CLEANLINESS and staffing levels at the Great Western Hospital do not meet expected standards according to a Care Quality Commission report.

The damning report followed an inspection in October which found that three out of six standards were not being met by the hospital, causing a moderate and minor impact on patients.

The report found that cleanliness on the wards was “unacceptable”, with clinical waste being found in bedside bins, dust gathering under the beds, overflowing rubbish bins, tissues and protective gloves discarded beneath the beds, and dirty commodes.

The report said: “We found that some commodes on the first ward we visited were stained underneath and the stains were removable with a damp cloth.

“This suggested the cleaning had not been thorough.”

It was also found that staff were not doing enough to prevent infection.

The report said: “Not all patient beds had hand gel placed at the end of the bed, as required.

“In some cases we observed, patients may not have been adding to infection risks for themselves and others, but nursing staff were not taking responsibility for managing this effectively.”

It was also noted that the hospital had been close to reporting that too many patients had caught hospital-acquired Clostridium difficile infections.

Numbers of nurses were also shown to be below expected standards to keep people safe and meet their health and welfare needs.

The report said: “Nursing staff told us they could not give care and support to patients to the best of their ability due to there not being enough of them.

“We were told that nursing staff were being ‘run off their feet’ or ‘they are doing their best but they can’t keep up with it all.’”

The GWH has already taken steps to address the concerns raised in the report and has established an action plan to ensure that all standards are met in the future.

Hilary Walker, the chief nurse at the GWH said the report also made clear that the hospital was aware of standards that had to be met and that it already had systems in place.

She said: “I would have expected CQC to pick up on it.

“We know the nursing teams haven’t enough people on the ground.

“It’s upsetting to hear that patients feel our nurses are run off their feet.

“We don’t want any of our staff to feel under that much pressure.

“We know we need more nurses to give patients the attention and personal care we strive for, which is why we began a big recruitment drive in April and have invested over £1m in staffing this year.

“There is a shortage of nursing staff nationally, so we have addressed this by extending our recruitment internationally, to Spain, Portugal and Ireland.

“I think the risks are not about medical care but about their experience.

“I want every patient, every day, to get top quality care and have a positive experience of their care.”

Steps are also being taken to address cleanliness issues and, as a top priority, the GWH is working with cleaning provider Carillion to develop a more strident monitoring system.

Hilary said: “The key issue is with how we monitor the cleanliness. As a priority we are working with Carillion, our cleaning provider, and our senior nurses, to strengthen the cleaning regime and review how we monitor cleanliness.”

We believe standards are rising

CARILLION, which is jointly responsible for the cleanliness at the hospital, said it would be looking in to how standards could be improved at the Great Western Hospital, following the report.

A spokesman for Carillion said: “The CQC visited the Great Western Hospital in October to assess performance across a number of areas, including cleanliness and infection control, healthcare staffing, patient experiences and record-keeping.

“Cleanliness and infection control is a shared responsibility between Carillion and the trust, and we work closely together to deliver a high standard of cleanliness at the hospital.

“We monitor wards regularly and do not believe that the conclusions about cleaning at GWH are representative of overall performance as standards have shown continuous improvement over the past year.

“However, we have taken the CQC’s observations on board and have already identified and implemented some actions to make cleaning more effective and to address the issues raised.

“We are also examining with the trust how housekeeping staff and nursing teams can work more closely together and take joint ownership of cleanliness.”



Nurses found to be caring

DESPITE its failings, the Great Western Hospital did come in for some praise in the CQC report, in particular the compassion shown to patients.

The report said: “Most clinical staff treated patients with compassion and kindness, particularly if the patient had a cognitive impairment, or were distressed.

“We saw gentle and encouraging practice by many nursing staff.

“We saw nursing staff being patient and understanding with patients who, due to dementia, asked the same questions many times; were not sure where they were or why they were there; and could also be hostile towards staff.”

Hilary Walker, the chief nurse at the GWH, said: “I am pleased that staff have been recognised for their kindness, compassion and professionalism. Of the 1.5 million patients we care for every year, the vast majority tell us they are pleased with their care and this inspection confirms that we get it right for most patients, caring for patients with privacy, dignity and respect.

“I am so proud of the compassion and care the CQC experienced when they were here. That is something you cannot train or assess.”