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Issued: Thursday 9th June 2011

CQC ‘Hospital Spot Checks’ are picking up examples of good nutritional care practice as well as areas for improvement

In the Reports issued today by the CQC of hospitals that passed the essential nutritional care standards, there is evidence of excellent practice

  • At the United Lincolnshire Hospital at Grantham, CQC found that the use of ‘MUST’ was consistent with care plans in place that were actively implemented and followed up. Training in nutrition is part of the Trust’s mandatory induction programme, and additional nutrition training is made available.
  • At the Western Sussex Trust (Southlands, Shoreham) the nutritional needs of an elderly patient with dementia were being met well by staff in partnership with his family carers. The hospital was also using ‘MUST’ consistently with records completed and updated as patients were monitored and referral requests to, and consultations with, specialists such as SALT and dietitians noted.
  • Whilst the CQC expressed minor concerns regarding nutritional care in some hospitals, they also demonstrated elements of good nutritional care policies and practices for example:
    • Whipps Cross at Leytonstone recorded screening for malnutrition for 96.6% of patients
    • Salford has link nutrition nurses on each ward, 82% of all staff have received training in nutritional care, and CQC were able to see clear records for all patients at the highest risk of malnutrition.

Dr Mike Stroud, Chair of BAPEN responds:

"The CQC Spot Check Reports are extremely useful. Not only are these checks picking up the hospitals failing to provide the essential standards of nutritional care, they are also recording examples of good practice which all hospitals should adopt.

CQC have already told us that around 25% of 100 hospitals are failing their Dignity and Nutrition spot checks, but this means that 75% are meeting the essential standards.

BAPEN’s question therefore is – if one hospital can do it, why can’t they all?

There really is no excuse. Hospitals have all the evidence, guidance and training materials they need - much of it provided by BAPEN. They should by now have made nutritional care a priority as they are legally obliged to do, and focused on redesigning systems to ensure that good nutritional care is delivered to all patients, whether that’s help with eating and drinking, provision of special diets or supplements, or interventions such as tube feeding.

It is unacceptable that patients are still being let down by managers and staff over this fundamental issue of care."

The hospital in this batch of reports Great Yarmouth (James Paget) that failed the CQC spot check on nutritional care, uses BAPEN’s ‘MUST’ to screen for malnutrition, but the CQC found that no robust procedures are in place to ensure appropriate follow-up or implementation of care plans. In addition not all staff received training in nutritional care or use of ‘MUST’

Three further hospitals in Swindon, Salford and Leytonstone passed the essential standard in nutritional care but the CQC reported ‘minor concerns’. These focused on food choice and meeting special dietary needs, inconsistent documentation across wards and inconsistent use of the ‘MUST’ for screening.

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