BEREAVED families in Dudley have told of the heartache suffered at seeing elderly and vulnerable hospitalised relatives discharged with no choice whatsoever to poorly rated care homes to free up hospital beds.
The Dudley Group has been operating a ‘no choice’ policy when discharging bed bound patients in need of nursing care.
The policy, a national directive, has seen the trust sending frail patients deemed medically optimised but unable to go home to facilities anywhere in the Dudley borough or in neighbouring authority areas.
Patients from the Dudley borough have been sent to homes in Sandwell, Wolverhampton and Birmingham - sometimes without the consent or knowledge of their relatives or Lasting Power of Attorney representatives.
The large Advinia Health Care-run Ryland View Care Home in Tipton is among homes that have hosted ‘discharge to assess’ beds. The facility has a ‘requires improvement’ rating from the CQC.
Select Healthcare Group’s Island Court Care Home in Coseley has also been used to accommodate vulnerable pensioners in need of care upon hospital discharge.
This home too has an overall ‘requires improvement’ rating and Dudley Council temporarily suspended the service to new users due to safety concerns.
Stourbridge man Anthony Gardiner, whose mother was sent to the home after a spell in hospital, has told of the suffering she and he endured during her stay there.
Mr Gardiner, who runs SAS Blinds in Wollaston, said visiting was difficult as many Covid measures were still in place at the time from mid-2021 onwards and his mother, who had diabetes and dementia, was not given chance to mobilise and suffered scalding from a hot drink.
He said she was also found to be “very dehydrated” when admitted to hospital again in her final weeks.
Mr Gardiner, who has been left traumatised by the experience, said: “She went in a strong woman and came out a broken one.”
And after a final discharge to a facility in the Kidderminster area, she sadly passed away.
Mr Gardiner said care provided at the last home, The Shrubbery, was excellent but by this time his 90-year-old mother (pictured) only had weeks left to live and she died on June 11, 2022.
READ MORE: Man haunted by elderly mother's care "hell" in final months
He said: “She gave up. The damage was done. It’s a human life at the end of the day. Mom had dementia but there was never a time when she did not know us.
“To go through what my mom went through, it broke me as much as it broke her.
“I believe it contravened the Human Rights Act passed in 1998.”
He told how he’d been contacted by the CQC to give his view of care provided at Island Court, which is rated ‘inadequate’ in relation to whether services are safe, and he said: “All homes should have that same impeccable standard.”
Another man from Dudley, who asked not to be named, told how his mother, who had been living with dementia in her own home in Coseley, was discharged from Russells Hall Hospital to Ryland View.
He described his mother’s stay in Bloomfield House at the facility as an “absolutely horrific experience”.
He said he tried to get his mother back home but by the time a care package was secured she had declined to such an extent it was not viable.
She later passed away, aged 87, in March in a different home not far away which he said was “wonderful” but he felt by the time she settled there “the damage was done”.
He said he felt his mother was “treated so badly” during her final chapter and the whole experience left him “so drained”.
READ MORE: Dudley man 'broken' after mum's 'horrific' care home stay
Another family from the Dudley borough told how they pleaded with hospital managers not to send their loved one with dementia to Ryland View - out of her home borough and eight miles away from relatives and her home.
The pleas fell on deaf ears, however, and the woman was sent to the facility against the wishes of her representatives with Lasting Power of Attorney.
Less than three weeks later the 75-year-old mum-of-two was readmitted to Russells Hall Hospital with suspected pneumonia, a dangerously high heart rate and dehydration.
Five weeks later she was discharged again, with the family given a choice of two homes – both of which had a ‘requires improvement’ rating.
They selected one just over the Black Country border in Worcestershire, which they felt would be more suitable, but she died three days later of sepsis due to an infected bedsore.
A relative, who did not wish to be named, said: “You hear so much talk about bed-blocking and ambulance delays and the need to discharge those hogging beds who are ‘medically fit or optimised.”
“The reality, however, is many of those patients are in the weakest and most vulnerable condition of their lives and sending them to any old facility anywhere with no thought for the impact on the patient and their family is not just robbing that person of their dignity and choice in what may be their final chapter but it’s also putting a greater burden on the NHS.
“Numerous patients, it seems, have found themselves readmitted to the very beds they were swiftly evicted from.
“We finally got mom into a facility that we know she would probably have chosen but she was too poorly to benefit from it. It was such a distressing end and could have been avoided if the hospital’s discharge team had worked with the family to find a suitable and safe plan for mom when she was discharged the first time.
“Mom was such a lovely, caring person who worked as a carer herself previously - looking after elderly people, and she deserved to be treated so much better than she was in her final weeks.
“The system is broken.”
The Dudley Group would not confirm in a Freedom of Information request how many patients have been discharged to nursing beds, via what’s called a pathway 3 discharge, without being given a choice, since the ‘no choice’ policy was introduced when rules changed due to the Covid pandemic.
Dudley Council has provided figures showing there have been more than 1,596 discharges of Dudley patients sent to pathway 3 nursing beds since 2020 – from hospitals in the area (not just Russells Hall).
In 2020, there were 376 hospital discharges where Dudley patients went directly to nursing facilities after a hospital stay; in 2021 and 2022 there were 519 and 422 such hospital discharges recorded respectively; and this year 279 discharges to pathway 3 nursing beds have been recorded since January 2023.
The Alzheimer’s Society has called for national and local discharge processes to work for people with dementia to ensure people do not stay in hospital for longer than necessary and that they are discharged with the right information, advice and after a holistic assessment of a place of their choosing and with the appropriate onward care and support in place.
The society said it recognises people with dementia can experience discharges that are inappropriate, unsafe, and untimely.
A spokesperson for the charity said: “This can lead to significant challenges, both for people and their families, as well as the wider health and social care system.
“These challenges can include physical and mental deconditioning, hospital readmission and premature admission to care home.
"We want to see better data collection and sharing, alongside greater involvement of the voluntary sector to support discharge, and guidance on leaving hospital that enshrines patient choice and recognises the specific needs of people with dementia and their carers.”
The Dudley Group said of its ‘no choice’ policy of discharging patients to care homes of its choosing: “The Dudley Group NHS Foundation Trust have adopted a ‘no choice’ policy for patients who no longer need to be in hospital but may need additional support or care in the community.
“The policy is a national directive and allows us to discharge patients to a place of safety when their preferred place of care is not available. We provide a sustainable alternative until long term care plans can be implemented.”
In a statement, trust chief executive Diane Wake added: “Patient safety and patient care is of the utmost importance to us and ensuring patients and their families are involved in the decisions around their discharge and if necessary their next place of care is something we work with our partners to make happen safely and effectively.
“Ensuring our patients do not spend any longer than necessary in a hospital bed where their independence could deteriorate is vital, as is making sure space is available for us to provide urgent and planned care for all.
“All patients who need care after hospital are assessed and placed in the most appropriate place that can cater for their complex care needs and we aim to do this as earlier as possible during their stay in hospital. Every effort is made to ensure factors such as personal circumstance and distance are always reviewed and considered during this process; however, aspects such as bed availability and the ability of the home to meet the needs of the patient are also important.
“At the point of assessment, families or next of kin are always notified prior to any discharge taking place to ensure all reasoning can be heard.
“We work tirelessly with our partners in primary care and local authority to ensure patients are transferred to the most appropriate place available.”
Dudley Council confirmed a suspension preventing the admission of new residents to Island Court was lifted earlier this year after improvements were made.
Select Healthcare Group, which runs Island Court Care Home, did not comment directly on the claims made about Mr Gardiner’s mother but said in response to concerns raised: “Island Court Care Home has moved on from previous CQC inspections and has met all requirements.
“Island Court works with both the local authority and Integrated Commissioning Boards to ensure compliance with regulations.
“The home has involvement with all multidisciplinary teams within the borough to ensure that safe, effective, responsive care is being delivered to all persons who reside within the home.
“Island Court has a positive impact on the lives of people who reside there and this has been evidenced in positive feedback from stakeholders.”
Advinia Health Care, which runs Ryland View Care Home, said the home does not currently have a contract for ‘discharge to assess’ beds with the Dudley Group NHS Foundation Trust” and that the company does not comment on individual residents - past or present.
A spokesperson added: “The current CQC rating of the home is over two years old and in the intervening time the home has been through a change of senior leadership and undergone a full review of governance, training and systems.”
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