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N&N says it is raising care standards with rigorous inspection routine

PUBLISHED: 12:00 07 February 2013

Eirlys McLean, trustee for Age UK Norfolk, monitoring lunch being served in one of the wards at the N&N.  Photo: Bill Smith

Eirlys McLean, trustee for Age UK Norfolk, monitoring lunch being served in one of the wards at the N&N. Photo: Bill Smith

Archant © 2013

Norfolk's main hospital says it is raising the bar in standards of care after introducing a rigorous inspection regime across all its wards.

Nursing chiefs at the Norfolk and Norwich University Hospital say they have dramatically improved levels of cleanliness, safety and patient care after implementing a “pioneering” daily audit project.

The Evening News joined one of the quality assurance audits at the hospital this week to see what is being done locally to ensure standards do not slip in light of the publication of the Francis inquiry into appalling levels of care at Stafford Hospital between 2005 and 2009.

Officials from the NHS foundation trust carry out one or two inspections a day at the N&N with the assistance of one of their 60 volunteer external auditors.

Hospital management introduced the inspections in October 2011, which are based on the standards of the Care Quality Commission (CQC) - the regulator for hospitals and social care in England.

The quality assurance audits normally take an hour and a half during meal times where standards in cleanliness, tidiness, documentation, infection control and patient care are thoroughly scrutinised. Afterwards, ward sisters and matrons are informed of any action to improve.

Emma McKay, director of nursing, said she was in “no doubt” that the system had improved standards of care.

“No hospital does it like this. If we find issues we ask for an action plan to correct problems and ask for a time scale for when to come back.”

“Every single time we raise the bar higher and we are getting less tolerant and ask for better standards every time. When we get at a certain level we say we want it even higher,” she said.

The audit of the Kimberley Ward - a short stay ward for older people - begins at the entrance with external auditor Eirlys McLean, a trustee for Age UK Norfolk, going in first to assess the welcome patients and visitors receive. The non-uniformed assessor also speaks to patients to get their feedback and ensure that they are being treated with dignity and respect.

Mrs McKay checks the ward to ensure there is no clutter and runs her finger along the top of door frames and curtain rails to check the area is being cleaned properly and is dust-free. She also checks the use-by dates on food in the fridge, inspects hospital equipment to make sure it is clean, and makes sure soap dispensers and hand saniters are not empty.

Meanwhile Liz Hogbin, head of compliance governance, looks at the documentation to ensure ward staff have carried out the relevant risk assessments on patients, including making sure patients at risk of pressure sores are regularly moved and change position.

Officials also monitor lunchtime and dinner time services to ensure patients that need assistance to eat their food get help. The Kimberley Ward inspection concluded with staff being praised for their high standards.

Mrs McKay said a ward would receive one the hospital’s in-house quality assurance audits once a month on top of the formal CQC inspection that comes once a year.

“What comes out of this are assurances for us to make sure our patients are receiving the care they should. All of these audits are written up and reported to the board every month to make sure we maintain the standards and quality that patients get. If there are things that we can improve on we want to know about that and patient feedback is really important to us.”

“Staff take it very seriously and the feedback is constructive. The staff are really upset when they fail an audit, but they take it graciously and they are keen to improve,” she said.

She added that their network of 60 external auditors from organisations such as Age UK, the Older People’s Forum, Norfolk LINk, governors and representatives from the University of East Anglia, offered a valuable fresh pair of eyes to ensure standards were upheld.

Patient Tom Stuttaford, 81, of Elm Hill, Norwich, who spent two days on the ward following a fall at home said he had received “absolutely wonderful” care on the Kimberley Ward.

“People on this ward are absolutely terrific and very clued up. It is first class medicine and they talk to you with compassion and kindliness,” he said.

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