Patients in low-staff ward unhappy with care

Inspectors from the Care Quality Commission said they were forced to intervene a number of times to attract the attention of staff to problems on ward 53 for orthopaedic patients at Leeds General Infirmary and also found problems on another ward nearby.

They said: “People did not receive the assistance they needed at meal times. People’s requests for assistance or reassurance were at times ignored.

“We saw that people were laid in their beds in undignified or uncomfortable positions and we had to intervene to get staff to atttend to people.”

They said staff shortages meant “there are often times on wards 53 and 55 when there are insufficient staff, and it is difficult to get more staff quickly, to provide care that is safe effective, meets people’s needs and minimises risks to the people they are looking after”.

On ward 53, which has since been closed, they reported patients at times tried to attract attention by raising their hand or calling out but staff did not always hear or notice them.

“We intervened and attracted staff attention for people on a number of occasions. Had we not intervened we believe some needs would not have been met.

“One person apologised to us for banging on their table to attract attention but said it was the only way they could get staff to attend to them. We saw that a person who was moving her food tray was told quite sharply to sit down. The patient seemed visibly upset by this, particularly as no reassurance or explanation was given by the nurse.

“We saw that a person being assisted back into bed was asking questions such as ‘Why are you taking my pants off?’ (but) nurses did not answer them. We also saw that the person was distressed and saying ‘Don’t be rough with me’. The nurses didn’t offer reassurance but just kept asking the person to put their head up and telling them they were going to move them from side to side. This did not reassure the person.

“We saw another person shouting our for assistance as a nurse passed the bay. This was ignored so we pointed it out. The nurse said she needed to get another staff member to assist but didn’t tell the person this. A few minutes later the person was ‘hanging’ their legs over the side of the bed, looked in danger of falling and their dignity was compromised. We intervened to get staff to come immediately.”

They said staff reported they were often short of numbers amid evidence from rotas that half of shifts were understaffed.

“They said people often have to wait over 30 minutes to go to the toilet and on occasions there is frequent bed wetting and poor personal care given as a result of being short staffed.”

Criticising nursing records as “chaotic”, they said one diabetic had three charts for blood glucose scores being used at the same time.

Managers at the Leeds trust say they are 450 nurses short of the number they would like. They plan to increase numbers by 200 in the next five years.

“These vacancies do have an effect on the availability of nursing care on a ward and this effect is not evenly spread around the hospital. It is more difficult to recruit staff to work on what are perceived to be ‘difficult shifts in busy wards’,” they said.

In interviews for non-qualified nurses two weeks ago, 90 applicants were shortlisted but only 30 appointed.

The main reasons were a lack of training for hospitals and poor numeracy and literacy.