Decision Report 201405382

Summary

Mrs C complained about the care her daughter (Miss A) received from Parkhead Hospital for anorexia nervosa. Mrs C was dissatisfied that Miss A lost weight in hospital and was not given enough calories. She said that the re-feeding plan was not tailored to meet Miss A's needs and that staff did not respond properly to the concerns she raised at the time of the hospital admission.

We took independent advice on this case from two of our advisers experienced in working with patients who have eating disorders, one of whom is a dietician and the other a mental health nurse. We found that there was an appropriate re-feeding plan and measures in place which were in line with national guidance. However, for approximately two weeks, Miss A's calorie intake was not in accordance with the re-feeding plan which the board acknowledged and apologised for. We also identified that the records made by the nursing staff should have been more detailed, and that there was insufficient historical information documented about Miss A's background and whether any psychological therapies had been offered to her or the family.

We considered that there was evidence to show that staff had listened to concerns raised by the family about Miss A's preference to have liquid nutritional supplements instead of solid food. Furthermore, an agreement had been reached for Miss A to follow the re-feeding plan rather than have a feeding tube put in place.

Recommendations

We recommended that the board:

• ensure their re-feeding policy includes guidance on offering psychological therapies and support to patients and their families; and
• draw to the attention of nursing staff involved in Miss A's care the importance of documenting relevant information related to a patient's behaviours, weight and family background.