Decision report 201104972

Summary

Ms C complained that a hospital failed to provide her late mother (Mrs A) with appropriate nursing care and treatment towards the end of her life. Ms C told us that several issues arose that caused her concern. These included the lack of support Mrs A received in order to help her to eat; visiting times; the method by which paracetamol was administered; the treatment of a skin rash; the lack of information given to Ms C about Mrs A's diazepam medication; communication with the charge nurse; financial harm; funeral parlour arrangements; the documentation of private conversations and a missing page of Mrs A's clinical records.

We took independent advice from one of our medical advisers, and took account of this alongside all the documentation provided by Ms C and the board. Our investigation found no evidence of failures in the overall nursing care or standard of record-keeping so we did not uphold any aspect of Ms C's complaint.

However, we were critical of the comments made by and the general tone of the written records of one of the nursing staff, and of the inflexible attitude towards Ms C and family members about visiting times and assisting at mealtimes, and so made recommendations to reflect this.

Recommendations

We recommended that the board:

• ensure that staff are familiar with all aspects of person centred care;
• ensure that staff are reminded that relatives and carers should be included in decision making and where appropriate involved in care planning;
• ensure staff are reminded that rules for visiting and meal times are for the benefit and care and treatment of patients, but should be flexible to allow individual care for patients and their families;
• ensure that consideration is given to the individual personal circumstances of those who wish to be with terminally ill relatives/patients;
• ensure effective and sympathetic communication is made with those who wish to be with terminally ill relatives/patients; and
• ensure that wherever possible leaflet information about undertakers is available on the ward to assist relatives at times of bereavement.