Decision report 201001727

Summary
Mr C was admitted to the Royal Edinburgh Hospital following a brain injury. He raised a number of complaints about his treatment while staying there. In particular, he raised concerns about the approaches and techniques used by staff members when dealing with incidents on his ward. He felt that he was not sufficiently involved in the planning of his treatment and did not receive adequate drug rehabilitation support. Mr C raised a number of verbal complaints with staff during his stay but he did not feel that these were listened to or followed up. The Board explained that raising frequent verbal complaints was a feature of Mr C's brain injury. They demonstrated that they had implemented a plan to set aside specific times each day for him to raise concerns with staff. However, we found no evidence that Mr C had been told about the arrangements that were in place for him. It was clear that the board recognised the need for Mr C to receive drug rehabilitation support, but based on our adviser's opinion we did not feel that the support offered to him best suited his particular requirements. We also found that the Board could have done more to involve Mr C in the planning of his care, or to record that he had chosen not to be involved. We were satisfied with the Board's approach to incident management, room searches and patient confidentiality.

Recommendations
We recommend that Lothian NHS Board - Royal Edinburgh and Associated Services Division:
• introduce a system of recording verbal complaints raised by patients and the action
taken as a result;
• review their approach to Mr C’s drug rehabilitation with the adviser's comments in mind
to ensure that patients in the brain injuries unit are given the most effective support for
their personal circumstances;
• take steps to ensure all patients' involvement in the planning of their care;
• remind staff that if patients decline to be involved in the planning of their care, this is
recorded in the records and a review date set; and
• consider taking steps to ensure that the uniform and name badge policy is adhered to by bank staff as well as permanent staff.