York Hospital criticised over patient resuscitation
York Hospital has been criticised for not asking relatives of some patients if they should be resuscitated.
The Care Quality Commission (CQC) said York Teaching Hospital NHS Trust had failed to meet its own guidelines.
It said Do Not Attempt Resuscitation (DNAR) forms should be updated regularly, with relatives' views taken into account.
The trust said it was "sorry" if any distress had been caused and it would "listen" to the CQC's recommendations.
Inspectors visited the York Hospital, St Helen's Rehabilitation Hospital and White Cross Court Rehabilitation Hospital in July 2011.
They found that DNAR forms at York Hospital and St Helen's were not being completed correctly.
The documents were also not being reviewed as required by the hospital's own guidelines.
This meant that some patients may have had an instruction in place which was out of date, incorrect or no longer in their best interests, inspectors said.
Jo Dent, regional director of CQC for Yorkshire and Humber, said: "We found DNAR forms which had been completed by a doctor but that there was no evidence to say that patients had been involved in the decision, or evidence that relatives, even where they were taking an active role in the patient's progress, had been consulted."
She added: "Doctors we spoke to agreed it was best practice to discuss these decisions with the family or next-of-kin and the patient themselves, where possible.
"But one doctor also told us that it was a difficult topic to raise with relatives and patients and that these decisions were often made when relatives were not around."
Patrick Crowley, chief executive at York Teaching Hospital NHS Foundation Trust said the trust was "disappointed to be found wanting in any area".
He said everyone within the organisation recognised the "importance and sensitivity" of discussions with patients and their families regarding DNAR decisions.
"We are aware of individual cases where patients and relatives have understandably found this difficult and we are sorry if this has caused any undue distress," he said.
"We want to listen to this feedback to help us develop our processes and ensure we demonstrate that we are acting in patients' best interests."
Mr Crowley added that a new system was introduced not long before the CQC's visit, and that the trust was continuing to roll that out across the organisation.
However, he added that while the CQC found "a small number" of concerns, the reports also highlighted "many examples" of good practice.
CQC has given the trust 28 days to provide a report that says what action they are going to take to address the problem.