"I am concerned about levels of..."

About: Manor Hospital

What could be improved

My concern is with the appropriate care of the elderly, largely manifested in poor COMMUNICATIONS. I was the main carer for my mother during her stays in hospital between November 2009 and May 2010 and have frequently visited friends and relatives over the past 5 years, including during the past few weeks. As my mother's next of kin, I found it extremely difficult to have a conversation with nursing staff - this both in terms of availability, knowledge and understanding, articulation and expression, continuity, and follow-through on actions.

There is no sense of team or working together - as a result I had to instigate a meeting and personally request that the physios, staff nurse OT and social worker sat down together with us to work out the way forward for my mother.

On visiting a relative this week, I had no sense that this has changed.

Anything else?

Evening visiting coincides with hand over/end of shift , thus staff are unavailable for conversation because they are in a meeting, or too exhausted by the end of shift to have a proper discussion.

Patients are moved without relatives being notified so on turning up at the normal ward one is alarmed to find the patient moved elsewhere. Discharges (to eg Richmond Hall) take place after dark which is frightening and baffling for the elderly.

Poor patient knowledge - senior staff are unaware (or not empowered to discuss) of a patient's progress or a likely outcome.

(Seemingly minor but important to the patients) symptoms such as nausea and diarrhoea and rashes, are not dealt with. This exacerbates feeling unwell or creates the feeling of being a nuisance by asking for bed pans, bowls etc. The wait for bedpans can result in accidents, which again makes the patient feel helpless and lacking in dignity.

Patients are left in chairs for long periods by which time they are uncomfortable and sore.

Depression - elderly people feeling low and unmotivated are chided and addressed with very negative vocabulary - eg "we're giving up on you", we're not helping you if you won't help


Large portions of food, presented unattractively or in a logistically difficult way, make it even more difficult for elderly people to maintain levels of intake.

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Response from Manor Hospital

Thank you for posting your comment, your feedback is very valuable to us. We’re working hard to provide quality care for all our elderly patients and feedback from relatives and carers is an essential part of developing our services. In your comment you have raised a number of concerns and I hope I can answer some of them here for you.

We understand that evening visiting times do coincide with the ward staffs’ shift handover however this should not stop relatives and carers speaking to the staff, if they need to. On some of our wards you can now book an appointment to meet with the senior nurse on the ward to discuss any issues or concerns and to get an update on the care your relative is receiving.

When planning a patient’s discharge from hospital, we now have discharge co-ordinators who will act as a liaison for relatives of elderly patients. The discharge co-ordinator can help with arranging meetings with physiotherapists and occupational therapists and be available to talk to relatives and carers and follow them through the discharge process. With regards to patients being transferred, when patients are moved from the hospital every effort is made to ensure that it is not late at night, and only in exceptional circumstances should this occur.

The wellbeing of all our patients is paramount to providing good patient care and to help support our elderly patients in hospital, we do have volunteers who visit the wards to help reduce the risk of isolation and depression that some elderly patients may feel during their stay. The volunteers are also available to help at meal times and for patients who would prefer smaller portions, their relatives or carers can speak to a member of the ward staff who can arrange this for them.

I hope this has been helpful and answers some of your concerns. If at any time you are concerned about a relative or patient staying in hospital, please do not hesitate to speak to a member of the ward staff or contact our Patient Advice and Liaison Service who can help on 01922 656363. Thank you for taking the time to post your feedback to us.

Jennifer Robinson

Lead Nurse for Older People

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