Lauren Finch

“1. Nursing staff and Health Care Assistants on Westleigh Ward at Atherleigh Park Hospital were carrying out (and continue to carry out) observations of patients at precise intervals (for example, if a patient is on half-hourly observations, staff explained that they would aim to carry out observations at 10.00 am, 10.30 a.m., 11 am etc.). Further, all records showed that the timings of observations were at precise intervals. This is not in accordance with the Trust's policy of observations (which”

“The Deputy Ward Manager on Westleigh Ward at Atherleigh Park Hospital confirmed that she did not and still does not check that observations by staff are being carried out in accordance with the Trust policy, despite accepting that this was her role when the nurse in charge of a shift. Further, the Deputy Manager of Westleigh Ward did not understand the Policy and thought that observations were to be carried out at regular intervals (as referred to above).”

“The Trust carried out an investigation following the death of [the deceased]. It was of concern that the lead investigator (who gave evidence at the inquest) did not understand the Observation Policy and suggested that observations should be carried out at irregular intervals (which was correct) but then gave an example of 10 minute observations being carried out at: 10 am, 10.08 am, 10.20 am (which is clearly not in accordance with the Policy). The interval should never exceed the 10 minute period (and”

“There were examples in the records of nursing staff putting in entries 24 hours after the event had occurred. Whilst it is accepted that nursing staff may, on occasion, need to wait some time before marking an entry into the clinical record, a period of 24 hours when dealing with patients at risk of self-harm and suicide means that relevant information is potentially not available to staff on the next shift.”