Decision report 201103141

Summary
Ms C has joint power of attorney for her mother (Mrs A). Mrs A has vascular dementia and can become agitated and present challenging behaviour. As she is reluctant to take her medication, her family often disguise it in fruit juice.

Mrs A had a fall and was admitted to hospital. Her daughter complained about the care and treatment her mother received when she was there. She said that the board failed to take her advice about medication and that this led to her mother receiving it intra-muscularly. She complained that this was inappropriate. She also complained that the board failed to proactively manage her mother's care and that this led to a worsening of her condition. She further alleged that her discharge failed and that Mrs A required to be readmitted to hospital.

We obtained advice from one of our medical advisers, a specialist in acute medicine for older people, who read Mrs A's clinical records. We did not uphold the complaint about administering medication as we found no evidence in the notes to suggest that the family had told staff about how they had given this to Mrs A. Our adviser said that, in his view, the notes suggested that the board acted appropriately in the circumstances. However, because the notes omitted information that could have been expected, we decided on balance that the board did not managed Mrs A's condition proactively and upheld that complaint. We also found that the board had handled Mrs A's discharge appropriately but had failed to properly address Mrs C's written complaints as they should have done.

Recommendation
We recommended that the board:
• apologise to Ms C with regard to their failure to proactively manage her mother's care.