Care levels and the elderly by the nhs

[tommy456]

I write this because a friend who is nearly 70yrs old has received poor quality of care following him falling and injuring his wrist (open fracture requiring it to be pinned) he was admitted to hospital and sent to a rehabilitation home for the elderly, from what he tells me the care levels he received whilst there weren't good as they ecpected him to sit in a chair at the table following breakfast for hours afterwards, he was in pain,as he had a fractured vertebra a few years ago, he informed staff about it, they also gave him morphine for the pain (fractured wrist ) which led to him being admitted to hospital less an than 2 days following him discharging himself from this so called rehab centre, with a blocked bowel, he had to undergo emergency surgery as a result of being given morphine as it turns out he is allergic to it, he was recently discharged from hospital and is recovering well,

recently he rolled out of bed, no injuries but was taken to hospital as a precaution, he tells me that in the ambulance on route to the hospital the paramedic asked him if he would like to see a priest (for his last rights) i asked was it said as a joke, he says not, he was kept in for several hrs for obs,then discharged

 

My questions are staff at the rehab centre guilty of neglect or malpractice ? and should a paramedic by scaring the life out of OAP's like this ,is this considered normal

It seems to me that they don't like or want to care to those who are old and frail , maybe they should seek a change in career ASAP ?

Who would he or i on his behalf complain to, just that i don't see getting anywhere by complaining to the rehab centre

[Mr.P]

Two routes of complaint that you can try:

lodge a formal complaint with the Care Quality Commission about the care home, they may also be able to advise regarding the comments of the paramedic.

Contact the Adult Social Services from your local council. Ask to speak to the vulnerable adults team and voice your concerns.

 

Neglect of the elderly in a care home environment is a form of abuse, so you could also try contacting Action on Elder Abuse to see if they can advise or assist in getting a satisfactory outcome to your complaints.

 

One question that springs to mind: Who prescribed the morphine and/or administered it ?

Being a controlled drug, there are strict rules as to the use and storage of morphine.

[caro]

Spot on Mr P. I believe the morphine was prescribed for the gentleman's wrist but this is still out of order.

 

Unfortunately many care workers are not only poorly paid, but poorly trained too.

 

I wonder if your friend might benefit from a visit from age uk to see if he may be able to get help of any kind going forward if he needs it Tommy.

Edited January 25, 2015 by caro

[tommy456]

Not sure if it had been prescribed or by whom, The rehab centre is run by the same hospital trust as the A&E he was taken to for the open fracture of his wrist, according to the web site it's staffed by nurses , thing is he told them that that type of pain killer wasn't good for him, he maybe old but still has good mental abilities IMO they just ignored him like they most probably ignore all those who they are supposed to be caring for and that paramedic should be sacked the poor man was stressed enough without an idiot like him/her,

[caro]

Sorry. My misunderstanding. Trained professionals should know better!!

[Mr.P]

Unfortunately many care workers are not only poorly paid, but poorly trained too.

 

Whilst some are also incompetent to the point of being criminal and being supported by their managers.

 

Currently have a personal interest in a case where a "carer" attempted to administer an overdose in excess of fifty times the prescribed amount to a vulnerable patient. The matter is being investigated by the CQC and Social Services and I'm hoping criminal prosecutions will follow.

[think about it]

Tommy,

 

Complain directly to the NHS Trust involved, have a quick look on their website and you'll find details of the concerns team, they'll co-ordinate the complaint as a whole rather than having to direct different letters to different departments.

 

Independant organisations like CAB or PALS might be worth involving too.

 

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When it comes to the prescribing of morphine, it's normally done together with a laxative to prevent the constipation that inevitably follows. However, to end up with a blockage is very extreme in the circumstances. As for being left in a chair, could he mobilise himself at all or was he totally reliant on being hoisted to/from where he needed to be? There's certainly scope to question the rehab unit's procedures for working with people with limited mobility and spinal injuries (especially if the pain was prevalent through the morphine!).

 

As for the paramedic, I'd want to get some answers. It may have been a poor attempt at humour, it might also have been a genuine question if the gentleman in question was very ill indeed.

[think about it]

It's worth adding that as a controlled drug, the morphine will have to have been prescribed by a doctor and in the circumstances most likely by the operating surgeon or his team for post operative pain relief.

 

If I was looking into this I'd be checking for parallel prescribing of some form of laxative. The obstruction in the gentlemans bowel is a worrying turn. Part of this complaint needs to look at whether any constipation was reported and what monitoring took place prior to discharge, were his bowel movements recorded I wonder? Was there any sign of impending issues prior to discharge?

 

Lots of questions to come I think to all involved.

[tommy456]

When he was admitted to hospital for an open fracture of the wrist , he stayed in hospital only a short time , his bowels where working at that point , it was during the short time he spent in this rehabilitation centre where he was given morphine for the pain, as far as i'm aware, & no mention of laxatives being given , He told them that it would cause him problems but he was ignored, i'm not sure if he had reported being constipated at the rehab centre in the few days he was there, but within 24-36hrs following discharging himself (due to how he was treated) he was constipated and was vomiting it wasn't until he was re admitted to hospital and treated for a blocked bowel, due to the morphine ,and it was found that he is allergic to it, so whilst in hospital his pain relief was paracetamol from a drip along with i presume electrolytes and food supplements

[think about it]

Tommy, I think this really merits some proper investigation and by all accounts the health board concerns team are best placed to help with this. Getting details of exactly what was given and when, what was written in notes - it might also be worth contacting the gentleman's GP (you'll need his permission, of course) to see what info is on his file with regards to his adverse reaction to Morphine.

 

Allergies such as these may (and should) be held on the gentleman's GP record but of course, as the initial admission was an emergency these notes may not have been available to the teams working with him.

 

In all accounts it's difficult to comment much further without having the facts in front of us. I hope he makes a speedy recovery and that you get the answers you're looking for,

[tommy456]

I found out that it wasn't the staff at the hospital who treated him for the fractured wrist, or his GP, but the resident gp at the so called rehabilitation unit who prescribed morphine, He was re admitted to hospital the other day due to the wound from surgery opening , a short time(several days) after the staples had been removed by the SRN who came to his home , Not sure what caused this ,but he is back in the hospital whilst it heals and he has re-gained his mobility and his home adapted ,bed & toilet raised to make it easier for him to get out of bed ect

[tommy456]

Had a response from the CQC who say that they don't investigate individual cases ( like ofcom) and advised the complaints should be to the hospital trust ect or

http://www.nhs.uk/Service-Search/Clinical-Commissioning-Group/LocationSearch/1

[think about it]

Tommy, can't think why you'd go directly to the CQC. Start with Health Board if you don't wish to write to each place and then if you're unhappy with the response escalate to the PHSO.

[tommy456]

http://www.england.nhs.uk/contact-us/complaint/

 

I don't think there is a health board in England ,they have one in Wales though , the info seems to be pointing to complaining to the hospital trust where he was admitted they also own/run the rehab unit, From what i can gather someone another friend has already or is going to complain to them , so i'll have to wait and see what transpires from that