1. Tim Wallis Kathryn Smith

3.  First 12 reports published May 2011 –republished in October.  Inspection into whether elderly people receive essential standards of care in 100 hospitals in England, focusing on: -treated with dignity and respect -whether nutritional needs being met  17 off 100 hospitals surveyed were not compliant with basic nutritional needs of patients 32 more were recommended to make improvements  Recurring concern: people not being given enough to drink  Chair of CQC to write to every hospital identified

4. 14/11/11 “Scandal of NHS care for elderly” - “the Care Quality Commission found old people being left unfed, without water” - 13/10/11 “Too many hospitals in England are falling short in the most basic care they are giving elderly patients”

5.  Included: All elderly patients on Lulworth, Brownsea, Acute Stroke Unit, Rockley and Lilliput. n=88  Excluded: patients NBM  One off spot check of the wards. No prior warning of survey The Study

7. We said we we’re doing well, but could do better!

8. The Recommendations  Presented the findings and recommendations to senior medical and nursing staff  Repositioning table after all patient interactions – education of medical, nursing and cleaning staff  Educating relatives to encourage patients to drink  Visual and memory aids to prompt patients to drink water  The Poster…

9. The Poster

10. The Re-audit  Same Cohort of Patients: Posters had been on wards for > 2 months  Included: All elderly patients on Lulworth, Brownsea, Acute Stroke Unit, Rockley and Lilliput. n=83  Excluded: patients NBM  One off spot check of the wards. No prior warning of survey

11. The Result of Re-audit

12. An improvement but we can still do better  We unfortunately cannot give ourselves the gold medal yet…  Improved from 1/3 without fluids in easy reach to 1/4 without  Further education/training of hospital staff  ? Water monitor NA to check all patients to have water QDS  Are there any times of day where it is better or worse than others? We have done the study at approximately 3pm both times

13. Further Changes  Red jugs for patients at high risk of dehydration Poor sight Poor functional capability Dementia Delirium