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An overhaul is needed in the way hospitals and care homes in England approach caring for the elderly, a review says.

The Commission on Improving Dignity in Care for Older People said too many people were being "let down" by the current system.

But some places are getting it right.

Above Frederick Steen's bed is a piece of laminated paper with a clock printed on it.

At first sight it seems innocuous. But Mr Steen - whose recovery from a knee replacement has been complicated by blood clots on his lungs - describes it as the most important piece of equipment he has around his bed at London's University College Hospital.

The hands on the clock indicate when he next has to be turned to stop pressure sores developing.

It is just one of a number of initiatives the hospital is using to ensure the basic care given to patients is of the highest standard.

Another example is the way the hospital delivers food to patients. UCH has reverted back to the old-fashioned way of handing out meals with catering staff wheeling around a trolley and nurses delivering the food to the patients directly, giving them time to talk and listen to them.

'100% perfect'

And, according to Mr Steen, who is in his 80s, it seems to be working.

"The care has been 100% perfect. I have been here for seven weeks and I can't fault how I have been cared for.

"You will often see the staff working after their shift has ended because there are jobs to do."

Darren Barnes, a nurse on the ward where Mr Steen is being cared for, said: "It is all about empowering the patient and getting them involved in their care.

"We value what they say and want to do the best for them."

It is a culture which is embedded in the way the trust is run.

For the last eight years, the hospital has had a senior nurse who oversees the care of older people.

The current incumbent, Vicki Leah, said the position had enabled the trust to stay on top of the issue.

"My job is to challenge people. It is easy to lose sight of what is happening on a ward when you are there day in, day out.

"Most people, when they take a step back, realise where things are going wrong. No-one wants to provide bad care."