Bute couple ‘let down by care services’

THE NHS has issued an unreserved apology for the poor quality of treatment and care given to an elderly Rothesay couple who died in the Victoria Annexe last year.

But Tom and Jennie Robison’s son says he is not satisfied with Argyll and Bute Council’s apology for its part in events leading up to his parents’ deaths in January and April 2011 – even though the authority has admitted, via its own internal investigations, that the care provided was found seriously wanting.

The Robisons’ son, Tommy, has spent almost a year since his parents’ deaths seeking assurances that lessons have been learned from the high profile investigations into the case, and apologies from both the health service and the council for the poor quality of care they provided and the distress caused to Tom and Jennie and the family.

Mr Robison told The Buteman that his parents’ health had been failing for some time - but that an incident in November 2010 left him seriously concerned at the quality of care they were receiving.

“My parents were elderly, and had received a care package from the council in recent years,” he said.

“I was happy with that package, but I knew my mum and dad were ailing. They both had a history of falls, and I was trying to coax them into agreeing to leave home to go into care.”

On November 20, 2010, Mr Robison travelled to Rothesay with his wife and their then three-year-old son. But as soon as they arrived at his parents’ home in Auchnacloich Road, it was clear all was not well.

“We immediately noticed things were not great,” he continued.

“Both my parents were agitated, and we had fears that my mum might have suffered a transient stroke.

“Both my parents had zimmers, which they were instructed to use. However, I noticed there was only one zimmer in the room where they spent most of their time, and it was out of reach in the corner of the room.

“There were two carers in the house when we arrived, and when I asked where the other zimmer was, one said it was in my parents’ front lounge, as far away as possible from where they spent their waking hours.

“That’s a bit of a distance away for both my mum and dad, so I asked why it was there, and she said my parents weren’t to use their zimmers - contrary to a condition of my father’s earlier hospital discharge.

“My dad was aged 94, and my mum was 88, so I asked what they were supposed to do when they needed to go to the bathroom in between carer visits. I was told they’d been given ‘bowel control advice’.

“I told the carers exactly what would happen if my parents couldn’t use their zimmers - they would need to go to the bathroom at some point, they would fall down, be taken to hospital, get patched up and sent back home.

“They would need to go to the bathroom and they, and the NHS and care services, would end up going round in circles again.

“Within 40 minutes of the carers leaving, that’s exactly what happened, and I had to call the carers to ask them to return to help them, such was the level of their distress and agitation.”

Less than a week later, Jennie Robison was taken to hospital after being diagnosed with a urinary tract infection; she never left, and died on April 5 last year.

By then, Tom Robison senior had also died. Only a week after his wife was admitted to hospital, he fell against a fireplace at home and was taken to hospital, before being stitched up and sent back home with instructions to his carers that he should not be left alone - instructions which his son says were not adhered to.

The following Monday his carers found him in bed, vomiting blood; he was taken back to hospital, where he died on January 3 last year.

Tommy continued: “Subsequent to my parents’ passing, the complaints I raised have been successfully dealt with by NHS Highland, who have taken appropriate actions to address their shortcomings and have implemented rigorous changes to their policies and procedures across the NHS, not just on Bute.”

As a result of a ‘critical incident review’, the results of which were published on September 23, 2010, Derek Leslie, the chief executive of NHS Highland’s Argyll and Bute community health partnership, wrote to Mr Robison to apologise.

“Their apology was very powerful and very emotive,” Mr Robison told us. “They said their review ‘clearly documented a number of shortcomings in regard to the care and treatment provided to both your late parents’, while Mr Leslie put on formal record his ‘deepest condolences...[for] the stress and emotional trauma which resulted to your family’.”

In his written apology Mr Leslie said it was ‘clear that on this occasion there have been a number of shortcomings in the quality of care you, and more particularly your late parents, have a right to expect’, and gave Mr Robison an assurance that lessons had been learned and implemented accordingly.

However, Mr Robison also told us that despite taking the same concerns through Argyll and Bute Council’s complaints process, the authority had not given a satisfactory apology for the poor standard of care its staff gave his parents – and, through its own investigations, had uncovered conflicting evidence about what happened on November 20.

“With regard to November 20, I have pictures to show my dad’s zimmer was in the front room of their home,” he said.

“I’ve sworn an affidavit reflecting the events and conversations with the carers that day. 

“Despite this, the carers deny the zimmers were anywhere other than by my parents’ chairs, as part of their at times contradictory evidence during the internal investigations.

“The NHS has investigated, apologised and put changes in place and, in my view, has come out of the matter really well – but the council has not.”

The authority has said sorry for misleading Mr Robison during its complaints procedure, and for “any distress caused to you and your family in taking forward your complaint”.

The council has also issued a series of ‘learning points’ to its health and social care staff as a result of Mr Robison’s complaint, but has not specifically said sorry for the content of an email sent by a staff member on November 23, 2010 which, according to Mr Robison, “said they should be talking about good news stories” at a time when, for the Robison family, the news was anything but good.

The authority’s executive director of community services, Cleland Sneddon, wrote to Mr Robison on December 22 to “extend an apology on behalf of the council for the issues that emerged as a consequence of our internal investigation”.

But Mr Robison told us he still wanted appropriate apologies – both from the appropriate senior official for the distress caused to his parents and the family as a result of the standard of care their employees provided, and from the employee who sent that inappropriate email.

“The council seems incapable or unwilling to say sorry for the stress that they put us, and my parents, through, or to properly investigate what happened on November 20,” he continued.

“They also seem clear in their intent to avoid moving to the final level of a complaints review process, given the publicity and outcomes that is likely to attract.

“I feel there’s a lack of responsibility and a lack of a duty of care. Why haven’t they apologised and got to the bottom of what they know has been wrong?”

We put Mr Robison’s concerns to Argyll and Bute Council, whose executive director of community services, Cleland Sneddon, told us: “I have sent a letter of apology on behalf of the council to Mr Robison assuring him that lessons have been learned.

“We are sincerely sorry for any distress caused to Mr Robison and his late parents.”

That, however, has failed to satisfy Mr Robison, who added: “I continue to campaign for justice for my late parents, acknowledgment and apologies for the stress that the shortcomings have brought to my family, and as importantly, to help avoid current and future elderly people, which one day might well be us, being subjected to an equivalent set of circumstances.

“If Mr Sneddon has issued an apology, it is to The Buteman, and not to me – it is also far too little, far too late.”