"Patients' Association Report 2nd December"

See case study from Jan 2010 at this community hospital.

It has been conveniently renamed since early this year and is now called Croeso Centre. This means 'Welcome Centre". From my experience I wonder if the same staff with their rigid and institutional culture are still there.

Patients’ Association – Princess of Wales Hospital and Maesgwyn Hospital (now called Croeso Centre)

11. Patient A

By her daughter

The following is an account of Patient A’s first experience of hospital care.

My mother’s health had already started to decline before my father died. Memory and mobility problems were noticeable before 2006. After my father died she became more and more reliant on family and carers for day to day living.

After two falls in October 2009 she was admitted to the Princess of Wales Hospital in Bridgend for tests and observation. This was the first time my mother had stayed in hospital, having been in fairly good health for most of her 82 years.

Communication – conflicting instructions and information

We (her family) received conflicting information concerning her condition and future care. She had a fracture of the hip/ she did not have a fracture. She had a chest infection/she had a urine infection. She needed EMI care/she could go home – It depended on who we managed to speak to. If the family were confused, then my mother most certainly was greatly confused.

Moving around – disturbs consistency in care

During her stay at this hospital she was moved 4 times between wards.

In my view staff too busy so shortcuts (Dignity infringed)

Staff were too busy to help her walk to the toilet – it saved time to either wheel her or bring a commode – also, to be on the safe side, incontinence pads were used. I think this combination is part of the institutionalisation of patients and the reason my mother became incontinent.

On December 20th at a family meeting with the geriatric specialist and social worker we were told that my mother could go home the following day. This was obviously impossible to arrange at such short notice – she would need four care visits a day, special equipment put in place, not to mention arrangements with medication and pharmacy visits. It seems rather harsh, but at this point we thought she would be safer where she was until after the holiday – it took some persuading for staff to see the sense in this.

On December 30th (just 10 days after we were told she could go home) at a meeting with the medical physician we were told that it would be unlikely that my mother would go home unless she had 24 hour supervision and encouraged us to look for a placement in a residential home. She stayed at the hospital until the end of January – we were hoping she would at least not be moved now until a place was ready for her, but bed-blocking (always a problem) necessitated a move, in the interim, to a community hospital – Maesgwyn.

At Maesgwyn Community Hospital

February to April saw a further decline in my mother’s mental health. The following statements constitute facts (while hopefully avoiding opinions) contained in a letter I sent to Abertawe Bro Morgannwg NHS Trust in April 2010. My assessment was:

1. During her stay at Maesgwyn my family mentioned to all levels of staff that Mum’s needs were not being met satisfactorily, but because in my view of the rigid, institutional atmosphere we were concerned not to compromise her care by complaining too much.

2. Undignified (quality) poor (amount of ) Personal Care. She was not bathed or showered frequently enough – this was very noticeable to visitors.

3. Unsafe, Unsupported neglectful. She was left to her own devices in the toilet – she couldn’t cope with incontinence pads and was seen on one occasion walking in the corridor with her underwear and pad around her lower legs – very distressed.

4. Infection control procedures ignored. Underwear and clothes that were soiled with faeces and urine were left in her wardrobe – resulting in the clean laundry smelling and possibly being contaminated. On reporting this to a senior nurse, the reply was that she couldn’t be present all the time to prevent this.

5. Nutritional assessment? (no dentures) . My mother was left without her denture until recently (October) because in February a carer inadvertently threw it away. It’s been left up to her family to arrange a replacement.

6. Rigid ward routine – preventing relatives visiting. (Control – so that relatives cannot see person too much to complain). It was very difficult for brief ‘out of hours’ visits to be made by relatives who, for example, work unsocial hours. Mum’s grandson was only able to see her on rare occasions because of his shift pattern. A little flexibility, even just to exchange laundry and say ‘hello’, would benefit the patient and relative.

7. NSF Person-centred care? There is a pleasant patients’ conservatory where visitors can sit with patients – but only if staff are not taking their break or having meetings. I and other family members were asked to leave on more than one occasion.

In conclusion, my mother’s first experience as a patient has been very unfortunate. At this point I must express an opinion - the general atmosphere and attitude of Maesgwyn Hospital is one of ‘institution’. Staff have a tendency to close ranks. Some patients I spoke to were afraid to complain. Having said that, some staff genuinely cared for and comforted my mother – and I’m grateful to those professionals.

Mum moved to a residential care home in April 2010. She took with her an undiagnosed urine infection (diagnosed 2 days after the move) and black mould between her toes.

Although myself and my brothers bought my parent’s house for them 12 years ago, we no longer have enough evidence to prove this, which means of course, my mother is self-funding. Her home has been taken over by the Social Services.