"Swah ED , social worker and ambulance crew"

About: Northern Ireland Ambulance Service / Emergency ambulance response Northern Ireland Ambulance Service Emergency ambulance response Belfast BT8 8SG Older People’s Services / Social Worker for older people Older People’s Services Social Worker for older people Londonderry BT47 6WH South West Acute Hospital / Emergency Care and Medicine Services South West Acute Hospital Emergency Care and Medicine Services Enniskillen BT74 6DN

Posted by oscarbj87 (as a relative), 2 weeks ago

My mum had a fall on 3/4/24, mum pressed her buzzer after she had obviously been lying on the floor for some time once again as this isn't this first fall mum has had and she has never called for help because mum is diagnosed with Alzheimers and vascular dementia plus mum's mobility is very poor and she has a zimmer frame that time's she just leaves and we are always telling her she can't do without it but memory is really deteriorating as well.
On this occasion it was the paramedics that found mum on the bedroom floor because when the buzzer went through to the call centre they had the wrong phone number for me as I am the point of contact, the first I knew of what had happened was when mum's provider rang me to ask did I know the paramedics were with mum and that she had fallen and I was like no!
So I got to mum's straight away, the male paramedic was in the bathroom with mum as she was sat on the toilet and then when she done he followed her through into the Livingroom so they could do her op's now I informed them that mum had been diagnosed with Alzheimers and vascular dementia and with me giving them this information I thought they would have given mum a full check over but no they took her at her word when they asked her if she hurt herself or was sore. Problem is mum doesn't realise she hurts herself and feels pain and she did say to them that she didn't know what had happened. The paramedics were happy to let mum to stay at home because her op's were fine and I had told them that she had a recent TIA as well , the paramedics left.
We got mum her breakfast after the paramedics left and after that mum wanted to go out for a smoke and it was then that mum couldn't get up , she had absolutely no use of her legs so had to get her into her wheelchair to take her out for her smoke. At was at this point that mum was coming out with things , she was asking about my late partner why she hadn't heard from him I said mum he's been dead nearly 3 years she was mortified.
My daughter in law and I took mum to the shower which was a really hard job because of her not being able to stand/walk and mum not understanding instruction from us but then mum said to us the side of her head was sore and we asked were and she put her hand up and touched the left side and she had a wee bump so mum obviously banged her head of the bedside locker when she fell and I ask her what happened and she said she had got out of bed and was standing and her legs just went from under her.
My daughter in law had to get into the shower with mum as mum had to sit on the seat on the shower, so got her showered and dressed and then got mum into the riser chair in the livingroom, mum started to deteriorate she was showing signs of a TIA again and the speeches were getting slurred. My oldest son came in and he looked at her and went to mum look at her she's took something, look at her face I said I know because the speeches are away too. Mum's carer came in when I was on the phone again to the ambulance service and even she said she could she the droop to one said of her face and I said yeah and her speeches are away too.
It took the ambulance about 45 minutes to get here and it was the same crew that had seen mum from the fall in the morning, I told them about the droop, speeches and mum and that their was a bump on the left side of her head from the fall she'd had earlier so they decided to take mum to the South West Acute Hospital ED they said she would be seen sooner there.
I didn't get up the road to the hospital till 6pm and I was annoyed that mum was sat in a wheelchair in the corridor in the ED and had , had a CT scan but that was it the handover information that the paramedics gave the ED staff wasn't given right they said mum was they're as a result of a fall I told them that's not why I phoned for the ambulance so I gave them the full story from what had happened.
Mum wasn't seen by a doctor in the ED till nearly 9pm were he took bloods and was waiting on the results of the CT, mum was left in the corridor again now mum is a type 2 diabetic and hadn't had anything to eat or drink all day and hadn't been offered anything. Mum was completely delirious and its a good job I was with her because she kept trying to get up out of the wheelchair and if I hadn't of been there she would have fell on her face , as the staff were run of their feet.
Mum was then called for an x-ray and then a while after the doctor came and said the x-ray showed a chest infection and she needed fluids and IV antibiotics, they got mum a bed which was in front of one of the nurses stations. Mum stayed there till Friday and they discharged her in the evening even though I told them not to as she's a risk. Mum's social worker suspended her care package as well but they still sent her home in a taxi and the taxi man gave off that she was confused, didn't know where she was and hadn't a clue.

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John Kerr

Emergency Nurse Practitioner SWAH ED, Acute Services Emergency Care,

WHSCT

assess and treat

Submitted on 14/04/2024 at 09:37

Published on Care Opinion on 15/04/2024 at 08:56

Dear oscarbj87
my name is John Kerr, an Emergency Nurse Practitioner, in the Emergency Department (ED) at the South West Acute Hospital (SWAH). I am sorry to read your opinions about your experiences recently, regarding your mothers care, while at the ED within the SWAH. I am responding on behalf of the ED, maybe other service providers will respond in due course. My attention is to address a number of points you have made.
All our patients are assessed by a qualified staff nurse and a priority of care given. I note that your mother had a CT scan in the department, before your arrival. This would indicate a high priority, in line with national stroke guidelines, to exclude the same. If any concerns were identified on the scan then this would be acted upon by the stroke team immediately. I can only assume nothing sinister was found.
I appreciate it can be frustrating to see a loved on on a chair in the corridor, however, with unprecedented demands and pressures on the ED, we have to prioritise bed space according to medical need. I can assure you that we have qualified staff nurses and Health Care Assistants (HCA's) allocated to the corridor areas on a daily basis. These staff members work diligently to ensure all nursing and care needs are provided in a holistic and dignified manner.
Once again, unavoidable delays in waiting to see a doctor, are due to the current demands on the service at this present time. We as a department endeavor to see all patient as soon as possible, based on their clinical need and within the resources available to us.
We have a full catering service based within the department, with patients provided with breakfast, lunch and dinner. The last meal is provided at 16:00 approximately and sometimes this may/ may not coincide with your attendance. Other factors such and nil by mouth swallow assessments have to be considered also. I can only apologise if your mother did not receive anything to eat while initially in the department.
I am pleased to read that your mother received a bed, that was in close proximity to the nurses station. This assures me that the nursing team were aware of your mothers 'delirious' status and were doing their upmost to provide due care and attention.
I cannot comment on your mothers discharge from our department and the suitability of a taxi transfer and the apparent cancellation of her care package by the social workers.
Finally, I hope that this response helps somewhat, and that this finds you both well. We as a department, as well as our sister departments through out the United Kingdom (UK) are working under extreme pressures at present. Our goal is to provide excellent levels of care at the point of need. It never our intention to fail in this duty and I apologise if you feel we have let you down in this instance.
kind regards
John Kerr
Emergency Nurse Practitioner (ENP)
SWAH ED

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Update posted by oscarbj87 (a relative) 2 weeks ago

Thank you for responding back to me John.
I am fully aware and understand of the pressures the NHS are under but when you are telling nursing staff that your mum is a risk to send home and you don't want her to be discharged, you should be listened to.
My mum's social worker suspended her care package because she believed it was the best place for me to be at the time and mum having the risk of falls.
When a staff nurse phones you at 5.30pm to say they are discharging her and you tell her but I told you I didn't want her to be discharged due to risk and then tell her, mum's care package is suspended and the staff nurse phoned the care provider to get it set up again.
The staff nurse also told me that all the community referrals have been made and having spoken to mum's social worker last week, she can't see any community referrals on the system. So was I misinformed about this considering mum's a risk?
Whoever it was in the ED department that made the decision to send mum home by taxi, even though I had said to the staff nurse on the phone that I would be coming up to get mum. I don't think someone that has dementia should have been sent home by taxi.
I just think when it comes to our elderly and vulnerable they are forgot about.

Maggie Hamilton

Experience & Involvement Facilitator, Quality, Safety & Improvement,

Northern Ireland Ambulance Service

The Northern Ireland Ambulance Service (NIAS) Experience and Involvement Facilitator is responsible for developing and delivering high quality, effective services and processes for NIAS Service Users, Carers, their Advocates, the Public and NIAS Staff across Northern Ireland (NI) to facilitate and enable them to fully contribute to and participate in experience and involvement in relation to the NIAS.

Submitted on 15/04/2024 at 19:34

Published on Care Opinion at 21:52

Good Afternoon oscarbj87,
I would like to begin by thanking you for taking the time to share your experience of the Northern Ireland Ambulance Service. I am sorry to learn that the service provided did not fully meet you or your mums expectations, as an organisation we are committed to consistently show compassion, professionalism, and respect for the patients we care for. I want to apologise wholeheartedly for the impact that this experience has had on you, your mum and family.
With regards to our response times please be assured that we are working closely with the Department of Health and the Strategic Planning and Performance Group to increase our available resources. We are also working with the local EDs to try to ensure that our patients can be handed over to hospital clinical teams as safely and quickly as possible so that ambulance are able to respond to further emergencies.
If you would like a member of our Service User Feedback Team to get in touch to progress your concern further, please provide your contact details or alternatively they can be contacted at complaints@nias.hscni.net or on 02890 400999.
I hope your Mum is recovering well from her fall and chest infection.
Kind regards,
Maggie

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Nicola Hayes

Dementia Service Improvement Lead - Acute & Non Acute, PCOP,

WHSCT

Submitted on 29/04/2024 at 03:50

Published on Care Opinion at 03:50

Dear oscarbj87
My name is Nicola Hayes and I am currently Acting Head of Service for Older People's Mental Health, although my substantive post is Dementia Service Improvement Lead for the Acute Hospital
Firstly may I apologise for the late response.
I hope that your mother is recovering from her recent hospital experience.
Thank you for sharing your experiences 'SWAH ED, social worker and ambulance crew'. I am saddened to hear that your experiences were not up to your or your Mum's expectations.
Coming into the Emergency Department can be a fearful and stressful time for any of us and the care and treatment provided is crucial to ensure that any hospital journey is person centred for people living with dementia.
Your feedback is very welcome and may I suggest that you share your experiences with the WHSCT Complaints Department so that your concerns are addressed and any learning from these can be shared to ensure safe, effective, compassionate and well led care is delivered.
Direct Dial 02871611226
Email: complaints.department@westerntrust.hscni.net
Best Wishes
Nicola Hayes

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