A watchdog found examples of poor care in one ward at West Middlesex Hospital – and said the examples were “notably more prevalent” than elsewhere in the hospital.

The discoveries were made after ‘enter and view’ drop-in visits by inspectors at the hospital, which serves  people from Richmond, Hounslow and Ealing.

Included in their findings at the Marble Hill 1 ward were:

  • A patient who had developed genital ulcers after, relatives said, not being washed properly
  • A patient who had been put in nappies instead of being walked to the toilet
  • And a patient left to eat rice with their fingers while unattended.

However, the rest of the report’s findings about the hospital were mostly positive.

Healthwatch Richmond published the report following its “enter and view” visits to the Isleworth site.

In such visits, officials spoke to patients, their relatives, and members of staff.

Healthwatch said that in the Marble Hill 1 ward, they spoke to four people with specific stories of poor care they had received.

One patient’s condition, according to their relative, had “markedly deteriorated” because staff had not been giving them enough physical help.

This relative said staff put the patient in nappies rather than helping them walk to the toilet, and washed them in bed rather than showering or bathing them.

Another elderly patient’s relatives said the patient had diarrhoea and had not been washed often enough, and that they had also developed genital ulcers.

During Healthwatch’s first visit to the ward, the ward “felt especially busy while lunch was being served”.

One patient was lying near-horizontally with a tray of food balanced “precariously” on them, who was picking up rice with their bare, unwashed hands, and spilling it over their neck.

The Healthwatch team had to alert staff to help the patient sit up and eat.

The report states: “Overall, patients in Marble Hill 1 appeared more likely to receive lower quality care than in the other wards we visited.

“It was unclear whether this was a result of staffing issues, management issues, or something else entirely.”

Healthwatch spoke to more than 100 patients or relatives, and most of them spoke positively about their experiences in the five wards visited.

Many praised the staff’s attitudes, their approach to patient privacy and dignity, and their responsiveness to requests for help.

In Marble Hill 1, Healthwatch noted a nurse working gently with an agitated patient with dementia to encourage them to eat.

However, there were also examples of poor care, for example staff left tea for a patient, but because they were blind in one eye they did not notice it.

Healthwatch concluded that the overall quality of care observed was “very good”, but singled Marble Hill 1 out as being the location of the majority of poor care.

The report states:  “This is not to diminish the efforts of staff in the ward, who were frequently observed to be working hard in a caring manner.

“Nevertheless, in this ward alone there were a concerning volume of issues that spanned a range of different areas.”

The hospital responded by telling Healthwatch they had increased staffing levels in Marble Hill 1, with a new early shift nurse to help doctors with their rounds.

A new matron was also hired in December – there was an interim matron at the time of the visits.

The hospital explained Marble Hill 1 used to be used as an escalation ward, and had a high proportion of agency staff, but during the 14 months since the ward became open all the time, this had gradually changed.

There has been a reduction in incidents and complaints in the last three months and recently met with the Care Quality Commission to discuss the ongoing improvements, as the ward was previously an area of concern for them as well.

A hospital spokesperson said: “We work very closely with Healthwatch and always welcome their feedback. Issues raised were addressed at the time, with ward staff and the senior nursing team in the area. Since the review by Healthwatch, a new matron is now in place and staffing has been further reviewed and increased.

“In the latest national patient survey, soon to be published, we are the 2nd most improved Trust for patient experience.

“We closely monitor our patient experience and have seen a reduction in complaints and incidents within Marble Hill 1. In January 2019, the ward had a 100% response rate to the Friends & Family Test with 97.56% of patients recommending the ward.”