Source · SPSO (Scottish Public Services Ombudsman)

Ayrshire and Arran NHS Board

SPSO (Scottish Public Services Ombudsman) Upheld Reference 201200696 Sector Health Category clinical treatment / diagnosis Decided 01 July 2013

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Full decision

Summary

Mr A was in hospital for four months, and his daughter (Ms C) was unhappy about aspects of his nursing care during that time. Mr A was prescribed a low dose of madopar (a drug used to treat Parkinson's disease), which was increased two weeks later. The medical records show that his behaviour became increasingly problematic, and Ms C said that Mr A became very aggressive while taking the drug.

About two months later, Mr A was transferred to another ward contrary to the wishes of Ms C. Ms C said that nursing staff sat at a table during visiting time and failed to attend to her father's needs or communicate with the family. Mr A had three falls and Ms C said staff failed to explain why this happened or how he had a cut on his head, and that there was an unreasonable delay in swabbing the cut. Ms C was also concerned about the management of Mr A's skin condition.

After taking independent advice from our nursing adviser, we found that aspects of the nursing care provided to Mr A fell below a reasonable standard, and we upheld Ms C's complaint. However, the board had acknowledged the shortcomings in relation to communication and nursing staff availability during visiting time and had taken action on this. The adviser reviewed evidence from the board's audits and quality improvement plan and was of the view that they took sufficient action to address these shortcomings. We, therefore, did not find it necessary to make any recommendations.

In relation to Mr A’s transfer from one ward to another, the adviser said that the decision was reasonable. The ward staff took the family's views into account, but there was a clear rationale for moving Mr A to a more appropriate setting. In relation to medication, we found that the prescription of madopar was reasonable.

Related reading

View Decision Report 201200696 as a PDF (11.56 KB) Updated: March 13, 2018

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