Mrs L’s entry to the ED and ward
17. Mrs L says she is unhappy as she accompanied Ms U in the ambulance to hospital but when she arrived at the ED, staff told her she could not enter due to COVID-19 visiting restrictions. She says staff later told her she could not go onto the ward with Ms U. She says this is wrong as Ms U lacks capacity and needs a familial carer with her.
18. The NHS guidance says patients may have a carer, relative or escort where appropriate to assist in communication and to meet their health needs.
19. On 4 November 2020, the Trust released a press statement saying it was restricting visiting in all its hospitals due to an increase in COVID-19 cases in the local community and in the hospitals. The statement says the aim of the policy is to reduce the spread of COVID-19.
20. The statement says there are exceptions to this rule which includes carers to patients with learning disabilities. The statement says a nurse in charge will decide and authorise admission for carers.
21. The evidence available to us shows indications the ED staff member was wrong to refuse Mrs L admission to sit with Ms U. There are indications the ward nurse was wrong to tell Mrs L she could not enter the ward to stay with Ms U, following her admission.
22. We are pleased to see staff eventually allowed Mrs L access to the ward to stay and care for Ms U, but there are indications the staff should have allowed her to accompany Ms U when she arrived at the Trust.
23. In its complaint response, the Trust admits its staff were wrong to refuse Ms L admission to the ED and says the nurse was wrong to tell Mrs L she could not enter the ward and stay with Ms U.
24. Before we decide if we should investigate a complaint, we look at whether there are signs the events complained about had a negative effect which the organisation has not put right.
25. We can see the Trust has a done enough to put right the impact of these events, in line with our Principles of Good Complaint Handling and Principles of Remedy.
26. We acknowledge the Trust’s actions caused Mrs L and Ms U unnecessary distress and we acknowledge Mrs L’s concern about Ms U’s wellbeing if she visits the Trust again for care and treatment.
27. However, we think the Trust’s response goes far enough to address her concerns and distress and provides assurance this will not happen again. This is because it acknowledges what went wrong, apologises and outlines what it did at ward level to prevent it happening again.
28. We are pleased to see the Trust’s speciality nursing staff put an alert on Ms U’s electronic records to say she must have a familial carer with her. This should make all staff aware of Ms U’s needs when she visits the Trust in the future.
Staff waking Mrs L and rudeness towards her
29. Mrs L says the nursing staff continually woke her up during the night to tell her that they were taking Ms U’s physical observations. She says there was no need for the staff to do this as the equipment was on the other side of the bed (contrary to the complaint response which said she was in the way of the equipment).
30. In her complaint form Mrs L says the nurses were rude to her throughout the night and showed no interest in the fact their approach to the visiting policy may cause Ms U distress.
31. We understand Mrs L wanted to rest. We acknowledge she feels the staff were rude to her and could have avoided waking her up. We understand it was a very difficult time and she was tired after providing care and support to Ms U.
32. We cannot say if the ward staff could have taken observations from the other side of the bed or avoided waking up Mrs L.
33. The clinical observation forms do not ask staff to record the location of the equipment or the side of the bed the staff take observations from.
34. Even if we could say the staff should have taken Ms U’s observations from the other side of the bed, we cannot say conclusively that this would have prevented Mrs L from waking up. The Trust admitted Ms U to its emergency assessment unit which is likely to be noisy at times given the nature of the ward.
35. Although we recognise this situation was upsetting for Mrs L, we are not critical of the ward staff for waking Mrs L. This is because there is no debate about whether the observations were necessary, and their focus was Ms U. We do not think it would be possible for staff to guarantee performing observations so quietly they did not wake a visitor.
36. The medical notes do not contain any account of a dispute between staff and Mrs L. There were no staff witness statements taken at the time of the events that we could rely upon.
37. We accept Mrs L’s account that she felt staff were rude to her. This was a difficult situation, and we understand she was not happy with the communication towards her.
38. In circumstances like this, it is difficult for us to say with certainty what happened, and even when we know what was said it can be hard to determine whether a staff member was intentionally rude. Because of this, we have decided we cannot say there are any indications anything went wrong.
39. In summary we have decided not to take any further action on Mrs L’s complaint.