AN NHS Trust responsible for two of the region’s major hospitals has been told it needs to improve by the Care Quality Commission (CQC) after concerns were raised about patients being fed properly.
The South Tees Hospitals NHS Foundation Trust, which oversees The James Cook University Hospital in Middlesbrough and the Friarage Hospital in Northallerton, was inspected by the CQC in February this year.
This followed concerns raised by other health and social care organisations which included whether patients were receiving adequate nutrition and hydration while at the hospitals.
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And although CQC officials noted the ‘kindness’ and hard work of care staff, they said improvements were needed in patient risk assessments, nutrition, hydration and discharge protocols.
The trust was issued with a warning notice and both hospitals remain as requiring improvement overall.
The CQC also downgraded the ratings for medical services and surgery at James Cook from ‘good’ to ‘requires improvement’, while the rating for medical services at the Friarage remained as ‘good’.
The trust says that some changes have already been made and others are ongoing as it overcomes the challenges of the Covid pandemic and the ensuing waves of Omicron and Delta variants.
Sarah Dronsfield, CQC’s head of hospital inspection, acknowledged that staff at both hospitals ‘worked hard and treated people with kindness’ but added: “We observed issues around nutrition and hydration, for example some patients were losing a lot of weight unexpectedly while in hospital, or not being fed properly.
“There had also been an increase in inappropriate discharge, for example, some patients going home without important medicines or social care packages in place which could put them at risk of harm.
“We also saw patients who required additional support with their meals not being given the help they need.
“Sometimes meals were left at the end of the bed, and people were unable to reach, and staff didn’t always adjust the beds to a comfortable position so people could eat comfortably and safely.
“We saw on the trust’s own incident reporting system that the frequency and number of incidents where people had come to harm had increased over recent months.
“Other organisations had also voiced their concerns about these issues prior to the inspection.”
Ms Dronsfield said that the same sort of incidents were reoccurring, leading the CQC to conclude that the trust was not learning from its mistakes and did not have strong enough practices in place to stop them being repeated.
The trust says it was already taking action on areas raised as a concern and has now made additional changes following feedback from inspectors.
It said more than £8million is being invested in new digital systems which will eliminate the historical reliance on burdensome paper-based recordkeeping and ageing IT systems.
The old paper-based way recording of nutrition and hydration assessments for patients is already moving to a digital system.
And a transfer of care hub has been created with local authorities to help people return home safely after their hospital treatment and to ensure support is available in the community.
Dr Hilary Lloyd, chief nurse at the trust, said changes have been made to mealtimes to make sure ward staff have the time to ensure patients receive the right meal at the right time with the right amount of support, and that food and drink is properly recorded.
Dr Mike Stewart, trust chief medical officer, said that measures brought in to reduce Covid infections, combined with the impact that record-breaking community winter infection rates had on staff absences, meant that ‘not every patient always had the experience we would want’.
He added: “As the Omicron wave reduced, we moved quickly to make immediate changes as part of our clinically-led recovery from Covid-19 and will continue to take forward the actions we need to make in response to inspectors’ feedback.”
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