Norfolk and Norwich Hospital told to improve elderly patients’ nutrition

Norfolk's flagship hospital has been told it must work harder to make sure patients are properly fed and nourished.

A report by the Care Quality Commission said there were 'moderate concerns' around how the Norfolk and Norwich University Hospital meets the nutritional needs of older patients, which means their health and well-being could be affected.

Inspectors carried out a visit to the Elsing and Heydon wards on March 23.

The report does praise some aspects of dignity and nutrition. The report says: 'The people with whom we spoke told us that they were listened to and were given the opportunity to express their views about their care, support and treatment. Some people were complimentary about the medical staff, they said that staff were always kind and made comments such as 'I am very happy with the care I am given'.'

Although a choice and a good standard of food was available, the watchdog said the red tray system designed to make sure that staff knew which patients needed help with eating and drinking 'did not work effectively' when they visited.

Some meals were not placed in reach of patients while others were waiting for at least 15 minutes with their food in front of them for a someone to help them them, while two members of staff were chatting to each other while helping patients eat their meal.

Ward records also showed that nutritional assessments had not been done with 24 hours of hospital admission and in one case took five days. One person who had been refusing food for several weeks had not been seen by a dietician because the assessment was not marked as showing a concern, while staff had no information or guidance setting out what support they could give.

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'People cannot be assured that their nutritional needs will be properly assessed and met due to a lack of effective systems that are intended to support people to maintain good nutrition and hydration,' the report said.

Minor concerns were also raised about respecting and involving people who use the service in the decisions being made about their treatment, but people using the service can be 'assured that they will be provided with respect, dignity and privacy by the staff during their stay in hospital'.

Nick Coveney, director of nursing, said since the report a comprehensive action had been put in place including new ways of managing meal times and making sure patients get the right food on time and are supported by staff.

'We are disappointed that while nutritional screening was undertaken by staff it wasn't always as timely as it should be and this is not acceptable,' he said. 'It is important we learn from this and put in place systems to ensure it happens promptly.'

The report follows on from a similar inspection at the James Paget University Hospital in Gorleston, which found that standards of patient dignity were not being met.

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