King's Mill Hospital 2023-12-23 Person 1 5 0

13/10/23 Mother admitted to KMH through A&E 14/10/23 Admitted to EAU where I spoke with nurse, raising the fact that she was confused and did not recall what had happened, explained more about home circumstances 17 or 18/10/23 I spoke at length with the advanced nurse practitioner on RSU, explained alcohol use, explained not eating properly, home circumstance, also discussed my concerns with mental capacity, also stated I have raised mental capacity as an issue during the September admission and the July admission. Between 17/10/20 and 26/10/2023 every time I visited, which was virtually daily, I spoke with a nurse in RSU, regarding what my mother was eating, how she was, what was happening, mental capacity and confusion. 22/10/23 I raised a concern on the ward that my mother's right leg was massively swollen and hot. A nurse had a look and called a doctor. The doctor assured me it could not be a DVT as she was taking blood thinners, at that point I mentioned that she has been taking blood thinners for the past ten years and had just been admitted with further PE’s. I would expect that to be known, especially on RSU. A scan was carried out in the following days and the kidney abscess was discovered. 26/10/23 I had a discussion with the doctor and a consultant from Urology and it was agreed that the move to City would be made for the draining of the abscess as it would be safer. During the stay at City Hospital (26/10/23-02/12/23) several CT scans were performed, and I was informed that a DVT had been discovered in the right leg and further PE’s. I had also seen notes written during the stay in City where I discovered that my mother was now doubly incontinent, her mobility was diminished, and she was periodically still using oxygen. 03/12/23 I visited KMH, ward 31, where I found my mother to be disoriented, unaware of her location, still not eating properly. I wrote a list of the menu items she liked, with her input to attempt to stop her living off two bowls of tomato soup every day. My mother was in bed, at 3pm, and clearly confused. 04/12/23 I received a telephone call from a physiotherapist who informed me that my mother was up and walking about and he was going to arrange for a second frame to be available for her use upstairs at home, he said she was completely aware of her surroundings, breathing was fine, and she was good to go home. I rang the ward, where I could not get an answer regarding the DVT and PE’s and was passed on to the Discharge team, after a lengthy conversation, where we both were bemused at the sudden and momentous change in health and mobility, it was agreed (reluctantly on my part) that discharge would be set for 07/12/23. The lady in Discharge was not made aware of the continence issues, so the proposed two daily visits were not sufficient, so four were to be arranged. That evening I contacted PET via email, where I raised several issues. 06/12/23 I had a lengthy conversation with Selwyn from PET, the proposed care provider rang me after that call, where I discovered, yet again, that not all information had been passed on to them. 07/12/23 I spoke to Lisa on ward 14, who said that discharge was unlikely as there were outstanding issues regarding treatment and care. Discharge failed. 12/12/23 As of today my mother is still in KMH, still doubly incontinent, has finally had a mental capacity assessment, which resulted that her capacity is diminished quite measurably. I have lost count of the times I have had to repeat her history. I have a real concern that without the amount of time and effort I have expended, having the same conversation virtually daily, my mother would be in worse health than she is now. I have repeatedly questioned her nutrition and every time I am there at either lunch or dinner another bowl of soup is delivered. I estimate her current calorie intake is under 500 calories a day. I sincerely believe she is at risk of malnutrition and further health complications after 9 weeks of an extremely low intake. I would be incredibly happy to be proved wrong in this matter if I could be provided with food intake charts or any documentation proving otherwise. NHS England have long since published guidance around nutrition and hydration, indeed, the guidance states that under the Care Act (2014) nutritional needs should be taken into account, particularly if physical or mental health is, or is at risk of, deteriorating (section 3(2)(a)). Since admission, a mental capacity assessment has found an issue, and my mother is now doubly incontinent. Those issues alone prove a deterioration in her mental and physical health. Every nurse, doctor, consultant, and HCA I have spoken to have been exceptionally kind and helpful. My frustration is there seems to be a complete breakdown in communication, either the staff have no time to read notes and digest what they are reading, or notes are not completed fully due to time and staff constraints. Something must change to create a more cohesive structure, especially when patients are changing wards or hospitals. This is where patients fall through the cracks in the system and without having someone to advocate for them are left in potentially dangerous, if not life-threatening situations. I wish to make it clear that this is not a concern or complaint against any staff member involved in the care, but it is a concern about the process and procedures which could lead to a complaint in the future. The response I wanted was an MDT but have been stone walled at every opportunity, we are now at three failed discharge attempts and they seem hell bent on discharging before Christmas I was informed today my mother has COPD by telephone but no further information was forthcoming