Decision Report 201400125

Summary

Mrs C complained on behalf of her mother (Mrs A) that the care and treatment of her grandmother (Mrs B), had been unreasonable. Mrs C and Mrs A felt that it was not appropriate to put the Liverpool Care Pathway (LCP - an end of life care planning system) in place in view of the state of Mrs B's health, and said that the family were not told that it was in force.

We investigated the complaint and took independent advice from an experienced registered nurse. The investigation showed that when Mrs B arrived in hospital with her son (Mr B) who was her next of kin, she had an ischaemic leg (where the blood supply to the leg is poor, causing the tissue to die). Her condition was so poor that amputation was discussed. Mrs B, who had capacity to make her own decisions, said that she did not wish an amputation even though she was aware that her decision would lead to her death. She said that she wanted to be kept comfortable and out of pain. Immediate steps were taken to do this and the LCP was initiated.

We found that the board had acted in accordance with Mrs B's wishes, which was appropriate. Mr B, as next of kin, was involved in the discussions and, although Mrs A believed that matters should have been put on hold until she arrived and they could be discussed with her, this was not reasonable or appropriate in the circumstances.