Overview
The complainant (Mrs C) raised a number of concerns about the prescription of antipsychotic drugs to her aunt (Miss A) during her admission to hospital in September 2009 and that the prescribing chain of command of the drugs was not clear.
Specific complaints and conclusions
The complaints which have been investigated are that the Board:
- (a) wrongly prescribed haloperidol to Miss A from 15 until 25 September 2009 (not upheld); and
- (b) failed to provide clarity surrounding the prescribing chain of command (not upheld).
Redress and recommendations
The Ombudsman recommends that the Board:
- (i) carry out an audit of their practice on implementation of the Adults with Incapacity Act with particular reference to consent and report to the Ombudsman on the findings;
- (ii) amend its guidance on managing patients with delirium to include the requirements of the Adults with Incapacity Act;
- (iii) share this report with staff to ensure they complete documentation properly and meet the communication needs of patients with cognitive or sensory (or both) impairment; and
- (iv) apologise to Mrs C for the failures identified in this report.
The Board have accepted the recommendations and will act on them accordingly.