4 April 2011
Dear Mr & Mrs Kinloch
I am writing in response to our meeting on the 2 March 2011 regarding your concerns about the care you received whilst on Ward 16. Firstly may I take this opportunity to thank you for inviting me into your home to discuss the areas of concern that have so very obviously distressed you both. I hope this response will confirm how sorry I am on behalf of my team to have caused you so much distress and to reassure you both that I am addressing these concerns.
I have spoken to the staff nurse that was on duty the night Mr Kinloch was admitted on to Ward 16 and explained how upset Mrs Kinloch was about the reply she received when enquiring after her husband, she cannot recall answering in this manner and expressed her concern that anyone would reply in such a way as to cause so much upset. I will be personally monitoring staff attitude in the future and I will ensure that all staff revisit their Nursing Code of Conduct. They will all be provided with The Principles of Nursing Practice to remind them what patients, families and carers can expect from nursing. I am very sorry that Mrs Kinloch's request for information about her husband's condition was not met with the appropriate manner and respect she deserved.
I have also raised the area of concern regarding why Mr Kinloch was told that all the doctors " have gone home for the weekend" and that he would " have to wait until Monday",As I explained when I visited you at home, there are always medical staff available when needed to review patients regardless of the day of the week or the time of day. Regrettably, it has not been possible to establish who made the comment to Mr Kinloch, I can, however, reassure you that Mr Kinloch's physiological observations were stable during his admission.
As an Acute Stroke Unit, we have strict guidelines about recording patient's observations and escalating appropriately to the medical team for review. It is documented in Mr Kinloch's care plan he did see a doctor on the morning of the 12th April at o5.50am at -his request because he felt everything was moving, 7 the doctor advised to continue with the present management plan. Mr Kinloch was also seen by Dr Chadha on his ward rounds Mondays and Thursdays and daily by his team for review. All medical patients have access to medical reviews twenty four hours a day, seven days a week. I did enquire as to why Mr Kinloch's scan took 9 days to be undertaken; due to the workload and systems in place scans can take as long as this and sometimes longer before they are carried out.
Regarding the used urinals left lining the walls for days I have addressed this with all the staff and told them I will be monitoring this closely. This is unusual practice because the urinals are made of cardboard and would start to disintegrate soon after being used so I am very surprised to hear this, when I am on my walk around every morning I have removed used urinals if I find them after male patients have used them in the night, in general, I do not find many. Our environment audits generally score high, the last one being a score of 91% . We have passed our yearly accreditation for infection prevention and control every year since the scheme started. In general we are very proud of our high standards of cleanliness and I am very sorry that we fell below our usual high standards whilst you were in our care.
The staff were very upset to hear this as they are conscientious and understand the importance of the Hygiene Code within the ward environment. Our infection rates are very low, both the nursing staff and our cleaners have to adhere to strict Cleaning Schedules, We are regularly audited and monitored for our hygiene and the cleanliness of the ward.
I am very sorry that on this occasion you found our standards of cleanliness to be poor. It is unacceptable and I will be monitoring the situation even closer, especially since you told me you were made to feel "Black" because, as you told me, you did not receive help with shaving or any clean sheets and because the floor was dirty. I did discuss the fact that you did not receive a shave with the nursing staff and one nurse recalls offering you help with washing and shaving and help with your meals however she also recalls that you advised her that you were fine on your own despite having some weakness so she advised you to ring the call bell if you needed help and she would assist you
Mr Kinloch also explained that he was distressed after being called a "dirty, disgusting man" following a choking episode. Mr Kinloch explained that he was not treated with any compassion by the nurses present and also explained to me that the food that he choked on landed on the floor and was not cleaned up. Regrettably it has not been possible to establish who made this remark in such an uncaring, unkind manner, nor why the food was not cleaned up,
I have addressed these kinds of unacceptable attitudes with all my staff and explained the seriousness of such actions. I believe that the staff were very upset and expressed their concerns about the situation especially the impact it had on Mr Kinloch. I must advise that this is very unusual practice but wish to reassure you both that I will be monitoring both staff attitude and standards of care very closely. I cannot express how sorry I am for the attitude of the nurse during a night shift who, as you described, "Insinuated" that you "liked a good time" and subsequently as you described to me went on to behave in a totally inappropriate manner towards you. Unfortunately, I cannot follow this up without some sort of description of the nurse or times/dates of the occurrence. Mr Kinloch told me during my visit with Denise Gardner that he was blind when it happened so he could not describe the nurse or the young "nurselette" who accompanied her. As Denise Gardner explained these are serious allegations of harassment and unless I have a description of the said nurse unfortunately I cannot follow this matter up.
Mr and Mrs Kinloch I can only convey my sincerest apologies for the poor standards of care you received whilst on my ward. The main areas of concern being communication and cleanliness. Outlined below is the action plan I have put in place. I will be monitoring it very closely to ensure the same things do not happen again to any other patient in our care.
1 Staff to receive copies of the NMC Nursing Code of Conduct and the Royal College of Nursing "Principles of Nursing Practice"( copy enclosed)
2 Revisit at each weekly team brief the implications of poor attitude and the impact it can have on patients/relatives by sharing experiences like yours.
3 As ward manager, I will constantly remind staff of the absolute importance of giving patients and relatives the information they need in a caring, compassionate manner.
4 Ensure all staff are aware of how vulnerable patients/relatives are whilst in our care and that they all should be treated with the upmost respect and dignity.
5 I have fed back your comments regarding being laid in vomit to the matron responsible for the area where this occurred and why Mr Kinloch's notes did not accompany him on transfer to Ward 16. On speaking to a Sister from MAU, she explained that sometimes the doctors are still completing the medical notes so they do not accompany the patient to the ward at the same time as the patient.
Once again I would like to take this opportunity to thank you for sharing these experiences with me and reiterate how very sorry I am to hear that the treatment and care you received may have fallen below our usual high standard and has caused both of you so much distress and concern I hope this letter has addressed those concerns.