Decision Report 201406424

Summary

Ms C complained to us about the medical and nursing care her mother (Mrs A) received at the Royal Alexandra Hospital before her death from heart failure. We took independent advice on Ms C's complaints from a nursing adviser and from a medical adviser who is a consultant physician and geriatrician. We found that the medical and nursing care provided to Mrs A had been reasonable and appropriate. It had been reasonable to catheterise Mrs A, as medication that she had been receiving for her heart failure made her pass urine continuously to try to reduce her excess fluid. It was also important to measure her urine output accurately during this treatment. We also found that the nursing care she received for pain and hydration was reasonable, as was the decision to give her oral and not intravenous antibiotics. In addition, the end of life care provided was consistent both with usual clinical practice and with the relevant guidance. We did not uphold these complaints.

Ms C also complained that staff in the hospital had not discussed a Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) form with her, before this was put in place for Mrs A. The records said that this had been discussed with Mrs A's daughter. Although it was not clear whether this was Ms C or her sister, we were satisfied that the board had acted in line with the relevant procedure on this. We did not uphold this complaint either.

Finally, Ms C complained that the board had not communicated with her properly. We found that the communication with Ms C at this distressing time for her, just before her mother's death, had not met her needs. We upheld this aspect of Ms C's complaint, although we were satisfied that the board had apologised to her for this and had shared their findings with relevant staff.

Recommendations

We recommended that the board:

• provide us with a copy of their action plan to address the failings they had identified.