"Ward 306"

My 95 year-old granny was admitted to ARI last month.  She was medically well but had fallen a few times and was awaiting transfer to a care home.  

Initially she was cared for in wards 101, 102 and 303.  We were hugely impressed with the quality of the care and would like to sincerely thank the staff for their hard work. 

However, she was moved to ward 306 which according to somebody in charge, is an overflow, winter-only ward.  There was no permanent staff on this ward - it seemed that a different ward sister was pulled from another ward almost every day, and all of the staff we came into contact with  appeared to be agency or bank. 

When my granny was admitted to ward 306, she was mobilising with a frame.  We were told by two doctors of the importance of her regularly mobilising to avoid permanently reduced mobility.  Granny was mobilised only once during her week on this ward - the rest of the time she was left in bed.  When we queried this we were given a variety of stories - she couldn't safely sit in a chair; she was waiting for a physiotherapist review; the physiotherapist had been but she was asleep; she was aggressive so they couldn't get her up.  Granny has no history of aggression and the nurse and I reviewed her notes together and nothing had been documented - there was also no documentation of the physio having reviewed or attempted to review her.  I mentioned to the nurse that aggression would be completely out of character for my granny, who said although this wasn't documented, they had heard this from another nurse, and I would be better off accepting that people can change behaviour when they are unwell than being in denial.  In any case, she was left in her bed for a week, and can now no longer mobilise.  The care home she has been moved into have been working hard to undo this and had her sitting in a chair within a day of arriving.  

On arrival to ward 306, my granny would occasionally leak a little wee when she stood up, so wore pads.  The staff on this ward reported that she is doubly incontinent, and gave my mother a pair of trousers of hers which were full of faeces - not just staining, but lumps of actual faeces.   It appears she had not been put in knickers or given a pad.  We explained that granny has never been incontinent, and were told that things change.  When we visited granny, the woman next to her complained they weren't getting the toilet access they needed.  On visiting my granny, she smelled very strongly of urine. We spoke to the nurse and asked for her to be washed, but it is not clear that this would have been done if we hadn't raised it. One day she wasn't dressed at all, but in a hospital gown; when this was raised, she was put into a nightie for the whole day. My granny has always been dressed during the day and placed high value on being smartly dressed.  This ward cares only for elderly women (at least it did when my granny was there), however the healthcare assistants were male.  I know my granny would have preferred her personal care to be carried out by a female member of staff and although I understand there are staffing difficulties across the NHS, I do believe this would have helped the patients to retain their dignity. 

During granny's time on the ward we became increasingly concerned that she was not being given safe, quality care.  I asked to speak to the ward manager and was told that was not possible as she was busy.  I offered to wait and was told she was 'busy in her office, with deadlines'.  I hope the hospital management are aware of this situation and taking urgent action to ensure high quality, safe and compassionate care is provided to this vulnerable population.  We would welcome the opportunity to discuss this experience further in the hope it can help other patients.