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14:58 GMT, Monday, 6 October 2008 15:58 UK

Hospital tied up elderly patients

Northwick Park hospital

Five vulnerable old people were "inappropriately" restrained by staff at a north-west London hospital, an inquiry has found.

The investigation by Harrow Primary Care Trust (PCT) found nursing staff at Northwick Park Hospital tied up five patients in Fletcher Ward last year.

The inquiry was launched following a complaint by a patient who was tied to his chair with a bed sheet.

Harrow PCT said staff shortage and lack of training led to the incidents.

The incidents took place between October and November 2007 in the ward where 42% suffered from dementia.

"Whereas some form of restraint may be used by nursing staff with an elderly patient to protect him or her from harm, the examples we discovered were unacceptable"
Dr Sarah Crowther, Harrow PCT

The report said although the use of restraint while caring for elderly patients is not automatically wrong as it can protect them from falls, in these five cases it was inappropriate.

Staff had restrained the patients in a chair or wheelchair, using bed sheets, men's braces or the integrated wheelchair straps - in some cases for long periods of time.

During the inquiry, the investigators interviewed 33 members of staff and 34 patients and their relatives.

Harrow PCT's chief executive Dr Sarah Crowther said: "Whereas some form of restraint may be used by nursing staff with an elderly patient to protect him or her from harm, the examples we discovered were unacceptable.

"Internal disciplinary action has been taken and a programme of training has been introduced to ensure that all staff provide the best possible care for vulnerable patients."

The investigators concluded that even though restraining the patients was wrong there was insufficient evidence for a police investigation.

Staffing skill reviewed

The report further added that financial difficulties experienced by the hospital since June 2006 led it to reduce training and freeze vacancies which led to a staff shortage.

On several occasions between May and November 2007 even the minimum staffing requirement could not be met.

The PCT added that although the staff involved were not individually identified, all nursing staff have now been given appropriate training.

North West London NHS Trust, which currently manages the hospital, said it is ensuring that recommendations of the report are followed.

"We have introduced a head nurse for elderly care at a senior level, more consultant and senior management presence on the wards and more staff meetings so that issues can be raised and there is continued learning in place.

"The staffing skill mix has also been reviewed to achieve more trained to untrained nursing staff," the statement said.

Daniel Blake, spokesperson for Action on Elder Abuse, commented: "I find it difficult to accept that staff shortages and lack of training were to blame. There are hundreds and thousands of nurses who do not resport to these methods."




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