THE latest report on the care of elderly people in hospital illustrates exactly why they and their relatives will experience a great sense of relief at the news that unannounced inspections of how acute hospitals treat older patients will begin next month.
Healthcare Improvement Scotland's (HIS) recent inspection of elderly patients' care in Glasgow Royal Infirmary found 17 instances where the hospital failed to meet the required standards. The dismal litany makes a mockery of the requirement to treat dependent older people with compassion, dignity and respect. Inspectors found patients who used a walking frame or required assistance from two nurses were unable to gain access to a toilet, many wearing hospital gowns that failed to preserve their dignity rather than their own clothes, patients having to wash in a basin at their bedside because there were not enough baths or showers and a shower with no lockable door or shower curtain. This was shared by 15 patients. There was also a failure to accurately record pressure sores and detail a treatment plan.
These troubling findings (along with four areas where the hospital was regarded as performing strongly) were the result of a pre-arranged inspection by HIS as part of a well-publicised rolling programme examining the standard of care for older people in acute care announced by the Health Secretary Nicola Sturgeon in response to alarm about the treatment of elderly patients in England.
This came after a reversal of planned cuts to the Care Inspectorate for nursing and care homes for the elderly and a new regime of unannounced inspections after the deaths of two residents in a private nursing home in Edinburgh.
There can be no doubt, therefore, on the part of anyone responsible for the care of elderly people, whether directly or at health board level, of the case for the current focus on standards of care. While it takes time and resources to instal additional bathing and toilet facilities, there can be no excuse for staff failing to treat patients with dignity. HIS has specified the areas it will examine as dealing with dementia and cognitive impairment, prevention of falls, nutrition and hydration, and preventing and managing pressure ulcers.
When a failure to record key information about patients with cognitive impairment or provide means to help them identify their own beds as well as inconsistencies in dealing with pressure ulcers are found during a pre-announced inspection, it is clear that the guidance on the care of older people is not being implemented. The point of inspections is not just to measure whether standards are being met but to ensure that improvements are made where necessary. That requires action on the part of board members and senior staff of health boards as well as those at ward level. Despite the real difficulties of managing tight budgets at a time of increasing demand, the proper care of elderly people must be a priority. Unless the needs of all older patients are met when they are admitted to an acute hospital, they risk becoming long-stay patients, a miserable prospect for the individuals and their families and an additional burden at a time of increasing funding pressure on the NHS.
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