Yet another damning report of services for elderly patients at Whitchurch Hospital
Unannounced Visit to Ward West 2, Whitchurch Hospital held on 23rd
January 2007 – Mr R Woodward
CARDIFF COMMUNITY HEALTH COUNCIL
Unannounced visit to Ward West 2, Whitchurch Hospital,
Cardiff and Vale NHS Trust, held on 23rd January 2007
Present Cardiff CaC Members FredaWebster(Co-ordinator)
Bob Woodward Cardiff & Vale NHS Trust
Michael Bogue Staff Nurse, Ward West 2, Whitchurch Hospital
A visit was made and a report written in June 2006. A CHC member had visited in December and recommended this visit in view of concerns about the ward.
It was noted that some improvements have been made to the furniture and fittings including pictures on the ward but that decoration and the provision of Therapies had not changed. It is understood that the relocation of the services to the Iowerth Jones is the reason that this ward has not been re-decorated. It is disappointing to the CHC that decisions relating to this relocation are protracted, which is having an acute impact upon this ward's environment.
Area Visited
The Ward Manager and Deputy were unavailable at the time of our visit and it appeared that the senior nurse on duty was not authorised to action some of the issues that had been identified during the visit - ie replacement bath.
The ward provides for 21 elderly male patients although there were 22 patients on the ward on our visit. There had been an emergency admission the previous week and an additional bed had been brought back into use-the ward had catered for 23 but we had previously been informed this had been reduced for health and safety reasons to 21. At 10.45 am most of the patients were in the dining room or day room. At this point some 18 had been washed and dressed although one was still in pyjama bottoms and 4 were in 'stocking' feet with no shoes or slippers. ( ? Risk of slipping on polished floors). Most of the patients with footwear were in slippers. At least one was still being helped to eat his breakfast and a few others were still in
aprons although we assumed they had been fed. As breakfast is served from 8.00 am we were concerned how food is kept hot and fresh until this time. Four patients were still in bed and
three were in the process of being prepared to get up - one was on a plan which involved rising at midday for 6 hours. We presumed those not yet up were still to have breakfast.
Tea or coffee was offered to the patients at 12 noon and this is also the time that patients are regularly toileted. Lunch was at 12.30 pm. The full complement of 6 nurses appeared to be on duty during our visit so clearly the physical demands of caring for the residents-dressing, feeding and toileting press heavily on the day's timetable. In the afternoon there are 5 staff on duty, with 3 at night.
11.00am -11.15 am We visited the 2 wards and 3 separate bedrooms. Four patients were still in bed and all were without pyjamas- a situation that occurs because we were told approximately 90% are doubly incontinent and if accidents happen there is no back up nightwear on the ward to dress them again. It was also easier dealing only with the wet or soiled sheets. We found this completely unacceptable in terms of the dignity of the
patients.
A similar situation arose over the lack of sheets. The previous day, sheets ordered in the morning were not delivered until 5pm. Clearly only the minimum had been sent as our inspection of the linen room revealed none in stock. Generally the bed linen was of very poor
quality- thin and in short supply. Beds were made, but the over bedding consisted of a mixture of duvet covers -no duvets on the ward or in store- nothing matching and the condition of all the bedding including that in store left much to be desired.
Hygiene
When we visited in June we were concerned that there were only 2 baths and patients only had one bath per week. The situation has worsened as there is now only one operational bath.
The other is unusable and needs replacing. It had been out of action for over a week and there was no senior staff member on the ward to put forward the case for a replacement-in view of the cost it was uncertain when a new bath would be available. This is urgent in view of the level of incontinence experienced.
Activities
....None of them were involved in activities during our visit –most were asleep, sitting in chairs or walking around the ward.
General conclusion
This was a short visit to follow up concerns which have been addressed in this report. As this was an unannounced visit, it was limited in scope. We were considerably assisted by Michael
Bogue, the staff nurse, and are grateful to him. We did not speak to any other staff and had some brief conversations with 2 or 3 of the patients but did not obtain any views from them about the ward.
We are extremely concerned that the ward environment and facilities are extremely poor, which makes it very difficult for the Trust staff to provide the care required to meet the needs of this particularly demanding patient group. In particular, the quality of bedding, clothing and baths fail to meet the standards of dignity we would expect.
The CHC would request that the Trust address these issues as appropriate.
Trust reponse
It doesn't seem likely that services will improve before 2009?
SERVICE AND FINANCIAL DELIVERY PLAN 2007/08 – 2010/11
..... replacement of Whitchurch Hospital. Through this Strategic Outline Plan (SOP) it is planned to bring forward the planned community developments and the replacement for Whitchurch Hospital by 2009/10. As part of this programme of change, the development of services for older people with mental health problems is also a priority, and will include the development of a new assessment unit at Llandough Hospital.
This has be been going on for some time
NHS admits deficits in care of pensioner Oct 31 2006
Louise Day, South Wales Echo
A family has told of the 'poor care' they say their mother received during the last three months of her life at a Cardiff hospital. Hilda Patterson, 80, died in Whitchurch Hospital, in October 2005, after breaking a wrist and a leg in two separate falls and having a lamp fall on her head just days before she died.
BBC - Report questions patients' safety Friday, 14 Jan, 2005,
Published: 2005/01/14 The BBC has learnt of serious concerns about the care of elderly patients at a major Welsh psychiatric unit. A leaked 2004 report on care standards at Whitchurch Hospital in Cardiff has questioned the safety of patients. Experts called in by hospital managers were told by staff that lessons had not been learnt from serious incidents involving patients' welfare.
Cardiff and Vale NHS Trust said it had since developed an action plan to tackle the issues raised by the report. However, the BBC News website has spoken to a number of people who remain concerned about patient care.
The report, commissioned by the trust and published in March 2004, was a review of the services for elderly mentally ill patients at Whitchurch. It said staff had admitted there had been a "high level" of "serious adverse incidents" and there had been a lack of management accountability……. More recently, the BBC understands that a nurse was suspended under the hospital's disciplinary procedure after a claim that a patient had been left lying overnight on the floor of a television room..…..The report did not identify these incidents but in September 2003 the BBC reported that a patient had lain dead in bed for almost 10 hours before her death was discovered.
Pat Erickson, of Penylan, Cardiff, whose mother has dementia, said she had been distressed at the care her mother had received during a month-long stay at Whitchurch early in 2004.
Mrs Erickson, who is herself a nurse, said: "I asked where her clothes were and they did not know. "I told them it was like going back to pre-historic times. I had to leave the ward, I was so distressed.
"Ward environments have been reviewed and further improvements planned, including new equipment."
Story from BBC NEWS:http://news.bbc.co.uk/go/pr/fr/-/1/hi/wales/4167789.stmPublished: 2005/01/14 06:42:27 GMT© BBC MMVII
Friday, 25 February, 2005, 16:53 GMT
Action pledge at psychiatric unit
Medical and nursing leadership at the hospital is to be reviewed
Executives at a major psychiatric unit are promising new action over "clear and unacceptable failures" in the care of elderly mentally ill patients. Medical and nursing leadership will be reviewed after patient safety concerns at Cardiff's Whitchurch Hospital.
In January, the BBC reported how two families said loved ones had died needlessly after incidents there.
Cover-up claim over suicides at hospitals Jan 27 2003
Martin Shipton Martin.Shipton@Wme.Co.Uk, The Western Mail -
HEALTH officials have been accused of a cover-up as it emerged that damning criticisms of two mental hospitals where six patients died unexpectedly in less than a year were removed from the published version of a report.
Between April 1999 and February 2000 there were five suicides at Whitchurch Hospital, Cardiff, and Sully Hospital in the Vale of Glam-organ. There was also a homicide at Whitchurch Hospital where a female patient was killed by a male patient on the same ward.
Family anger at 'needless' deaths 20 Jan 05 Wales
Report questions patients' safety 14 Jan 05 Wales
'Failures' before knife killing 01 Dec 04 Wales
Patient lay dead for 10 hours 22 Sep 03 Wales
Brain charity's anger at man's care 12 Aug 03 South East Wales
RELATED BBC LINKS:
iCan - Mental health in England and Wales
RELATED INTERNET LINKS:
Cardiff and Vale NHS Trust
Welsh Assembly
Alzheimer's Society Whitchurch
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