Enter and View: Ward 27

Healthwatch Wirral conducted an announced Enter and View visit to Ward 27 at Arrowe Park Hospital on 11 April 2018 as part of a thematic programme examining catering and nutrition provision within health and social care services. Ward 27 is a 29-bed female acute medical ward for older people.

Healthwatch representatives found that staff treated patients with kindness, dignity and respect and that the ward was calm, well organised and efficiently managed despite being busy. Patients appeared well cared for, comfortable and clean, and those who spoke with Healthwatch reported being satisfied with the care and treatment they received. 

The visit identified a strong focus on nutrition and hydration. The ward used the Malnutrition Universal Screening Tool (MUST), completed fluid balance and dietary monitoring where required, and had a designated mealtime coordinator to support patients during meals. Patients were offered choices of food and drink, and relatives were encouraged to assist at mealtimes and bring in food where appropriate. Patients who required support were identified through measures such as red trays, adapted cutlery and specialist assistance from staff. 

The ward had introduced the “Eat, Drink, Move” initiative to improve nutrition, hydration and mobility and reduce the risk of pressure ulcers. Staff also described plans to implement the “End PJ Paralysis” campaign, which encourages suitable patients to get dressed, remain active and participate in their recovery. The ward had also taken part in a pilot scheme introducing finger foods for patients who may find conventional meals more difficult to manage, including some people living with dementia.

Healthwatch found evidence of effective quality and safety systems. Staff reported significant improvements in patient safety outcomes, including 177 days without a fall resulting in harm and 222 days without a hospital-acquired pressure ulcer. The ward had also achieved a Gold Standard rating in infection control audits. No safeguarding concerns were identified during the visit.

The ward environment was observed to be clean, tidy and well maintained. Entrances were secure, hand hygiene facilities were readily available and information for patients and visitors was clearly displayed. Healthwatch noted some minor environmental issues, including damaged curtains in one bay and toilet signage that was not easily visible from ward entrances. 

Staff and patients told Healthwatch that additional staffing would be beneficial during particularly busy periods, although patients reported that staffing pressures had not negatively affected the care they received. Some staff also stated that workforce shortages could make it difficult to complete all available training opportunities.

Overall, Healthwatch concluded that Ward 27 provided a positive patient experience. The report commended both staff and leadership for the standard of care delivered and recommended continuing the ward’s improvement initiatives, ensuring patient concerns such as night-time noise are routinely identified through patient rounding, and exploring funding opportunities to refurbish unused rooms for patient and family use.