"Concerns over care of an elderly friend at Andover"

In early October I sent the following feedback to the ward manager, Kingfisher Ward:

“Andover Hospital Rehabilitation Ward - Feedback Following A Patient Visit

I visited a friend, an elderly patient who is in Kingfisher Ward, recovering from an operation following a particularly bad leg break and a subsequent lack of basic nursing care at a hospital in Wiltshire. I have been out of the UK but now intend to make regular visits to my friend to encourage his recovery and ensure that he receives active input and encouragement for his rehabilitation and discharge. On my visit the following concerned me in respect of the prospects for his rehabilitation:

Only 2 physiotherapists on the picture board to cover all the patients which suggest one-to-one physiotherapy sessions are unlikely to be more frequent than weekly;

The storage of a large number of boxes of nursing equipment in the patients' day room in direct contravention of a specific notice on behalf of Paula Southgate pinned on the adjoining wall;

The chairs in the day room lined up in rows. This mitigates against patient and visitor interaction and many were placed sideways on to the TV screen which mitigates against a patient watching TV. The general demeanour and decor of the Day Room is bleak and unwelcoming;

The fact that the only regular opportunity for patients to use this Day Room is once a week during the time when their ward room has to be cleared for cleaning;

The "Releasing Time To Care" display outside the wall is completely unfathomable in its present form and therefore meaningless and a waste of time and effort. There is a grammar/spelling mistake in the section headed "How Will It Be Implemented" which apparently has been there since July suggesting that apart from the carelessness of this error, no one has bothered to read it in the intervening time. The graphs are not explained and the keys are difficult to read rendering them meaningless. The timeline finished in August. What is the purpose and effect of this programme? What is happening now? Was it a success or failure?

I look forward to direct contact to answer the points I have made.”

In late October I sent the following feedback to the ward manager, Kingfisher Ward:

“Andover Hospital Rehabilitation Ward - Feedback Following A Patient Visit

The elderly, frail patient needed the toilet and operated the buzzer. Stating his need was urgent he was assisted from his chair by a visitor and began to make his way to the toilet just across from the ward. A nurse on other duties in the room told him he could not go on his own and as she was busy with another patient she took him back to his chair and told him to use his buzzer.

On being told that had been done the nurse said she would go to the nurse’s station but the visitor went instead. On reporting the need for assistance the visitor was frostily (actually rudely) told that she was aware the buzzer had been sounded but there was no one available – despite a nurse sitting right next to her – but that a nurse would attend. A couple of minutes later the nurse who had been sitting at the station appeared to attend to the patient explaining that she though another nurse was attending to him. In the meantime the nurse on the ward realized that no one was going to respond to the buzzer, quickly packed away and assisted the patient. This lack of basic nursing care when nurses were clearly available happened during visiting hours is it considered to be an acceptable standard of care? What would have happened if it had happened outside those hours?

Earlier in the week the patient's next of kin noticed that an observation of his blood pressure a couple of days earlier had recorded a level at which on an earlier occasion had resulted in that patient being rushed to Winchester hospital for immediate attention. The next of kin expressed her concern about the inconsistency and was told “you should not be reading that”. Is it correct that the patients’ notes should not be available to the next of kin? Is it acceptable for a ward sister to ignore concerns that the next of kin have regarding their loved ones? Is it acceptable behaviour on behalf of the ward sister?

The patient was not permitted by nursing staff to visit the toilet on the same level and across from the ward without nursing assistance. What is the basis for the decision that a few days later the patient would be at home with the nearest toilet up a flight of four stairs and across a landing?

A couple of weeks ago the patient was taken to the “gym” to practice stair climbing by a nurse, in a wheelchair. On arrival it was found that the “gym” was locked and the nurse left the patient in the corridor to go away and investigate. After approximately one hour (based upon the return time to the ward) the patient stopped a nurse who was passing in the corridor which resulted in him being returned to the ward – without stair climbing practice or an explanation. Why was the patient abandoned in the corridor without water of means to request that or a toilet visit? How can a patient be absent from the ward for an hour without the alarm being raised?

This is not an anonymous email. It represents extreme concern on behalf of a dear friend in hospital who is unable to act for himself and whose treatment has fallen well below any acceptable standard, particularly that of an NHS establishment. My hope is that someone will have the courage to address my concerns – I will be happy to visit for a meeting – on the basis that others will not face similar poor treatment in future.

I look forward to an early response.”

3 days later I sent further feedback regarding the same patient’s experience at Andover Memorial Hospital via their website feedback facility. This raised concerns over the lack of fluid and blood pressure observations; the aggressive attitude of the Ward Sister towards the next of kin; the failure to dress the patient in socks after a bath.

The concerns I wish to raise today are:

“One week ago the patient’s next of kin was advised that her husband would be discharged. The patient is in his mid-80’s and his wife is in her mid-70’s with health problems. Whilst the depressed state of the patient as a result of his nursing care and the natural concern of his wife made this move an apparently welcome one, they were clearly in no position to realistically understand the exact implications of how they would cope with his discharge. It was clear to them that this was a discharge and not a trial: observations of fluid intake and blood pressure were not made for several days in the last week and the hospital physiotherapist was at pains to emphasise the patient’s ability to climb stairs. This is key because their house is entirely unsatisfactory for anyone lacking mobility, being on two floors with the nearest toilet up a set of curved stairs.

Today the patient was delivered to his home with all his possessions and apparatus designed to help him cope at home. Upon his arrival it became clear after a trial at climbing the stairs to the toilet that, in the words of the same physiotherapist, he was “not safe” to be in the house. In addition there was no provision for sleeping on the ground floor and so a single bed was moved into the dining room. However, no account was taken of the patient’s concern over being alone at night, nor of his wife’s poor hearing which meant she would have to sleep in the same room, nor of the absence of any suitable bed for her to use in that room. In addition the patient was returned with supplies of 20 (!) different medicines to be taken each day compared with around 6 which were being taken before his hospitalisation. His wife has no idea why all of these are necessary but given the patient’s confused state she is now totally in charge of administering the correct dose at the right time.

Despite the expressed concerns of the professionals during their discussions away from the patient and his wife today, they departed leaving the couple to cope with the situation. It is not clear that they even considered, much less thought through, the ability (inability) of the wife to cope as part of the overall patient care and safety. Stair climbing is not an option and a stair lift will probably be needed but that will take time to commission and install. As my wife (unrelated to the couple) cannot bear to think of the consequences of how they have been left, she is sleeping at their house on a make-do bed tonight. Not least because she is clear that the wife could not handle a patient’s toilet visit, never mind a fall or emergency.

We are concerned that expediency has prevailed over patient care and safety. Andover War Memorial Hospital staff bears the responsibility for this and I cannot stand by to see the patient and his wife effectively abandoned by a service designed to protect the vulnerable – not to exploit them. I am more than willing to contact someone at Winchester & Eastleigh NHS but as I am yet to receive any response to my initial concerns and their website is unhelpful in this respect I simply do not know what else I can do.”

These unacceptable circumstances have been compounded by what appears to me to be a total disregard for my concerns as I have received no response or acknowledgement whatsoever as a result of my feedback – nor has it been added to the AWMH website. This has only served to increase my determination to get responses and if that means airing all of this more widely then I shall do so.

In addition my report to the PALS office for AWMH sent at the end of October has elicited no response whatsoever.