spoke to two staff nurses, who told us that they had received training in privacy and dignity. They told us that they would discuss patients needs, choices and preferences when they are first admitted to the wards and involve relatives or representatives in the planning of their care. They also told us that they always speak to patients to confirm what they want and try to promote independence by allowing patients to try things for themselves. Across both wards, we observed staff taking time to listen to patients and respond to their requests appropriately. We saw that call bells were within reach; however, these were not used while we were on the wards. We observed a patient calling for Page 8 of 15

9 assistance and a member of staff promptly attended to them. We observed patients with higher dependency supported by staff. For example, a patient was assisted with mobility by a member of staff and another patient was assisted to change position. A review of four patients case notes showed that discussions about risks and benefits were documented. For patients who were not capable to making their own informed decisions, an assessment of each patient s mental capacity had been undertaken and appropriate processes put in place. We found that patient records were kept in a number of files that were stored in more than one location. This made it difficult to locate information easily. The records we looked at were generally complete and included some information about people s individual choices, beliefs and preferences; however, there were limited spaces for staff to record information relating to peoples choices and preferences. The trust has identified that the process for record keeping needs improvement and has an ongoing project to improve the quality of nursing documentation. This is currently being implemented as is due for completion in The trust has a range of information for patients and visitors on its website. This includes information relating to admission, discharge, meal times and compliments and complaints. Across both wards, we saw a number of information folders for patients, which also contained this information. The trust collects feedback from people who use the service through a number of sources, including in-patient surveys, localised surveys, real time patient monitoring reports and survey performance comparison papers. The trust also provides a patient advice and liaison service (PALS). The ward manager on ward 6 told us that she sends out monthly ward level questionnaires to patients and visitors. We saw a recent questionnaire for a nutritional food tasting day, which asked for information relating to the quality and choice of meals that are provided. The ward manager told us that patients also provide feedback during daily interactions with staff. Our judgement People s privacy, dignity and human rights are respected and their diversity needs are understood. Staff actively consult with and involve people who use the service in planning their treatment and support. People are involved and listened to by staff and requests made about their care are acted upon. Most staff are aware of the agenda for equality, diversity and human rights. Page 9 of 15

10 Outcome 5: Meeting nutritional needs What the outcome says This is what people who use services should expect. People who use services: Are supported to have adequate nutrition and hydration. What we found Our judgement The provider is compliant with outcome 5: Meeting nutritional needs Our findings What people who use the service experienced and told us The results from the latest adult inpatient surveys relating to quality of food, choice of food and help with eating did not highlight any areas of concern and the responses received were similar to expected. We spoke to three patients and they told us that they did not have any concerns with the meals they were offered. They also told us that they were given a choice of food of drink and staff regularly asked them if they needed support. Other evidence The information we hold about the trust shows that there is a low risk of non compliance with this outcome. The Patient Environment Action Team (PEAT) assessment data from 2010 rated the trust as tending towards worse than expected for the proportion of wards that operate a protected mealtime policy. The trust has a process in place to determine patients medical, dietary and hydration requirements. We looked at four patient s case notes, which showed that each patient had received a nutritional assessment. Those at risk had been identified. Information relating to the dietary needs of each patient was also displayed on a white board in the two wards we visited. Within ward 6, photocopied food chart sheets were being used staff and the information on these was blurred Page 10 of 15

11 and illegible. During the visit, we spoke to two staff nurses, who told us that each patient is assessed on admission by nursing staff using the malnutrition universal screening tool (MUST). Staff also obtain a history from the patient and calculate how many calories they require daily. If a patient is deemed at risk, then nursing staff would inform the dietition or a diabetes nurse, if required. The staff nurses told us that some wards also have a dedicated nutritional assistant, to provide additional support. There was a nutritional assistant on ward 6, who told us that ward staff use food charts and fluid balance charts for patients with nutritional needs. She also told us that if a patient is transferred or fasting then ward staff can offer tea and toast or a sandwich from the main kitchen, and there is a soup and a sandwich box available during the night. Within both wards, we observed staff offering drinks to patients after 10:15am. We observed staff encouraging and assisting patients to drink throughout the day. The majority of patients we saw had a jug of water available at bed side. During the morning, ward staff asked each patient what they would like for their lunch from a set menu. The trust has a menu that provides a wide choice of meals, drinks, desserts and snacks. There was also a list of individual soft meals and halal and Caribbean menus available. Staff told us that the menus are updated regularly so that patients have a variety of meals to choose from. Lunch was delivered from the kitchen at 12 noon on both wards. The meals arrived on a trolley and individual items of food, such as vegetables or lasagne, arrived in individual foil trays. We observed staff checking the temperature of the food using a temperature probe at regular intervals. Ward staff told us that the minimum temperature of the food should be 75ºC. In ward 6, staff wiped the temperature probe between items of food; however, staff on ward 7 did not clean the temperature probe between foods. We also saw that staff used separate serving spoons to serve each item of food. However, after use some of the spoons were placed together on a plate, which meant that there was a risk of cross contamination of the food. The trust uses a red tray system to identify patients who require support to eat and drink. We observed staff encouraging and assisting patients with their meals during lunch. Each patient that needed assistance was supported by a member of staff. There were at least three members of staff on each ward involved with serving meals. On ward 6, the nutritional assistant also supported the staff with serving meals. On ward 6, the service of food was started at the male section of the ward at 12 noon. Each patient in this section was offered a starter, drinks, main course, dessert and tea or coffee. Staff documented what they served and referred to a list that contained each patient s preferences. We saw that a hot pudding was served whilst patients had not finished eating their main course. This meant that the pudding could be cold by the time the patient would eat it. Page 11 of 15

12 The trolley was then taken to the female side of the ward at approximately 12.20pm to serve their food. After serving food to all the patients in the ward, the staff then went to collect plates. On ward 6, the nutritional assistant was involved throughout the process and told us that she had noted the amount of food people had eaten; however, we did not observe any staff documenting what people had eaten. On ward 7, we observed staff document patient s intake in the food chart record after people had finished their meals. On ward 7, the food was delivered at 12 noon, however, the roast potatoes were burnt and the time taken to replace these led to an approximate 40 minute delay in serving the food. We spoke to three patients who told us that this had never happened before and the service is normally quite good. We saw that staff were not organised and did not have a structured approach when serving the lunch meals. Some staff appeared to be rushing, but this may have been due to the delay at the start of the meal time. Across both wards, we observed an inconsistent approach by staff to hand washing before and after meals. We only saw some staff offering patients the chance to clean their hands either before or after eating. The environment within both wards was relaxed and the majority of patients were not disturbed whilst eating. On ward 6, staff took blood samples from one patient during the mealtime. Staff told us that a medical decision was made for this particular patient and staff would normally wait until after mealtimes so that patients are not disturbed. We also saw that staff took blood samples from a patient on ward 7 during their meal time. Our judgement Peoples nutritional and hydration needs and medical dietary requirements are assessed in their plan of care. People are offered a choice of food and drink and food is generally presented in an appetising manner. Support is offered to people when eating and drinking. The process for serving meals is unstructured and poorly organised, which can lead to delays in people receiving their meals, insufficient time for people to enjoy their meals and interruptions during meal times. Page 12 of 15

13 What is a review of compliance? By law, providers of certain adult social care and health care services have a legal responsibility to make sure they are meeting essential standards of quality and safety. These are the standards everyone should be able to expect when they receive care. The Care Quality Commission (CQC) has written guidance about what people who use services should experience when providers are meeting essential standards, called Guidance about compliance: Essential standards of quality and safety. CQC licenses services if they meet essential standards and will constantly monitor whether they continue to do so. We formally review services when we receive information that is of concern and as a result decide we need to check whether a service is still meeting one or more of the essential standards. We also formally review them at least every two years to check whether a service is meeting all of the essential standards in each of their locations. Our reviews include checking all available information and intelligence we hold about a provider. We may seek further information by contacting people who use services, public representative groups and organisations such as other regulators. We may also ask for further information from the provider and carry out a visit with direct observations of care. When making our judgements about whether services are meeting essential standards, we decide whether we need to take further regulatory action. This might include discussions with the provider about how they could improve. We only use this approach where issues can be resolved quickly, easily and where there is no immediate risk of serious harm to people. Where we have concerns that providers are not meeting essential standards, or where we judge that they are not going to keep meeting them, we may also set improvement actions or compliance actions, or take enforcement action: Improvement actions: These are actions a provider should take so that they maintain continuous compliance with essential standards. Where a provider is complying with essential standards, but we are concerned that they will not be able to maintain this, we ask them to send us a report describing the improvements they will make to enable them to do so. Compliance actions: These are actions a provider must take so that they achieve compliance with the essential standards. Where a provider is not meeting the essential standards but people are not at immediate risk of serious harm, we ask them to send us a report that says what they will do to make sure they comply. We monitor the implementation of action plans in these reports and, if necessary, take further action to make sure that essential standards are met. Enforcement action: These are actions we take using the criminal and/or civil procedures in the Health and Adult Social Care Act 2008 and relevant regulations. These enforcement powers are set out in the law and mean that we can take swift, targeted action where services are failing people. Page 13 of 15

14 Dignity and nutrition reviews of compliance The Secretary of State for Health proposed a review of the quality of care for older people in the NHS, to be delivered by CQC. A targeted inspection programme has been developed to take place in acute NHS hospitals, assessing how well older people are treated during their hospital stay. In particular, we focus on whether they are treated with dignity and respect and whether their nutritional needs are met. The inspection teams are led by CQC inspectors joined by a practising, experienced nurse. The inspection team also includes 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. This review involves the inspection of selected wards in 100 acute NHS hospitals. We have chosen the hospitals to visit partly on a risk assessment using the information we already hold on organisations. Some trusts have also been selected at random. The inspection programme follows the existing CQC methods and systems for compliance reviews of organisations using specific interview and observation tools. These have been developed to gain an in-depth understanding of how care is delivered to patients during their hospital stay. The reviews focus on two main outcomes of the essential standards of quality and safety: Outcome 1 - Respecting and involving people who use the services Outcome 5 - Meeting nutritional needs. Page 14 of 15

15 Information for the reader Document purpose Author Audience Further copies from Copyright Review of compliance report Care Quality Commission The general public / Copyright (2011) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Quality Commission Website Telephone address Postal address enquiries@cqc.org.uk Care Quality Commission Citygate Gallowgate Newcastle upon Tyne NE1 4PA Page 15 of 15

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