Decision Report 201703227

Summary

Mrs C complained on behalf of her adult son (Mr A) about the care he received when he presented to the emergency department at St John's Hospital. Mr A has autism (a developmental disability that affects how a person communicates with, and relates to, other people) and a learning disability and attended A&E after suffering a dissociative episode (disruption in aspects of consciousness).

We took independent advice from an emergency medicine consultant. The adviser noted that the board failed to meet contemporary best practice when taking the decision to perform a sternal rub (rubbing knuckles on the sternum as an act of stimulation); however, we did not conclude that this action was unreasonable. We found that, in one instance, staff did not communicate reasonably with Mr A. We also noted that the emergency department team did not meet with Mrs C after she made a complaint, which showed a lack of supportive partnership working. Therefore, we upheld Mrs C's complaint.

Recommendations

What we asked the organisation to do in this case:

• Apologise to Mrs C for not responding to her concerns in a way that reflected partnership working. The apology should meet the standards set out in the SPSO guidelines on apology available at https://www.spso.org.uk/leaflets-and-guidance . Reconsider their decision not to meet with Mrs C and Mr A. The board should inform Mrs C of whether they are prepared to offer a meeting or if an alternative arrangement to effect partnership working would be more suitable.

What we said should change to put things right in future:

• Staff should recognise that patients with autism and learning disabilities might find the emergency department distressing and this may result in challenging behaviour.

We have asked the organisation to provide us with evidence that they have implemented the recommendations we have made on this case by the deadline we set.