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Case ref:201608736
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Date:January 2018
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Body:Grampian NHS Board
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Sector:Health
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Outcome:Not upheld, no recommendations
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Subject:clinical treatment / diagnosis
Summary
Ms C, who is an independent mental health advocate, complained on behalf of her client (Mr A) in relation to community mental health (CMH) nursing care Mr A received after discharge from Dr Gray's Hospital. Mr A took a large overdose of alcohol and prescription drugs two weeks after discharge and said that, without the support of his family, he would have completed suicide. In addition to the complaint about nursing care, Mr A also felt that the introduction of occupational therapy (OT) services prior to his discharge could have benefited him and aided his recovery.
We took independent advice from a mental health nursing adviser. We found that the CMH nursing care offered to Mr A had been reasonable. The CMH nurse had visited Mr A within five days of his discharge, which the adviser considered to be good practice. The nurse had appropriately discussed coping strategies with Mr A and had made sure that he was aware of other sources of support available as they were going on leave for two weeks.
The working relationship with the CMH nurse broke down after they returned from leave. Mr A requested a different CMH nurse, but his psychiatrist referred him instead to OT services. This referral was not successful either, again due to problems in the working relationship. We considered that the aftercare provided by the board was reasonable, although the adviser highlighted some shortcomings in the records, which we fed back to the board. The board confirmed that Mr A was involved in his discharge planning, but there was no evidence to support this. Aside from shortcomings in record-keeping, we considered the CMH nursing care provided to Mr A to have been reasonable and we did not uphold Mr C's complaint.
We considered that OT services would largely have overlapped with the support being offered by the CMH team, and saw no evidence to support the complaint that OT input in hospital would have made a significant difference to how Mr A coped post discharge. We did not uphold this complaint.