Overview
The complainant (Mr C) raised a number of concerns about aspects of the care and treatment of his mother (Mrs A) by NHS Greater Glasgow and Clyde (the Board) from May 2005 until her death in October 2005.
Specific complaints and conclusions
The complaints which have been investigated are that:
- (a) records were not knowingly available to staff or of sufficient quality (upheld);
- (b) action taken to prevent falls was inadequate (not upheld);
- (c) there was a lack of planned therapy for Mrs A (upheld); and
- (d) there were delays in providing adequate pain relief (not upheld).
Redress and recommendations
The Ombudsman recommends that the Board:
- (i) reflect on the lessons that emerge from the record-keeping issues in this case, consider whether the documentation should be changed or if the issue is rather about staff induction/training and advise her of the outcome of this consideration;
- (ii) complete the work on a Bed Alarm Policy and submit a copy to SPSO when this is issued;
- (iii) arrange for staff to reflect on the importance of good communication and involvement of patients and relatives in decisions about care and treatment and advise her of the steps taken to achieve this; and
- (iv) consider how to address the needs of longer term patients for mental stimulation to enhance their quality of life and advise her of the outcome of this consideration.
The Board have accepted the recommendations and will act on them accordingly.