THE family of an elderly woman who was given a wrongly-assessed treatment plan which said she lacked the ability to make decisions about her own end-of-life care have spoken out – as they believe that it could be happening to others.
Sally Bleasedale contacted the Champion after being send a copy of the Mental Capacity Assessment used to create her mum Ethel Farrand’s Anticipatory Clinical Management Plan. This Plan is created to set out how a patient will be treated in the event of a serious illness or injury.
At the time of the Plan being created, former teaching assistant Ethel, 91, was deaf but had no mental capacity problems and had a very good quality of life living at The Spinney Care Home in Upholland.
She has since passed away from the coronavirus – but her daughter Sally was able to have the Plan dismissed before she became ill, meaning that she was able to be treated in hospital during her final days. She believes that other elderly care home residents may have been given similarly incorrect Plans which could affect their treatment – including whether or not they would be sent to hospital.
The Champion has seen West Lancashire GP Federation OWLS CIC Ltd’s Plan for Ethel, which wrongly states that she was seen in person during the making of the document – but this would have been impossible in April due to the care home’s coronavirus lockdown rules.
The Plan, allegedly made following the face-to-face meeting that did not take place, states that she ‘does not have the capacity’ to decide her treatment for herself. It states: “Ethel has a diagnosis of cognitive impairment (CI) fluctuating capacity and deafness. During an episode of ill health, primary care teams should be mindful that admission to hospital can be distressing for people with CI and that the decision to admit must be based on the premise that the benefits must outweigh the risks to Ethel’s mental stability.”
Ethel’s daughter Sally told the Champion: “Mum had limited vision and after a fall in August 2017, she went to nursing home to recuperate. She stayed as a full-time guest from April 2018.
“The care home, The Spinney, have been wonderful and we have never had a problem with them at all. They rang us to say that mum’s Plan bore no resemblance to her condition at all and asked us to have a look at it.
“I was so shocked. Mum was, at the time – and until the very end - completely compus mentus and has always been able to set out her own treatment plans.
“As she is hard of hearing, I was called by the CCQ who wanted to make a Plan. Me and my brother both agreed that her end-of-life plan would be left to medics.
“It’s disgusting that these Plans are writing off amazing, wonderful older people without due care. If I had not rung up, they would not have sent her an ambulance. Added to the stress and the grief, enough to make your toes curl.
“The report wrongly said that she had seen my mum in person but she has not. It shows a list of questions and ‘responses’ from my mum but she she had definitely not been in to see her as the home was not taking visitors. I am very unhappy about the report – and if they would do this to her, they would do it to others! I reported the Plan to the CQC and to my mum’s GP as well.
“We did not want a specialist plan, just medical advice to be taken – but we just wanted the truth!
“Sadly mum did get the coronavirus, was sent to hospital suffering from pneumonia as well as died on April 11. We were lucky – we were able to fight the Plan and she got the best treatment possible. But how many other people across Lancashire have received this same letter as we have?”
NHS West Lancashire Clinical Commissioning Group (CCG), responded: “The CCG is unable to comment on individual patient cases. Anticipatory Clinical Management Plans (ACMPs) have been in place in West Lancs for some time, and are not a new approach due to the pandemic. They allow clinicians and care homes to work together to understand how a resident would like to be treated in certain circumstances, so that we can carry out medical and nursing care in accordance with their wishes. During the pandemic, care homes are on occasion playing a greater role in contributing to these plans in order to limit footfall into care homes.”