"History repeating itself"

About: University Hospital Aintree / General surgery

(as the patient),

In November 2011 one of our relatives kidneys stopped working and she acquired pneumonia, Our relative was admitted to the Medical Assessment Unit (MAU) at Aintree University Hospital, My sister and I were informed that our relative might die.

A request by our relative for us to be present when she was seen by a doctor was ignored. The request was blatantly ignored. One doctor argued with me in front of my my relative and said family can only stay with relatives if they are dying. I later met with this doctor who informed me our relative was not dying.

Our relative lost use of one arm many years ago and their right shoulder had been broken some years ago, because of this our relative struggled to cut up food open containers etc. My sister and I made this known to staff and requested that we stay to help our relative eat and because of their lack of mobility and poor eyesight we asked that they help with medication. This request was refused and we were told that we would have to leave during medication and meal times and that Nurses would assist. At this stage I was already concerned about the care and conflicting information on the MAU. On more than 1 occasion I found our relative sitting in front of a cold tray of food with the food uncut, and tops left on desserts and drinks. When I challenged this Nurses replied that they were busy and they would get round to it. This seemed quite typical in terms of what we saw.

Our relative was then sent to Ward 22 where they stayed for approximately 2 weeks. Our relative was discharged without an aftercare plan despite them living alone.

Our relative had also developed a pressure sore on one heal on ward 22. (we think this is more evidence of poor care). The night they got home, our relative fell on the stairs on the way to bed and she was readmitted to ward 32, we were informed that the pneumonia had not cleared. Our relative was eventually discharged with a full aftercare package and still requiring a nurse to dress her pressure sore. They were readmitted again to Ward 15. The pneumomia had not cleared.

It was at this point my sister and I decided we should note some of the incidents we observed.

On numerous occasions Tablets were left on the table in a dispensing cup Having restricted use of their arm and had poor eyesight our relative could not take their medication unassisted. Despite telling staff about this, it happened time and time again.

We requested a meeting with the doctor and the Consultant. Again we raised our concerns about poor treatment and our relatives fear of hospitals and doctors and it was agreed there should be 3 way communication.

When our relative had water retention and her ankles were swollen. The footstool provided was far too high and it was causing pain. The physiotherapist said they would provide a lower footstool.

We noticed that Mum was not eating but the food chart stated that our relative was eating almost everything. We informed the nurse. We were told they would monitor her food intake.

I informed the nurse our relative was in severe pain and was tired, was visibly weaker and appeared to be deteriorating. I asked if the oxygen levels had been tested and I was informed they were OK.

I spoke to the deputy ward manager and told our relative was still not eating, they were tired and weak and breathing seemed laboured The Deputy Ward Manager told me they were not too weak and that had walked to the toilet alone using her delta frame.

We observed that all of our relatives tablets had again been left on the table in the dispensing cup. Mum had been put on oxygen and had deteriorated further. A Nurse brought a drip and hung it over the bed lamp She informed us that our relative had a chest X-Ray and had pneumonia on her lower left lung. Although a cannular was due to be fitted for IV antibiotics early afternoon, it was not fitted until late evening.

When we met with the consultant we asked the prognosis - given the fact that we were told on the MAU that our relative was dying. We were informed that they were poorly and may require an operation on her kidney.

We informed him about tablets constantly being left on the table, he said he would speak to the ward manager

I asked why I was ignored when I had told the nurse I suspected or relatives oxygen levels had dropped and was subsequently proven right there was no reply

We informed him that our relative had deteriorated and their speech was not right and the fact they struggled to get to the toilet with a frame and assistance was a long long way from how they were before admission. He did not comment

We also informed him that our relative's legs were swollen but despite this no footstool had been provided

Our relative had not eaten all of her food but the food chart said that it had been eaten. Tea was being counted as fluid (despite the dehydrating effect of caffeine) and our relative was only having small sips of tea. The chart incorrectly recorded the time the cannula was fitted.

While we were there a nurse had asked our relative what they had eaten - They could not remember, it was at this point we realised our relativess food intake was not being monitored.

It was noticed that the antibiotic drip had finished and was uncomfortable. We asked for it to be removed in the afternoon. At 7. 15pm I had to ask staff again to remove the same drip. The footstool provided with was on the opposite side of the bed.

Nurse said our relative was lively - this was a lie, their speech was slurred and they were very grey in colour and was lethargic.

We met with the consultant and informed him of our grave concerns

Doctors kept referring to Mums TB - Our mum had NEVER had TB

We highlighted that up until admission our relative was able to walk, they were independent despite their impairments. We highlighted that their speech was slurred and they were unable to stand unaided the movement in the left arm had deteriorated and they were drooling from one side of her mouth.

My sister asked for our relatives oxygen to be put back on and a Nurse did this. Later the doctor pulled me to one side and told me that ONLY nurses should put the oxygen back on. He was implying that my sister had done this and it was against the agreed plan of care. I informed him that a Nurse had put the oxygen back on. He said nothing in reply.

Tablets left in the dispensing cup on the table but the Nurse informed us they had observed medication being taken. This was untrue.

Our relative had not had any of her ensure drink. they were clearly upset and had been crying. Our relative informed me that the urologist had told them he was going to put a drain in their kidney "early next week". I spoke to nursing staff about this - they were gathered around the table having a chat. They informed me the Urologist had not seen our relative and they were confused. I spoke to the doctor who informed me nothing would happen until the pneumonia had cleared. Once the pneumonia had cleared, they would move our relative to the rehab unit and they would be treated as an outpatient for her kidneys. I went to explain this to our distressed relative, but the patient in the next bed said that she had heard the doctor and our relative was was right. I went back to tell the Nursing staff and they laughed and said "we have more than one confused patient on the ward' I found this comment particularly offensive and left the ward sobbing as the pressure and stress was becoming too much to bare.

Our relative had a very sore mouth, it was dry and cut and it was too painful to eat. I asked the Nurse if our relative could have porridge I was told porridge was not on the menu but used a low salt menu to get Mum her porridge.

Our relative still had difficulty eating their mouth was still very sore I asked another nurse about porridge, she brought a soft food Menu - this had never been offered before.

I arrived on the ward our relative was sobbing. They had been told they were having a nephostromy tomorrow. A Nurse confirmed this. Again despite numerous requests to be present whenever our relative was seeing a consultant our requests were ignored. We had even put the request in writing.

Our relative had been put back on oxygen The doctor informed us that they had pus in her kidney and the kidney wont clear while the pus is there so a nephrostomy was essential.

Our relative was taken down for her Nephrostomy. The surgeon informed me that they had TWO pressure sores, one on each heel and told me that she was completing an incident form as one wound had gone close to the bone. She asked me to ensure that the staff on the ward dressed the wounds.

I had to remind The nurse to dress the pressure sores

On ward 15 on 2 occasions our relative contracted the Norovirus, yet doctors and ward staff were frequently observed not following the correct hand hygiene procedures when they were walking on and off the ward and between rooms.

My sister and I complained about the standard of care in writing to the Matron and even though she met with us they later said there was no record of the complaint.

Our relative was moved to Ward 2 Much better standard of care! They were given a chair with a leg rest and was offered a soft food menu, without us having to ask. A red tray so given for for assisted feeding.

On ward 2 we didn't keep detailed notes as the standard of care was good.

We were informed our relative would be home in a few days.

Our relative got another infection. Doctors tried to insert a drip into but couldn't find a vein. A senior doctor told us our relative was close to death and they thought it best not to take them to intensive care and scare them by putting "lines in the neck" He said all of this in front of our relative who was terrified so said they didn't want to go to intensive care.

Our relative was moved into a side room. The doctor told us they would die in a day or 2. On the first day we tried to give sips of water but the nurse said we were best not giving anything to drink and just to use swabs in the mouth. After 5 days of no food and drink, Our relative was still alive but was in a great deal of pain. My sister and I queried the withdrawal of treatment and we were asked to speak to a palliative nurse. The palliative nurse informed us that our relative was on a care pathway and this slow death was normal and could take up to 2 weeks.

Our relative was in agonising pain for 10 days and this to our mind was caused by the Liverpool Care pathway. It got to the stage when we were unable to hug them, or comb their hair or hold their had. Our relatives body began swelling - we were not warned of this and we had to remove a ring from their finger as they were turning blue. Fluids were leaking through their hands (we were not told about this either) after 10 grueling days our relative died. This was not a painless and peaceful and kind death this was torture.

We sent a letter of complaint to the hospital and received an 8 page replay apologising for their shortcomings and telling us things had been put in place to prevent it happening again.

History repeats itself:

Yesterday we visited a very ill friend in hospital on ward 15 and this is what we found/were told about:

She was left unwashed as nobody even bothered to check if she needed assistance

Her tablets were left in a cup on the bedside table despite the fact her memory is poor and her eyesight and mobility are bad she could not reach them and did not know they were there.

Despite lack of balance and poor mobility our friend was lying on the edge of the bed without the cot sides up

She was unable to use the control on the bed and the emergency call button was out of reach.

She was left undressed as she was unable to put her pyjama bottoms on and a member of staff had told her she could not assist but failed to get her any help.

Her wash things and toothbrush had been left on the bed because she was unable to reach her own locker

Her hands and fingers were swollen and her fingers were blue but no one has bothered to take off her wedding ring

Her feet were swollen yet her legs were not raised.

She struggled to drink out of a glass without assistance yet no beaker has been offered.

Nurses sat at their station chatting and ignored people waiting to see them.

My sister and I were distraught this brought back horrific memories about the poor treatment of our relative and we have major concerns about the treatment of our friend.

It is obvious that the 8 page apology was merely lip service to appease us.

Not only has this hospital failed but I feel it's complaints procedure has failed. I now feel it has proven to be a complete waste of time.

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Responses

Response from Head of Patient Experience , Head of Patient and Staff Experience & Engagement, Aintree University Hospitals NHS Foundation Trust

These are serious complaints which will be investigated by our team.

Please call us at 0151 529 3287 or email us at customerservice@aintree.nhs.uk or visit http://www.aintreehospitals.nhs.uk/PatientInformation/Patient-Advice-and-Complaints-Team/Pages/default.aspx so that we can discuss this further with you.

Update posted by Carol H (the patient)

We have already complained received an apology regarding our relative.

RE: The most recent matter regarding our friend. We see no point in persuing this for 3 reasons:

1. We are already traumatised after seeing our relative suffering a horrible slow and painful death and each time we have to go over the events brings back horrific memories, and causes me to sink into a depression.

2.Thankfully our friend has now been discharged.

3. We have no confidence in your complaints procedure whatsoever. Our last complaint resulted in a promise that changes had been made and things would not happen again and that was clearly untrue.

The purpose of my writing this review is solely to make other relatives and friends aware, so they can be observant and proactive in preventing this happening to their loved ones.

Rather than speak to me as part of your investigation, I suggest you go onto the wards undercover and see what is happening for yourselves.

Updates, changes and questions related to this story