An external independent review of the Princess of Wales Hospital and Neath Port Talbot Hospital has identified significant failings. The Review which was led by Professor June Andrews (Director of the Dementia Services Development Centre, University of Stirling) and Mr Mark Butler (Director of The People Organisation) focused on the care of older patients at the two Welsh hospitals.
The Review Team visited the hospitals on a number of occasions over a four month period between December 2013 and April 2014 and spoke to a range of people including staff, managers, patients and volunteers.
The review concentrated on four areas:
- the culture of the care of older patients, particularly in the medical wards;
- the administration and recording of medicines, particularly how medicines are administered to patients who are cognitively impaired or have other challenges taking medicines orally;
- how professional nursing standards are delivered; and
- complaint handling
The report includes anonymised quotes from staff and others. One patient’s relative was concerned that his father has someone to help him wash and dress every morning at home, but in hospital they left him with the cloth and a bowl to wash himself. On being discharged home, he found dried excrement on his father’s legs.
The report makes 18 recommendations for Abertawe Bro Morgannwg University Health Board, which is responsible for the two hospitals.
These recommendations include:
- creating a set of clear standards for the care of frail older people in Accident and Emergency and general medical and surgical wards within the two hospitals, within three months of the publication of the report, and auditing them quarterly thereafter;
- implementing a skills and knowledge programme to ensure all staff working in its hospitals understand and are equipped to meet their obligations to frail older people;
- running an intensive education programme on delirium, dementia and dying in hospital;
- introducing a coaching scheme for front-line clinical leaders provided by senior people from outside the two hospitals;
- adopting a “zero tolerance” approach to the improper administration of medicines for all clinical staff;
- addressing hydration, mobility and feeding practice for all older patients and publish audited results on a quarterly basis; and
- reviewing how well ward accommodation supports care for those with dementia, delirium, cognitive impairment or dying at both hospitals, covering physical design of the clinical spaces and equipment available.