A hospital has been roundly condemned for providing elderly and frail patients with a tambourine to attract attention.
The single musical instrument is the only emergency call system available to patients using a day room at the Cardiff Royal Infirmary’s West Wing.
Patients say they are “too scared” to use the day room in case staff do not hear their calls for help.
An NHS watchdog and Wales’ Older People’s Commissioner strongly criticised the hospital for not installing a proper alarm system.
Steve Allen, chief officer of Cardiff and Vale of Glamorgan Community Health Council, said: “This is totally inappropriate – patients shouldn’t have to resort to shaking a tambourine to get a nurse’s assistance.
“It is totally unacceptable and the health board must address this as a matter of concern.”
A concerned relative took a photograph of the tambourine in the day room after visiting his 90-year-old mother over the weekend.
The 65-year-old, who has asked not to be identified, said: “I thought she was joking about the tambourine but I went to the day room and there it was.
“My mother and other patients won’t go to the day room because of their fear of being left in a distressing situation, particularly toileting.
“I gave the tambourine a good hard shaking – after 16 minutes I gave up as no-one responded. Not surprisingly few patients use the day room, and the new television has few viewers.”
He added: “My mother has another six to eight weeks in the hospital and her time there could be made more enjoyable and bearable if she was able to watch the television.
“But she and other patients feel there’s too much of a risk of being left there.”
The man said he was also told there was a pair of maracas in the day room for patients to use to get nurses’ attention.
When he questioned staff at the hospital he was told there was no money available for a more effective call system.
“The staff do make an effort, they’re just stretched beyond belief,” he added.
Ruth Marks, Wales’ Older People’s Commissioner, said: “This does not afford any patient dignity and respect, let alone safety.
“The day room gives an opportunity for patients to relax and socialise away from their beds, which is important as the days in hospital can seem very long.
“Whatever system is in place to call for help, it is vital these areas are checked regularly by staff. If there was an emergency, there may be no opportunity to call for help.
“Resources may be limited, but installing a system so people can easily call for help whilst in hospital must be a priority.”
Ruth Walker, executive director of nursing for Cardiff and Vale University Health Board, said: “It appears well-meaning staff have looked for ways to allow patients to make better use of the day room as part of their recovery and provide a way of calling for help when physio or other staff are not nearby.
“A hand-bell had previously been provided but was deemed too heavy and cumbersome for frailer patients and staff looked for an alternative.
“Sadly the solution, while well intentioned, was not appropriate.
“A lightweight hand-bell will now be sourced as a matter of urgency and patients will be accompanied while using the dayroom in the meantime.
“We will also review dayroom arrangements in other areas.
“The care and dignity of all our patients is vitally important to everyone at the health board and we sincerely apologise for any distress this has caused.”
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