Bed-bound patients were told to “soil themselves” in a busy A&E department because there were not enough staff to take them to the toilet, according to a new report.
One desperate patient urinated in a bottle without any privacy curtains at Medway Maritime Hospital, according to the report by the Care Quality Commission (CQC). Some were left in soiled clothing and bedding for “hours”.
Inspectors described how a patient had been forced to wait 55 hours on a chair in a corridor at the hospital in Gillingham, Kent, which is run by Medway NHS Foundation Trust.
Other people described waiting two days or more for a bed. Some staff said they did not feel safe raising concerns, while some nurses “lived in fear of punishment from senior leaders”.
The new CQC report states: “Patients, relatives and staff contacted us prior to the assessment process to tell us that staff did not always protect patients from degrading experiences.
“Examples included frail patients who could not get up and take themselves to the toilet were left to soil themselves and left in soiled clothing and bedclothes for hours.
“Staff reported that frail, bed-bound patients had been told to soil themselves because there were not enough staff to take them to the toilet.”
During the visit, inspectors saw “a patient passing urine into a bottle with no privacy curtains.”
The report adds: “Patients were stranded in ED [emergency department] for 50 hours or more, with no access to wash facilities.
“There was a lack of pillows and blankets for patients, including those located on trolleys close the ambulance entrance, and patients were left in their soiled clothing, and medications not given.”
One told inspectors they were “so cold” but had not been given any blankets. Inspectors also met a patient waiting on a chair who had been in the corridor for 55 hours.
‘Staff crying on the phone for help’
Patient feedback to inspectors included: “Corridor care, it is horrible and a disgusting level of care that is being provided.
“There are multiple people lying on floors and elderly people in beds who haven’t even been given their dignity and respect, they have no blankets.”
Another said: “Elderly lady had to wait in the emergency department corridor due to lack of beds. No privacy or dignity, screen pulled round her to use bedpan, nowhere for her to wash or change clothing.”
Staff described a shortage of qualified nursing staff which resulted in delays to patient care. One patient contacted the CQC and said that “staff were crying on the phone for help, no one seemed to turn up.”
Patients said: “They had been left sitting in their own faeces all day because there was no one available to help.”
Some workers told inspectors the emergency department did not have enough medical staff and that the number of consultants employed did not meet the Royal College of Emergency Medicine (RCEM) guidelines.
However, senior leaders told inspectors they had completed a staffing review, and that the department was adequately staffed against the budget.
Following the CQC inspection in February last year, urgent and emergency services at the hospital were rated as “requires improvement” and it issued a warning notice to the trust, demanding certain improvements.
Some 15 hospital staff contacted the CQC between 31 August 2023 and 4 April last year to raise concerns about the culture of the department. Some described the culture as toxic because of the behaviours and capability of leaders.
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“Three staff told us about bullying by leaders and five said staff were threatened with disciplinary action or targeted for speaking up,” the report states.
“Nine talked about leaders taking no action when staff raised concerns, so nothing changed.”
Workers described “mean” interactions from some leaders. These included halting conversations by saying “conversation closed” and “discussion over” and telling staff they were “dropping the ball” and “should work harder.”
During the on-site assessment some staff said that when they escalated concerns about staffing and overcrowding to immediate leaders, their comments were ignored and not taken seriously.
What do hospital bosses say?
The trust that runs Medway Maritime Hospital said it had made “significant improvements” over the last year.
Jayne Black, chief executive of Medway NHS Foundation Trust, said: “We are very sorry that despite the best efforts of our hardworking staff, at the time of the last February’s inspection, the inspection team found that our care fell below the standard that everyone should expect in their time of need.
“Over the last year we have made significant improvements so that patients attending our emergency department are treated sooner, are cared for in areas more suitable for their needs, and receive appropriate and compassionate care.
“We recognise there is much more for us to do, particularly to reduce delays for patients waiting to be admitted to a ward, so that every patient receives the high standard of care that we aspire to provide.
“Staff throughout the hospital continue to work tirelessly, together with our ambulance, community and social care partners, to reduce delays and improve care for all for patients attending our emergency department.”
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