"Good care in parts but could do better!"

My mother was admitted to Ward D8 following a fall and hip replacement. She has difficulties communicating as a result of vascular dementia and her hearing and sight are impaired. I visited her every day and completed a 'This is me' form to provide background about my Mum's preferences so that nursing staff could better communicate with her. Some of the nursing staff were exceptional and demonstrated concern and sensitivity. Others didnt seem bothered and showed very little empathy with patients. On at least half of my visits Mum had a full water jug on her bedside table but no cup from which to drink. Completion of the meal preferences sheet was perfunctory and no one appeared to have time to establish ny Mum's likes and dislikes. I was permitted to visit at meal times to assist in her feeding, especially in the immediate post op period, and brought some familiar frozen microwaveable food to encourage her to eat. This worked well until one day a new nurse said it contravened policies and would not be possible. Nursing presence on the ward was generally sparse and staff seemed more concerned to input obs details into their computers than they did engaging patients. An indication of the highly variable standards of nursing were on those numerous occasions when my Mum needed assistance with toileting or cups for drinking etc. - i'd go to the nurses station to seek help. On a few occasions a nurse would immediately ask if everything was OK (esp the ward sisters), but more often than not staff would carry on what they were doing without even acknowledging my presence. Some nurses didnt always check whether Mum was happy for them to change her or help her with visits to the toilet and this only appeared to be addressed when I challenged this practice. There appears to be a big problem with communication between different specialisms. At one stage during Mum's stay I was having parallel but conflicting discussions with medics, occupational and physiotherapists , and social workers about whether Mum was able to return to her home. Even after she was discharged to a residential care home I was receiving calls from agencies wanting to deliver adaptations and assitive technology into her home. At the end of Mum's stay I offered to come to the hospital and accompany Mum as she was discharged from the ward. The day before her discharge I was categorically promised an early call so that I could come in. Not having heard by mid morning i called to find that she had already been discharged and was en route to the care home. Altho a small matter, this final episode seems to capture the huge problem that Addenbrookes seems to have with internal communication which even new technology doesnt appear to have helped! In summary, some wonderful caring people who have great communication and people skills, but also some complacent and poor practice which should be receiving some attention, particularly when people using the service are so vulnerable.