Patients unwashed ‘for three days’ at trust under ‘extreme pressure’

Staff at York hospital told inspectors they were not able to interact with individual patients and cater to their needs, with one saying: “We have to choose, do we turn, check, and make sure all patients are not soiled, or do we fully wash 10? Some of these patients haven’t been washed for two to three days.” 

York and Scarborough Teaching Hospitals CEO Simon Morritt said: “Many of the issues raised by the CQC were known to us, and reflect the extreme pressures facing the trust, the demands of covid and associated staff absence, and the well-documented recruitment challenges. The report demonstrates that, when faced with these pressures, it is not always possible to give the standard of care we would want for all of our patients all of the time.”

The CQC said there were “significant safety concerns about fundamental standards of patient care” at the hospital. The trust has now been issued with a section 29a warning notice, which is applied when the regulator believes concerns “affect the entire system or service rather than being an isolated matter”. The warning notice was applied because the trust had “ineffective” systems for managing patient risk assessments, nutrition, pressure area care and falls prevention.

“The service didn’t have enough nursing staff with the right skills, training and experience to keep patients safe and to provide the right care and treatment,” said Sarah Dronsfield, the CQC’s head of hospital inspection. “It was disappointing that managers didn’t regularly review the situation and change the staffing arrangements to accommodate this.”

Nurse and healthcare assistant numbers did not meet planned levels on six of seven wards looked at by inspectors, including some shifts that had just one HCA when four were required. Inspectors also raised concerns that staff were not able to give patients enough food and drink, particularly those who required assistance when eating.

The CQC report said: “The service frequently used bank and agency staff or moved staff between wards. Many of the staff we spoke to told us they could not answer our questions or find documentation as they were unfamiliar with the ward. On Ward 29, a safeguarding incident occurred between two patients, this was not appropriately safeguarded as two agency nurses had been on shift.”

The overall rating for the trust, which was not considered in this inspection, remains “requires improvement”.

Heather McNair, chief nurse at York and Scarborough Teaching Hospitals, said: “We absolutely recognise the seriousness of the concerns raised by the CQC and since their visit there have been a number of actions taken, including an immediate inspection of every patient’s care on medical wards, including documentation and risk assessments. We also have daily staffing meetings to help identify gaps and any wards which require additional support.

“Like other NHS trusts, nurse recruitment continues to be a challenge and we are currently undertaking a nurse staffing establishment review to have a clear understanding of the enhanced required staffing levels on every ward to meet the current clinical demands.”