Decision Report 201604316

  • Case ref:
    201604316
  • Date:
    July 2017
  • Body:
    Grampian NHS Board
  • Sector:
    Health
  • Outcome:
    Some upheld, recommendations
  • Subject:
    admission / discharge / transfer procedures

Summary

Mrs C complained about the care provided to her husband (Mr A) from Lochhead Day Hospital, which is a specialist assessment unit for people with known or suspected dementia. Mrs C complained that she was not adequately consulted about the decision to discharge Mr A. Mrs C also complained that no alternative day time care was offered to Mr A following his discharge.

During our investigation we took independent medical advice from a psychiatric nursing adviser.

The adviser considered that it was reasonable that Mr A was discharged from Lochhead Day Hospital, due to safety concerns. We did not uphold this aspect of Mrs C's complaint. However, the adviser considered that there was an unreasonable failure to involve Mrs C in agreeing a follow-up plan for Mr A's care before his formal discharge. Therefore, we upheld this aspect of Mrs C's complaint and we made recommendations in light of our findings.

Recommendations

What we asked the organisation to do in this case:

  • Apologise to Mrs C for failing to involve her in agreeing a clear and effective follow-up plan for Mr A's care before his discharge.

What we said should change to put things right in future:

  • At the point of discharge from a day hospital or clinic, secondary care services should work with primary care services and partner agencies to ensure that there is a clearly formulated plan in place for follow-up care. Relatives and carers should be involved in this in a meaningful way.

We have asked the organisation to provide us with evidence that they have implemented the recommendations we have made on this case by the deadline we set.

Updated: March 13, 2018