Older people in nearly a fifth of hospitals are not being treated with dignity or afforded the respect and privacy they need – and the situation appears to be getting worse, according to the Care Quality Commission.
The CQC's first dedicated review of privacy, dignity and nutrition in hospitals and care homes tells of staff talking about patients as if they were not within earshot and of wards where call bells went unanswered, leaving people without help to get to the toilet or support for other needs.
CQC inspectors visited 50 hospitals in 2012. It said "disappointingly fewer" hospitals were respecting people's privacy and dignity – 82% last year, compared with 88% of the 100 hospitals inspected in 2011. Nearly one in five was not treating elderly patients as well as it should.
An inspection team wrote of one member of staff at a hospital who "stood directly behind a patient and leant over them to cut up their food. They also called across to a colleague who was supporting a patient with eating: 'I think you've got a lost cause there,' referring to the fact that the patient was falling asleep during the meal."
The CQC chief executive, David Behan, said: "We found good care and care that had improved. However, it is disappointing people are still not being given enough privacy when receiving personal care and that they are left alone when they call for help.
"This is basic care and getting it right can transform a stressful experience for an older person into a supportive and caring one. Safe, good-quality care is not complex or time-consuming. Effective leadership and staff who feel supported make this happen every day. We want services to learn from the best."
More people were getting help with eating where they needed it. In 2011 83% of hospitals helped people eat and drink; inspections in 2012 found that had had risen to 88%. There were still pockets of poor practice, however.
"We saw that some patients did not receive appropriate support and encouragement," said one inspections report. "For example, staff woke one patient when they took the patient's lunch to them. The patient went back to sleep and the meal remained in front of them until they woke up."
The hospitals were assessed against five standards: respecting and involving patients, meeting nutritional needs, safeguarding people against potential abuse, staffing and record-keeping. Three hospitals – Chesterfield, Alderney and the Queen Elizabeth Hospital in King's Lynn – met only two of the five standards, Newham met one standard and Milton Keynes, failed to meet any.
Lisa Knight, director of patient care and chief nurse at Milton Keynes hospital, said they had put in place an action plan. "We are sorry that our patients did not receive the high standard of care that they deserve," she said.
CQC also inspected 500 care homes and found 84% respected people's privacy and dignity and 83% met their nutritional needs. The inspectors found homes where toilet doors or bedroom doors were left open without thought for people's privacy and where staff held conversations with each other over the heads of residents they were helping to eat a meal.
Jo Webber, deputy director of policy at the NHS Confederation, which represents all organisations commissioning and providing NHS services, said: "It is every patient's fundamental right to be treated with dignity, and it is every NHS staff member's job to make sure that all patients are treated with the respect and dignity they deserve. Anything less and we are not doing our jobs right. We should consider any occasion when we fail to provide dignified care to be as significant as a prescription error or similar untoward incident."