DOCUMENTARY EVIDENCE

Thesecopy documentsevidencethe differencebenveenElderholme'sstatementsandreality.

Doc. I NHS letter dated Ilft July 2011

a) The matrontold the GP shehad a complaint from the dietician that I had interfered,and confirms in her statement:" The
r*any specialist nulses that visited Mrs Bed&rus orten ma& verbal complaints to Elderholme staff about Mr Beddows
behqviour/demmdsetc." The NHS Head of the Dietetic Serviceandthe Head of the ContinenceService"the GP and the NHS
CHC Managerhave sinceconfirmedin writing that noneof their staffhad madeany complaintsaboutme. SeeNHS letter I le
July2011.

b) The matrontold the GP that the Continencenursehad complainedthat I had stoppedher from removingmy wife's catheter.
TheHeadof the ContinenceServiceconfirmsthat no suchcomplaintwasevermadeaboutme. SeeNHS letter 11* July201l.

e) The matronwrites '? csn stste that we neverhad or rqised a concemthat Mrs BeddowswasTns.singtoa muchurine. " The
matron statesthat the GPsstatementto this eflect is "irxrccurateandmisleading". NHS recordsshowthat Elderholmedid raise
sucha concern.SeeNHS letter I t ft July 2OI I .

Doc. 2 Minutes of Meeting l2ftMay 2009

Theseminuteswritten after the meetingand agreedby the GP were sentto Elderholmein 2009 and alsoto CQC.Elderholme's
statementswerewritten five yearslater. Theseminutesshowthat Elderholme'sstatementsbelow arenot correct.

a) The matroncomplainedto the GP that I was insistingon three staffto transfermy wife. The matronnow states"At no pint
did I "complain" to the GP aboat tlrs". Both the GF and I confirm that shedid,canfirrnedin the minutes.

b) Matron "I nevermadethe statementto GP that Mr Beddows'permissianwss required beforestaffconld contactthe GP."
Both the GP andI confirm that shedid, confirmedin the minutes.

c)" I disagreewith GP whenhe saysI talheddown to Mr Beddowsand I was not aggressive,anly assertivein my manner.The
aboverecollectionof eventscan be confirmedby other qualified nursesas to sn accaratedescriptionof the meeting.The other
nurseswere not at the meeting.Both the GP andI confirm that shewas, confirmedin the minutesand also in the NHS letter of
1Ifr July2

d) * lVe have no recollection, htowledge or docamentedevidencethat the cantinencenarse camplainedthat she wsnted to
removeMrs Bed&ws uqra pubic catheterond thqt Mr Beddowshd stoppedher. To the bestof rny fuuruIedgeno comments
were madeto this efiect by ar4toneat Elderholme.Both the GP andI confirm that shedid, confirmedin the minutes.

e) "To the bestof aur knowledgeat na point did Mr Beddowsdisagreewith this dressingandwe neverreportedthat he had. Is
GP refenrng to me when he says "she also told me". If so I did not say this to GP. Both the GP and I confirm that shedid,
confirmedin the minutes.

f) GP: HW informedme that Mr Beddtmshsd beeninsisting on threestaff to transferhis wife

Matron: " At nopoint did I "cntplain" to Dr. abozrtthis". Both the GP andI confirm that shedid, confirmedin the minutes.

Doc. 3 Noteson meeting28e October2009

Matron: * Wehsve no reeollection,lmowledgeor dacumentedevidencethat the contifterrcemtrse complainedthst she wanted
ta removeMrs Beddowssuprapubic catheterand thotMr Beddowshad stoppedher. To the bestof my knowledgern comments
were msdeto this effectby anyoneqt Elderholme". Highlighted on Notes : " WeIlshetold us different"

Iloe 4 Continencereport
Matron: "In our opinion shedid not needto be cqtheterised.We wrnld appreciatesight of the repart which GP sayshe hasfrom
the continencenursestating that this cathelerisationv'asin Mrs Beddowsbestinterest.It wcrsMr. Bed&ws who wontedier to
remqin eotheterised".This letter provesbestinterests.

Doc 5 Letter from Elderholmedated 23d December2010

a) GP; " I have seenthe letter from EldBrholmewritten sometimeafier the meetingin which they suggestthat checkingMrs
Beddou,swhen giving her medicationfour timesper 24 hrs. is consideredregular enoagh.In my opinion a Wtient in Mrs.
Beddows'conditionin u bedwith detachablesideroils is at risk and checkingfitur timesper 24 hrs. is insufficient.

Mstron: "Neverhos this suggestionbeenmde and is refuted by all Eulifed staff. Wefindwlwt GP hoswritten baffIing md
tomlly unlrae. Mqt we see the letter that we lwve purportedly written". This letter proves the matron's statement is not
truthtul.

b) Matron: *From admissionuntil some time in 2007 fururly docamentedcheckswere not carried out".Matron's statement
conflicts with Dinectarof Elderholme, who writes that "whenDoreenarived (in2}}})hourly checkswithfall docamentation
wererequired"
Doc 6 Letter from Elderholme22d May 2008from Matron Chris Whiteside
Doc 7 NHS Review Nurse Statement; RGN Statement
Doc I Minutes of 30e July meetinggiving reasonsfor hourly checks
Doc 9 List of cuts and photos
Doc 10 Letter from Elderholme 10 June 2010
Doc ll Scheduleof checla

GP: "In March 201I I saw severebruising to Mrs. Beddows'foot'nlhich was unexplainedby staff but was consistentwith
ha$ng beentrappedin theside rails of the bed"

Mstron: "This is actually untrue. GP did not uisitMrs Beddowsin Msrch 201l.Mrs Beddows'big toe wasfound to be braised,
and swollenbut not red to touch on Friday 25" March 201L If at anypoint during her stay GP, Dr.P. (consahant)or the CHC
teamhad given q valid reasonwlry hourly documentedcheckswere needed,we would have of coursecompletedthem.I scid
"will afuays checkhourly".

All documents6 to 11 concernrecordedhourly checkswhich were madepart of the careplan in 2008,butwere always done
without recordingfrom 2000.Therew matronstoppedthemin 2010,Elderholmeclaimingnot to be paidfor them.Thecutsand
bruisesshowthat hourly checkswere needed.The NHS ReviewNurseaskedElderholme to reinstatethem but the schedule
showsthat therewere long gapsbetweenchcks. :

concernthe complaintprocess:www.scribd.comldoc/2345O8123/Complaint-Process
Thefollowing documents

Doc 12 CSCIInspectors MeetingMinutes 1lft June2008:ElderholmeChairmanundertakes to resolveall complaints

Doc 13 Elderholmeacknowledge receiptof Minutesin Doc 2 above
Doc 14 FormalComplaintto Elderholme
Doc 15 Elderholme'sresponseto conrplaint
Doc 16 Noteson resolutionmeetingwith Elderholme.See para10 askingif response
wastheir final word
Doc 17 Elderholmeacknowledge notesreferredto in Doc 16
Doc l8 Noteson resolutionmeetingwith ElderholmeDirectorsDecember2010
Doc 19 and}A Immediatelyfollowing meetingin Doc 18matronmadethis referralto Safeguarding
Iloc 21 Followingmeetingin Decemberl0 whenI advisedinvolvementof MP,Chairof Elderholmesentthis letterto all local
MPs.
Doc22,23and 24 Responses to Doc 21
Doc 25 CopyofDNAR
Doc 26 Minutesof SafeguardingMeetingl lh November2011heldwithout my or my wife's knowledge
 Ch$hfr, Irbrlngton ard Utirral
Clusterref: AMGl1-0$16Beddows Qrr llroE
Localityref: KD/JPH/Beddows/MP021-11 lillldocpml BuskcsFrrt
Yourref: BEDDO1003/01100414/JcG GlcsnallbAu:nr.p
Stodcbnlllrtst
tryrnitgtoa
wA/t6ltt
AlisonMcGovemMP (WinalSouth)
Alison.McGovem.
mo@oarlianrent.
uk *t O15l5l{ 6.m
Fc 0t516fil268t
11Juty2011

DearAlison

Mr Len Beddows,7 Weald Drive,Little Sutton, Ellesmereport GH664yW

I am writingin responseto your letterdated16 May2011with regardto the abovenamedconstitr.pntand

his erquiry regardingthe ElderhomeNursingHomewherehis wife receivescare. pleaseacceptmy
apologiesfor the delayin forwardingthis responseto you.

With regardto the question_s

naisedby Mr Beddowsin his letterto you dated9 May4011,NHSWinal has
liaisedwith MrsBeddows'GP andthe rebvantHeadsof serviceai ttHs wirralandwinat community
NHSTrust. I will respondto the gtlestionsraisedin the orderin whichMr Beddowshas raisedthem.

With rcgardto the questionsrelatingto the Nutrition& DieteticServicethe Headof Servicehas informed
me that:

a) The recordsshowthatElderhome's RGNcontacted the seruiceon 3 March2011concernedabout

Mrs Beddowsfluid intake. I havebeenadvisedthat Mrs Beddowswas receiving3800mlfluidper
day andth RGNfettthis wastoo muchas therewas a highurineoutput. I undlrstandMrs
Beddowsweightwas 67kgandthat ler baselinerequirements weretherefore2013m1.The RGN
wasadvisedby the serviceto give2480m1(1000mlfeed, l000mtadditionalflushes
and4g0ml
from 16 x 30mlflusfrespre/postfuedand medicatbn)and to monitorany detrimentaleffecton
urineoutputand a fluid rcgimenwas sentto Elderhome.
b) lt is confirmedthat_thegnstrostomy tubeneedsto be flushedbeforcard afterthe feed,and this
flushis partof the fluidinput.
c) lt is also confirmedthat it is importrant
and gpod practbeto keepdaily fluid balancerecordsand
lfrb b reguested to be monitored as part of the care plan.
d) The Nutrition& DieteticServicehas nevermadea complaintagainstMr Beddows.

uorthl Togf,fu?-cr|tt|d rrd Erc*n chshl'E. wrntrgbn ternrr oErhrr fid wftrl Ffr
Chdn Hnt(dryonrrilDt
Ch|rfhodtm l#tefiyDoren
 with regardto the questionsrelatingto the continenceservicethe
Headof servicehas informedmeas
follows:

e) Elderhomeadvisedthe continenceservicethattheywereexperiencing
catheterisations difficufthsw1hre-
andwere increasingly uncomfortaule
auoutierrormlni tn" changesat
Elderhome.
f) Therewas a discussionaboulthe possibilityof removing
the supra-pubiccatheterif it was not
possibleto resolvethe problemswithcatheierisations.
i unoersiaruithis rtiscussionis undertaken
with any patientswhosecatheter_is
duringthe discussion, lecomingprobtematic forthem- ihl oinicianrecallsthat,
it was.not.Mr
Beddowi'prebrencefor thecatheterto be renpvedbutMr
Beddowsdid nottry to stopit beingremoved.?he clinicianatsorecalsihat
monitorthe situationand rcmovator tne catheterwouldbe a last it was agreedto
g) with regardto lhe abdominalr*ound, resort
option.
I havebeen-advisedthat Mrbeddowsoia not try to stopthe
clinicianfromsofleningthe wound.
h) The clinicianhasconfirmedthatshe dkl not makea complaint
aboutMr Beddowsbeingpresent
whilethe necessaryprocedurcswerebeingundertaken.'lunderstianJ
\// clinicianhadcontracted in* on turooccasionsthe
Mr Beddowsdirecti to anangea mutualtimefor servicevis1sto
place. take

NHSwinal hasliaisedwithMrsBeddovvs'GP, Dr Meyer,*ill to questionsraisedby Mr

Beddows' Pleasefindencloseda copyof conesponolntie lg-"to the
NHSfoirraltrasrieiveo from Dr Meyerin
responseto Mr Beddows'questions.

wilh regardto the questionsrelatingto the ContinuingCareTeam

I havebeenadvisedby the Headof
continuingcare that Mrs Hurstis no longererproyei gv-rvus
winat. 1,e HeaJof continuingcare has
reviewedthe recordsand liaisedwithoth-ermemodrsof ihe
continuingcare Teamand lcan adviseas
follows:

') ofMrsHurslasking
EHerhome
Nursing
ilISEJ:##:"to Home
abour to Drpinderfor -i(
a refemal
j) lt is confirmed thattheContinuingCarcTeamattendeda meetirgin July2010andthatMrs
Beddows'careplanwas revierared at thattime. I unoerstanaine continuingcare Teamalso
undertooka reviewfollowinga meetingin Novembe r 201O.
*) confirmedthat Mr Beddowshis not madea comptaintabout
ll,iX."'"o rhe medicatcaregivento his

\-' I trustthat the informalionprovidedaPvg answersthe questions

r:aisedby Mr Beddows.lf I can be of
any furtherassistancepreasedo not hesitateto contactme.

Yourssincerely
NFI 5 tnvv5it (6f r-r N f|eP.ta-"J
t l

i , . " r * Tn
-T -[ tt
Kathy Doran Vta1 t 5 5l n . tn el,F.r"l [r'r 'a 5
ChiefExecutive
NHSCheshire, Wanington& Winal t $.lZ',n-1t-ee;.. AFrl> fLE <.rralf f fr ot-r

Erc TFrpii 5 U Ca R fi-Q.t,.ffI fo* A

'TnE
(Ltrsnn-nL Lrra, ,\n) n7
Nt=t1 ArD l$x.tu fLeD r5y ln>D((H dLrh
Wa*lnt loo|d|tr-crnttttmd ErrEn Cl|3tthr. ltr*rfigbn, hi*tt Chrrnfrgldfrlbnrf prce
Ordn ltrrEdryorllDt
Chhf Enorthe * ttafry Oonn
TheWillaston
Surgery
Neston Road, Willaston,Neston,Cheshire,CH64 2TN
Tel:01513274593 Fax: 01513278618

7nJune201I

MrsJanetHope
SsniorComphints Officar
Cheshie,WantmtonendWnal Ctuster
Quayside
\Mtdrspool&rgfiess Park
Greenall'sAvemre
stocktonHath
Wanlqton
WA46HL
DearMt: Hope
Re MP anguiry- AlisonMcGovemMp
Mr Len geddorys.7 WaalctOrive,UflleSutbn. Ellesmerepoft CH6g4yW
Mrs DoreenBoddows.Bdarholrno NursingHome.CHE34Jy

fn rerponso to your conspondnce6 2an May I anr happy to rsspond to th

you encbsdd entitled-Resumsof
gesttols raisedon gage4 of the conespordence
Complainflsection3C"
I can confirm that I was approechdby the Matron ol El,erholmcreguestifrga
meetingbeireen oursetuesetd Mr Beddomb discusslhe difricultieswhichshe ind
the nursingstafrr'vBrexperbncingbecauseof expctationsthat ha had insistedon.
For instancethat h mustbe prcsefitwhanI visitid and that the nursingstaff could
only ask lor visits with his ag'smnt;as I hlt lhis was urreasonaue-t felt that a
meetingwouldbe appropriateard it wasdulysnanged.
I have to be honestt'!at I had expaciedthat Len wouH have been informedof ths
pa91 lor lhe mestingpdorto it but it soonbecameapparsntdwing the metingorat
he did not knowthe rernon th9 meetingat all and so hed no tiire to prege hrs
$
ttnJghb and an$rsr apprcplgtsty, in fairnosshe did extremetywdt. The
meelirg itsefirwg quite inlimilaling?iho,rytr
for nim, especiaflygivenhis hck of preparatbn
and kno$dgp of its rea6on,in that I was pressnlso wJs the Matrcnor Euirtrome
Sbng wdh other senbr nurEsfrom Eloerdrome, t teft that this wag e particutarty
antimidatingsfillg fof Hm , butat th time I assumadthat he had agrred to it , but I
felt quiteuncoffifurtablowithinten mhutesor ao when ?r.esrisecurEtne us nor in
any-ltypreparedfor it' His shocksdreactionvviththe t$o aboveclaimsin perticular
confimedthat to m.
11lad it became apparentdurirq the mseungthet Len had not made such a
slaEmentand.rcally h"_a-n9expectgti,on
ot oein! presntat all my visita,nor even
askingbr nvolvemenlwiththe decisionmakingpocass for E visit
I do accept ldr Beddotr/sstatemedthgt f|e Matronwa6 aggressrveto him in the
sensethat she sal quitecloseto him,inlamJpted him on severaloccasionswithout
enorA,ing
hkn to completehis sentgnes and | f,rouldagrea that she spole do^,n to
D'l ,1i,161.
Drs G fuleyerR l!4.trtin. fui|lassan,C i;rne
wv/wl'vrl;aStolsufgerYrtlrsttk
 him and inCeoctI di
-ld. jnlorvene when he
n.r *"." ti,[-, beeame quite upccl oyer
the accusations
I have lo caVthd Lr
lll his;ii ;;;il il?"lTJ";lffr#l,:Lf''tmefy rwrandrhsrI recosnise
ff ['#'l"ffi
vcry
ffig;m jrumfi n"s,,"s?l'i#ro?nt;i"H*f
Pjs"r
tonorning
accrnare
;ilil;;iffi ii,lT lli_i.t
ilrierncerinsl;il:rftt'*
l Tn * himtutfy*rd hearrrays
notesof anvmeerinss,
he didto rne
"l'iliJJo
Anhe lime t rsad it th
othsrwise
n'*" lherewesonryoneveryminor
Hfllil:;"fffft et*ration
bur
""ry
ffiiffill"Y#,T3.9":: isarmo$
n"r"1.pj_"".rr
wrren r visil.
unbss
onthc
t ?;Jf
ffifrtrHi,id;#lo:?a;
ffiTiljs;hr:,H#::*iffi
I canareoconfirm **irsfr neverbcen
Iturse'oraD,cficianhevemade.ri;fr#"h a singte.instance
inwhictra "continent
al automeEboutMrB(bo,,r6.
f tra.vg
to saythatwer r

*-
ffi#;uflfitme*,,*'ay;,m
,tjg"_.jn"t
ms*frffi
I haw oovaredthe poinre
Intormatbn orclarncation fuflv
rhenpreaie-oi'n;1il,?$"'J" anyrurrher
IH,"T ;T*r
Wilh bst wishes.
 ON TITESDAY I2THMAY 2fi)9
EXTRACTS OF THE MINIITES OF MEETING HELD AT ELDERHOLME

Present: Dr. Meyer - GP to DoreenBeddows

Heather Ward Matron Elderholme
Vicki Wotton AssistantMafion Ederholme
L.Beddows Husbandof DoreenBeddows
A)
clinical personnelincluding the dietician and
Matron openedthe meetingby sayingthat she had spokenwith severalsenior
Beddows was preventing them from nursing noreen as they seefit
continencenurses,who had all expressedeoncernstnaiur.
good-c-are'
ii i"t"tf"*"g io ir"" .urC"od that his Uenaviour_was#rimental to her .O .
diet wfrlenit was arranged on 7thMay'
Mr.Beddows said that Matron had told him that tfre rneetins was about hii wife's
B)
get his permission before contacting the
Matron said that Mr. Beddows had instructed $teff that they must call him and
Doctor and thst he must be present at oll times' i",'Li
than he wants to be advised when the
Mr. Beddows said this was simply not true. He had never given such instructions other
staffthought it necessaryto caUthe doctor in and certainly not before it was done'

not been presenton his visits for some

Dr. Meyer said that he was pleasedto hear it and confrrmedthat Mr. Beddowshad
considerabletime.
c) permanently and go over to psds'
Matron said that Mr. Beddowshad not allowed the continencenurse to take the catheter out
remove the catheterpermanently and had not askedto usepads
Mr. Beddows said that the continencenurse had not askedto
O". Meyer to con{irm that the letter which he had from the continencenurse had not suggested
instead.Mr. Beddowsurt
"O
either permanent removal of the catheteror to resort to nads' ff
mention of pads or taking the
Dr. Meyer conlirmed that the report from the eontinencenurse following her visit made no
catheter out PermanentlY.

D)
thet the
MatrOn said thet the continenCe wanted a sore
nurse wanted
continencenurse catheter to be kept'\ret'
the Crltneter
near Ule
sore near and Mr. Beddows had stoppedher
and said that he did not agree with this and wanted it to scab over'
@
to look at the
Mr. Beddows said that this was untrue. The specialist nurse had explained that she would get tissue viability
sorethen go from there.
E)
whilst she was on
Matron said that she had received a written complaint from nurse John who had put it under her door
by Mr. Beddows-vhohad shouted loudly at John in the corridor in front of
Lo[day.John felt that he was beenvictimised
other staff, that he could not organisea piss up in a brewery i.:,
twenty to two
Mr. Beddowssaid that the argument with John had beenbecausecarers had been available to get his wife up at
Mr. Beddows had asked John why his wife had
but did not do so becausea nurse had told them to leaveher until two thirty.
may be unwell and John replied that he was manager in charge of the flosr and he would
teen t ept in bed thinking she
organisewho got up.
F)
Dr. Meyer said that the nurseshad informed him that the dieticianl4rd criticisms about Mr. Beddows.
\:./
Mr. Beddowsexplainedthat he had never met the dietician and had only spokento her twice on the telephone.
G)
being
Matron seid that Mr. Beddows insisted on there being tlree people present on transfer. He dso insisted on his wife
wery hour and ii leing recorded on the tun*chart.Sire saio that Mrs. Beddows received more care than any other
checked
in intensive
resident in the home and there iere fiflry nine others to look after. Shewould not receive such attention if shewas
car. 1 { I

oa
Mr. Beddows said that the transfer by three people was the result of a note in the Nursing Needs sheetfrom the hospital
transfer to Elderholme and also as aiesult of a risk assessmentthat is in the care plan. Mr. Beddowssaid that the previous
matron had introducedthe hourly checkbecausehis wife could not usethe nurse call systemo-rshout for help.If her catheter
previcus
had bypassedshe could be wet for three or four hours. Her face neededobservationto seeif shewas in pain.Tbe
matron had insistedon all charts being completed.
year.
Matron said that half the peoplein the homecould not usethe call bell and the previousmatron had beengonealmosta
was
Mr. Beddoys said that he bad never overrode a nurse's instructions as otherwise what was the point of being in care. He
plan was met with that was his onty concern.Howcver for the
happy with the standardof care and said that aslong asthe care
he askedthat they agree that three pe-ople
were needed on transfer, his wife is checked hourly,and she is got out
sat e of cUrity
of bed betweenone and two. Vieti saiOtnat they could not guaranteethe timing but would try to achievethis.
Noteson resolution meeting with Matron 28e October 2{XD

On SundayI lft October,after receiving the reply from the directors about my complaint I saw the matron and
said to her that we both disagreedaboutcertainthings but the looserwas Doreenandthereforelet us havea truce
over thesematters.She agreedand said Thankyou.Thenext day I suggesteda meetingto go through everything
and trv to resolve our differencesand see what lessonscan be learnt. Shehad a look in her diarv and said she
would be &ee on 28ft October.

On that day we had a meetingin Doreen's room. I openedit by sayingthat we neededfrst of all to find some
commonground . Sheaskedwhy I was only bringing this up againafter five months - how could sheremember
what was saidthen.

She said the Directors told her to arrmge the meeting with Dr,Meyer after they receivedthe letter of complaint
from John.Mafron saidthat her staff wereon eggshellswitl me due to my involvementwith FARE (the relatives
goup). I pointed out that tle nurseshad their owr group which wrote letters of complaint to the directors.No
comment.

Shedeniedtelling methat the meetingwasaboutdiet.

Shesaid that shewas not going over every point againand sheneversaid that shewantedto restrict my time with
Doreenand sheneversaidthat I was detrimentalto her care.When I had glen her the minutesshehadtakenthem
homeandput yellow lines throughalmostall of it becauseit wasnot hue. I askedwhy had shenot told me this at
the time. No response.

I pointed out that Dr. Meyer wasthe Home's appointedwitness.They recommendedhim to us and he wasnot my
GP but Doe's and I hadnot seenhim for two years.Hehad agreedthe minutes.

I said could we agreeaboutthe complaintfrom the continercenurse.Shesaid that the continencenursehad told
"us" that shewantedto take the catheterout and I would not let her. I referredher to the letter to the doctor by the
continencenurse on 26e Marctr,sixweeksbefore the meeting in which she statedthat shehad told me that she
wantedto re catheteriseDoreenand I agreed.Matronjust said "Well shetold us different''.

I then said canwe agreeon the diotician.The commentI hadbeentold by Tanya wasthat shethoughtthat diluting
the feed was old fashioned.Matron said that the dietician had said to tle nursesthat diluting the feed was no
longer approvedbecauseit meantopeningthe feedbottles.I told Matron that the dieticianshad orderedthis to be
donenine yearsago as a way of getting enoughfluid in to Doreenas shewas vomiting water given to her bolus,
andwhilst they visited every six monthsthey had never alteredit. Staffcould look it up in Doreen'sfiles, I do not
make decisionsabout Doreen's diet. She said that she called the dietician in becauseof the confirsion but I
remindedher that therewasno confrrsionuntil after her call.

We went over Vicki and Johnscommentsabouttoo much water and shesaid that if you had donea flush wit]r t}ts
mds you did not haveto do anotherone. I pointed out that in Vicki's caseshewas showingcarestaffhow to set
the feed up so even ifa flush was not neededthen, she shouldmsntion to them about it being normal procedure
otherwiseit would neverbe done.I said that I had agreedwith Johnto agreeto differ on what hadhappened.

Shesaidthat the staff were also on eggshellsbecauseI was alwayswriting things down.Mahonwas getting more
andmore in a temper just as shehad at the meetingon 12'May.

I explainedhow John and I had cometo have words and that it was threedays after we had both agreedto differ
over what had beensaid aboutdiet. All shekept sayingwas that Johnwas very upsetandthe staffthought that I
was askingthem eachquestionsin the hopeof tripping them up. I pointedout that I was trying to understandwhy
they wantedto reduoethe fluids when they had not discussedit with Doe's own namednurseswho knew nothing
about it. I said that shehad said to the dietician that Doe was passingloo much wine and she said that she had
never ever said that - who said shedid. I told her that the dietician told me and shesaid that shehad never said
that.

I ttrensaidthat the commentaboutneedingto get my permissionbeforecalling the doctor was not fue. Dr. Meyer
confirmedthis and he was their choice,fheir witnessandthey had recommendedhim to us and I had not ssenhim
for over two years.I said that I had not beentold of most of the doctor's visits and had not beenpresentat any of
the last twolve calls. Shesaid that they werebeforeshecame!They were not.I saidthat I shouldbe told when my
wife is ill enoughto call the doctor in.Whenreviewing the careplan in JanuaryI had asked nurseTmya to let me
Lnow when the doctor was to be called in becauseno one hadbeentelling me and I had found out later by reading
the professionalvisits pagein the careplan.

The meetingwas difficult becauseMatron deniedso much of what is minutedandjust kept repeatinggeneralities
about me upsettingthe staff. She admittedthat it was the newly registeredless experiencednurseswho had a
problembut it was all sortpdnow.
 Wirral
PrimaryCareTrust
W'|as f ,gg;uv.4"g,
; r f A f $,r"; f gr# fl.-l*,i ; f rf f ,* ;.i * u # # gw{.: l;

SpecialistNursingCentre
3 Port Causeway
Bromborough
CH524NH
Tel: 01516435330
Fax: 01516435440
Our Ref: JJljcl1113

26 March2009

Privateand Confidential
Dr Meyer
TheSurgery
NestonRoad
Williaston
CH642TN

DearDr Meyer

Re:DoreenBeddows,ElderhomeHomeNursingHome
DOB: 10/03/1945

I visitedtodayfollowinga requestfromnursingstaffat Elderhome

whowereexperiencing
difficulties
withre-catheterisations,
makingthJmincreasingly uncomfortable
about
performing the changesat home.

MrsBeddows was alsoin attendance andI hada longdiscussion withhimregarding the

-myself
catheterproblems.I discussedwith Mrs Beddowspefrorming the re-cath"t.riirtion
whichwouldenableme to moreaccurately assessthedifficulties
and advisethestaff,and
hewasin agreement thatthiswouldbe in Doreen'sbestinterests.
On removalof the cathetersomeresistance wasfelt,butthiswas consistent
previous withmy
experiences of removinga siliconecathetersuprapubically.
On insertionof the
catheterI againfeltresistanceandwasableto advancethe catheterno morethan2-3cm
initially.
Afterapproximately l0minuteshoweverI experienced a relaxation
withinthetrac[
andthecatheterinscnedeasily.

I havediscussed withMrs Beddowsthatthismaypossiblydueto a bladderspamoccurring

butobviously I am unableto statethisas a certainiy.
I feeltrowever,thatalthoughideallywe
wouldliketo insertthe catheterimmediately afterremovalof the old catheter;it maybe more
appropriate thatnursingstaffto waitthistimeratherthanarrangeadmission
occurred to A&Eas has
in the past.I havearrangedwiththe nursingstar tnatmembersof the
continence
Servicewillattendon the nextfew plannedchanges-until staffbecomemorecomfortable
withthe procedure.

Followingthe procedure I cutthe catheteralongits lengthandnoteda smallamountof

mucousonlywithinthe lumenwhichliftedeasily;I havi advisedthe
staffto changeto optiflo
s cathetermaintenance solutionas I notethatboreenwas receiving
longperiodof time.I alsonotedthatstaffwereusinga non-st"rile optifloR solution for a
bed baginserteddirecly
intothecatheter;I haveadvisedchanging thisto a Jterile2litredrainagebag.MrsBeddows

i$: iii 'tlrfl ,i

i'',,r,. I : l. :.ji.i.- r,.j iflqi,Ty; l-,f ,, 1.,'
r,r11'11'';"

'l
f'. r-iOlY:,,'t.Ljt;i.lij,:?r,r.-:,.,L Chairman:Mrs FrancesStreet
Flai;,.: i trr ll
Chief Executive:Ms Kathy Doran OBE
 wirrallffrI3
PrimaryCareTrust
hassomeconcerns thatthe tubing-maybe too longon these,but I havereassured
if thiswasthe casewe wouldlooliforalternatives.- himthat

My mainconcernat thistimewas an abdominal woundMrsBeddowsshowedme;on

examination escharnotedon thewound,whenthiswaslifteda smallamountof pustular
exudatenoted'However, whenI insertedthe instillagel
viathe cystostomy
I clearlyobserved
:9me of the gel exiting
via the wound,
I feeltheretorE tnaittrewoundcouldhavesinused
intothe cystostomy tract.
I contacted MariaHughes(TissueViabilityNurse)for adviceas I was concerned
Instillagelwas thatif the
exitingviathe wound,theexudatecouldalsobe drainingintothe cystostomy.
We discussed usinga hydrocolloid dressingat thistimeto softenthe eschar,hopefully
allowing the exudateto moreeasilydrainviathe*orno; rt't" alsorecommends
eitherGeneralSurgeonsor a referralto
for
-urologists furthetinu"rtii"iions.
I havediscussed withMaria
lugl'": thatit maybe beneficialt6 changeto a silveralisiliconecatheterin the meantime;
sheis in agreement withthis.
I haveenclosed the codesfor the itemsmentioned, if youcouldkindlyprescribethese.
lf yourequireanyfurtherinformation
pleasedon'thesitate
to contactme.

Dover100%SiliconeSilverFoley 16ch Code:6051631C

x2
Catheter
_yp_Ill_e"*p_-k_?g-r-qr-e-r-Matntenancesolution
c ss50
Barddrainabte
neOJiOe"Siq D 8 1 3 1 3 1x 1 0

Yourssincerely

r'lgflUr. O *\s>*'-\b ??J

JennyJehamneh
Continence
Nurse

CC ' t,de.tho.n"ra

TheNHSis Smoke-Free, thankyoufor notsmokingon oursitesandthe Truststronglyrequests

thatyou,yourrelatives
or visitorsdo notsmokewlrilstreceiving
a visitfroma memberof ourstaff.

ffi:;,,""ffirliffili;i":, Chief
Chairman:Mrs FrancesStreet
$ecutivei Ms Kathy Doran OBE
 Elderholme
( L-\rt hRttRfiX;l-.
Irt)$plTAl.{;RouNr}s}

rr*T- CI-ATTERBRIDGE ROAD

BEBINGTON
WIRRAL
&. CH63 4JY

TELEPHONE: r)ti r 33+ {)2ft)

FAX:0t5t 343 t-3t2

Mr L Beddons
7 Weald Drive
Litrle sutton
Cheshire CH66 4yW

23 December2010

DearMr Beddows

Thank 1'oufcr ]'our time u"hen}4e had

a very open discussionregardingthe care plan
1-ouru'ife. for

It appearsto me that *-hen Doreen arrived

at Elderholme her coadition required hourly
checkswith full documentation. since then
her t*, to somedegree,stabilised
and it would appear&om the minutes of the "ono;ii*
*.*ilng *lo iurv 2010 that specific hourly
checks could be dispensedwith so rong as regutar
checks were made.
As Doreeu has medicatigns forl times per
day, then it would appearto me that she is
on a regular basis and if one adds in lier seen
washing,po*nJcare and face creaming
she is seenon a very regular basis. then

Furthermore' you upryT to have agreed

to this change of care plan but aot
medically minded no doubt you have-acomment being
to makJ. If this is incorrectio *y *uy,
shapeor form I would st gg"*t a firrther
meeting with gea*er ward and the Long
care Team is arrangedin order to eradicate Terrn
once and for ail any ambiguity.
Yours sincerely

B Woods
Director

llfRi:cr(-)ltsr:j' rr'': 't h*tutnit,llrslllh,r-,i .-r<ul-'huirnten(,Dr..!.()\'onnttr

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li prrsonageEsq.-f.tr !! Trs+*.S. lfi;i.;,r*.

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f-[ cr \ \f (CLArIERBRlt)Cr: I l()SPITAL fi ROUNIISt
*." CLATTERBRIDOEROAD
BEBiNCTON
WIRRAL
CH63.1JY

TELEPHONE: 0l 5 I 33:l 02UJ

F A X : 0 1 5 13 4 3 l - 3 1 ?

Mr Lrn Beddows
7 Weald Drive
Little Sutton
SouthWirral
cH66 4YW

22d May 2008

Ref, ConcemsMeeting and Outcomes

Dear Len
:
I am writing to confirm detailsof both our discussionheld on Tuesday20s May 2008
and the outcomesagreedin relationto your corrcemshighlightedin your letterdated
l6'h Ma;*2008.

all areasas *e discussed

ln orderto ensureI hate addressed ' ' t highlight
I will if I ma,v - i f t :
'
l t r t r - - r t ' ' - - - -
r t '

ObservationMonitoring

IN could be considered
During our discussionthe concernof Doreennot receiving what
monitoringwith regardsto position91hel zuprapubrc-*t*t
( art-e ti."fi- appropriate

P taN but this is as we

that Doreen'throughthe night or early morning hasbeenrepositioned
and to which nurses
also discusseddue to o*Jt not chiking the,reforeas we ag'ed
this is performed Dolen's
have alreadyexpressedtheir commitmentto ensure
v at regUlar intervals by
observationalchart *d h", prcsentposition should be checked
tlre nursein chargeof Dorcen's care.
for saffbe it a
I would also wish to confinn as we discussedthat it is not unrealistic
quickly check shelt-ol .
carer or a nursewhen passingDoreen's ncomto call in and
physical (facial)
tooting to ensue her cath*i is not bypassingandlot-showing any
ensuresheis pain
sigtr o"fai$resssuchas pain. With regardsto monitoringDoreento
with the
free as we discussedt witt Uereviewiig the documentationwithin the home
what is more appopriate is that
view to purchasing"Standex" Pain cha*q however
just deliver her
nurss*O .ur. tt"ffAl" time to get to know Doreenand not

""*ffi
ChristineM Whiteside
RegisteredHomeManager/Tvlatron
NHS ReviewNurseStatement

FYI
Whilst I worked at NHS Winal as the Physical& SensoryDisability ReviewingOfficer,
part of my role was to review patientsin receipt of Continuing HealthcareFunding who
were residentin carehomeswith Nursing.In April 2010 I visited Elderholmeto review
Mrs Beddowsasroutine for an annualreview, after reviewingthe careplan I discussedMrs
Beddowscare with one of the staff nurses,she told me that they neededmore funds to
carry out the care that Mrs Beddowsrequired and that if 3 staff were neededto carry out
the care, they should receive an increasein what the NHS were paying, I explainedthat
evidenceshouldbe providedin the care plan that the needshad increasedto recommenda
new application to panel, for further funds. The care plan did not show any increasein
needsand the staff felt that if they were to carry out regular Checkson Mrs Beddowsthey
would need extra funding for more staff. This concernedme somewhatas regularly
checking patients in your care should be part of basic nwsing. There appearedto be a
disagreementin whether or not Mrs Beddows required checking hourly between the
Matron and Mr Beddows, I therefore recommendedthat the Nursing staff refer Mrs
Beddowsback to the RehabConsultantto clarify the needs.Mrs Beddowscondition meant
she had no head control, if left unsupervisedthere would be a high risk that her head
position could change,this could restrict her airway. In order to gain clarity from the
Consul'tantand agreethe care plan gcing forward, an MDT was arrangedfor July. At that
meeting the referral had not been made for a clinical review, the Matron had agreedto
reinstatehourly checksand to documentwhen those checkshad been made, any issues
noted and any actions required,as far as I am awarethesecheckswere not put in place,
unfortunatelyI movedon from the PCT shortly after.

Kind regards,

PaulineHurst

RGN Nurse Statementre dnar

Hi, I rememberit well. I put a note underheathersdoor tellingher you didn't agreeto dnar. Happyto helpin any way I
can. I hada chatwith you in lounge2 andyou saidthat whilsther coMitionwasstableyou did not wantdnar . I informed
heatherin writing
 I

ReviewMeetingfor DoreenBeddows
Minutes
ElderholmeNursingHome
Friday30 July 20{0
t{:00am

Prcsent:
PaulineHurst (PH) PSDReviewing fficer
DawnVasco (DV) ContinuirgCareManager
HeatherWard (l"lw) Manager/hlatron
RachelBlacklock (RB) Nurse
LenBeddows (LB) Husband

SharonShacklady (SS) CCT(Notes)

\v/ PH * thankedLB for attendingthemeeting.Confirmedthe purposeof the meetingis

to lookat the issuesthat havebeenraisedover DB'scare. Themainissuebeing
raisedby LB whythe hourly1:1checkswerestopped

LB- wantedto knowreasonwhycheckswerestopped-A situationhad arisenthat

couldhavebeenprevented

PH- LB is concernedoverwhathappenswhenhe is notat the home

LB -the careplanis the sameas whenshe anivedten yearsago. The planwas

rewrittenfour yearsago. He acceptsthere is a lot of detailwihin the care planse.g.
- thereshouldbe 3 personsto FansferDB, hourlychecks,staffarc in and out of her
room. Careplansaysshe shouldbe tumed at 2am and Sam,buttherewere
ocasions whenshewas nottumedat Sam. Staffareassumingshe has been
tumed. Problemwifr the alarmbells,forthosethat cannotusethe alarm,hourly
cfreckswere made. Occasionarosewhenshe was not tumedfor Shours.
Mentionedto HW aboutcfrecksbut she statedthat DB is cfieckedregularly,she had
withdrawnthe hourlydocumenting of checks.Careplandoesnotnowrecordchecks

HW- alarmbellsystemwasdrangedbeforeshe cameto fre horne.Asked

LB if therewerehourlychecksfromffut pointorfrom tenyearsago

LB* ftom whenthe alarmswerechanged

DV - when DB was first admittedto home,were the hourlychecksa

recommendation fromthe MultiDisciplinary was
Teamandthe NeurologicalWard,
for
therethat levelof regularity turnsin the hospital?

LB showedDV coPYof a rePoft

HW- all clientsarechecked.All conidorshavgtwo tiainednursespluscarersfor

12 clients,andtheyare all checkedon a regulaibasis
 DV - careplanstatesturnedeveryfour hoursandskinchecked.Justtying to
ascertainif this is caniedout? Careplan statesrequirestwoto three peoplefor
movement.3d personassistsfor headcontrol.

RB- thisdoesnot happenwhenLB is presenl he assistsso thereforeit wouldnot

to have4 peoplepresent,but whenhe is notat the homeanytransfer
be necessary
or movementis alwayscaniedout by threestaff.

DV - so thenLBis involvedto thatlevelin DB'scare?

LB - yes alwaysassistswhenpresent

PH - hopesthatLBfindsthatstatementrelatedto alwayshaving3 staffpresent

reassuring.
whenhe is notin attendance,

LB - yes. DBshouldbe turnedeveryfour hours,but understands

that it couldbe
\v
lonqerif the nursefeelsshe is as
comfortable she is

HW- stafflookat the individuals

needsat the time,notalwaysnecessaryto move
to a stricttimetable

LB- the problemhoursarebetweenSarnand 10am

RB - statedshe is normallyon dutyfor tfre morningshift,medsare done at around

8:30. Goesbackat around9:30to flushDB PEG. So DB is alwayscheckedduring
the earlYmorningPeriod.

PH - so you wouldcheckher skinor whether shewas mrnfortable?

RB - dependson whictrcareris on duty,if ifs a mde carerthenDB wouldbe left

untillastas shedoesnothavea malecarer.

PH - LB needsreassurance
thatcheckingof DB is carriedout
-
'\/ LB - concemsoverdayshewas leftfrom 10:30to 16:30,whenshe wasn'tgot out of
bed or tumedduringthat time, askedwhy tris had happened.Was only bld that
there was an emergencyin the home,thereforeregularshff uere ergaged
elsewhere,br-rtarguedthatall staffshouldknowwhather neds are becausethey
shouldbe on herchart

RB - askedhowLB knewthishadhappened

LB * she was on her backwhenhe left her and was still in the same positionwhen
he retumed.

RB - explalnedthatshedoesn'tatwayscompleteherpaperworkuntilthe end of her

shift,bui thatdoesn'tmeanshewasn'trytng out whatwas required
 LB - therewasnothingon the careplanforthis occasion,she shouldhavebeen
sittingoutduringthe aftemoon.Thenporntedout thatthe careplanshouldbe
checkedhourly

PH- if DB is in no distressand appearsto be comfortable,

thisindicatesthat her
needsare met,if its notdocurnented thisdoesnot necessarilymeanto that care
wasn'tgiven.

LB - coupleof weeksafterthat incidentDBwas left up, and carestaffdid not know

she shouldhavebeenretumedto bed

PH* whatis neededfor LB is confidence that care$ans will be foltowedaccurately.

Hasno problemswiththe levelof caregiven,whatis needednowis that LB is
confidentthatthe levelof carefor DB is whatis required

LB - felt untilrecenty eveffiing wift the homewas fine, but tensionshave

increasedrecenfly
\-- HW- the homeare concemedaboutthe requestfor hourlychecksto be
documented

LB - HWtold himthat DB wouldonlyget the sarnechecksas otler residentsat the

home

HW- therewasno mentionof DBnot beingcheckedregularly,onlythattrose

checkswouldnot be documentedon everyoccasion. Care plansay hourlychecks
doesnotsaydocumentcheck. Wll notdocumentbut will alwayscheckhourly.
Puttingstaffon line,to haveto documenthourlyputstoo muchonuson staff

LB - onlyconcemis that she has beenlefi

PH - canevaluationsbe donesayingwhatcarehas beendeliveredforAM Period,)

and PM Period.Statinghowlongfeeding,medsetc has taken?

DV- guessthatcareplanfrom hospitalwouldhavebeenthat way,docurnenting

all
,{ areasof carein that way

LB - happyfor thatto happen

HW- qualiftednurseswill be the onesdocumenting,

takinginformationftom carers

LB - fieltmaybehe was makingtoo mucfrof care plansbut was concemedfor his

wife

l-tw- homevalueshls observations

RB - staffareonlyhuman,mistakeswill be made

LB - howcanwe ensurethat DB is not leftfor longperiods

DV * do youfeel happierwithwhathasbeensuggested,doesthatgiveyou
confidence

PH- if thereis any issueyouwishto bringup. lts notjust aboutDtsbut LB as well,

managinghis concerns. Anyotherissuesshouldbe highlightedas theyariseso
{rey can be addressedstraightawayand hopefullyresofued.Dailyevaluationto be
completed, whichmaythenhelpto reassureLB

HW- theseare legaldocunerfrs. Sbff are wonied that if trcryput Ut$rgson form$,
and a chartis not corn$etedhoutlythenthey felfiey slu.Sdb liablein a court of
law

PH- if dailyevaluationsarecornpleted, to staffand LB that

it w{llofferreassurance
care plan is beingfolbwed. Therehasto be compromise,we commissioncare and
we needto knowDB's needsarebeingmet

HW- gladthat this meetinghasbeenconvened,has helpd to clearthings. Horne

are hereforthe benefitof bothclientsand stafr. \Arilldo whathasbeenagrcedand it
is the rightthingfor DB

LB - thankedHW,felt maybebothhimselfand HW oveneacted

RB- willingto go throughcareplanwith LB if he wishes

LB- no is happywithcareplanas it is

PH - ensureall care staff areawareof the agreementsmadetcdayrelatingto the

SuggestedRB and LBto get togetherand
completionof the dailyevaluation's.
decidethe bestwayforward

DV* careplansare 10yrsold,stillapplicable.Hornehavedevelopedrobustcare

plansfor eachindividual

HW- careplansare clearforanyonecomingintothe home,will be ableto provide

carefor anyresidentby lookingat careplans

RB- staffare movedaround,so maybesomeonwa$n'tawareof routine.This is

unlikelyto happenoftenas thereis alwaysa memberof staffon dutywho knowsDB
well

PH- CCTwill reviewDB in 3 months.

HW- reiteratedto LB any furtherproblemspleasedo comeand see her

PH-ttranked everyonefor attendingand felt that all had benefitedfrornthe meeting

 1

Doe's Cuts and Bruises Unexplained 2ffi6 _

20ll
28* August 2008
A carernoticeda out on Doe's left eyelid'This
was ar 2045andDoe had beentumedat about
the sametime onto her left side for the enema
and I had ie{r at
ilii:1l1ffi':TJ#tgmxm:t1*1;,::**:*#-:HTiiu,notuscratchrthadbeencausedbyeitherurungoo&;*ts
Suuday l2hOctober200g
Doe had a out on her right eye' It was
an L shaped quite deep cut ulth swelling
paracetamol rhey thoueht that she had round it above the eye.I shorr'ed it to both
t"*r"h"d htt'"litut i porntea o", rutir" Jeanette and Brenda. Brenda had gi'en
I said that she must havi be"n ba,,gea not scrar.chLer ru"" *,r"r. .b" hud been her
again"itrt" t"Jt"lir" *"" rr-J ""Iii laid with ber arrn bent up to her face.
the *are plan record. rt u* * n"ar.iL* -""i*"a
"g;io". "yl!""a on handover and there was no enry at an in
Friday 7& Novernber ?d 2008
*tt stillsrvollen
andshejustsaide-r-r-r-m.
It wasn'tar thatbadbutstilrl
nTltrrptffi?;;; "t"
andl"mponherIeRelbow which nooneknov's anflhins
ffitri;{HJrbruise about.

ff*ilHfif_"q-:':::i**"L'*'ffi,ffi.TffiK%*nff;#*iyffitrggrownbrownbrackandyeronrdoa,tknoww
Tuesdayth Jrme2009 Seephoto bejow
i*#-Ht--ffiT*fA$mXj*m;,nffi*":"X1ru;fffiil#.rtbruisederbowandshesaidshedoesn,tsewrtobe
Mondayl5eJune2009
Doe wasmurmuringquite a bit. she had
anotherbruiseon her knee.
SahrdayZZbfuneZbOg
j'st below the other onewhich
t*g;;i;#nn* is four weeksotd and sti1lyellow. No one
fi;rff "oo* knew anyrhingaboutit
uoe hadan rnchlong red mark on her forehead
atroveher left evebrow.It could hal'e been
sardthat shedid not know, a scratchor a burst blood vessel.I asked...
. what it was and she
Wednesday l9s Ausust2009
she had a cut that ha'dbeenbieedingjust belowher
le{t eye'It could only havebeencaused
her face insteadof-beingp;fi;;;#;ides. by a fiageraail and ifit was Doe,sthenher
Toni showedmethe permysizedmore on handsmust have
Hfrffi;tfft Doe,s back
herupperlip left sidew'hichnooneknewhorvithad
ffiS#ffion happer.red.It
lookedlike bangiag on the side rail &.hen turnins.
na{ scralch on ber lip and on her left arm.
S 1_{een
I i'' and 18"'Septernber20l0
:o-?nd.
Lroe nad severe nose bleds during
the night for wbich the doctor was called.
22@November 2010 There was no explanation.
Doe had a sore e! e with rvhat looked
like a nail mark just above her eyelid
24e November 2bi0 in the comer. Iasked nurse MAeve to
rook at it but she said it was nothing
I reported to nwse Aiix that Doe had
not opened her e1'esfor three days and
25q November 2010 could she ask night staffto check ifDoe
rs awake during the night.
I asked nurse lvlaeve if night staffhad
reported whe&er D:,"y:.:j":trg
t'es not the sofl of rhing that you noticei alr-mght or nol.sr'e said they had not
*'r"-t y* i..f.a for it ie did Jrr" -r""i said that they had noticed anylhing.r
*"."eh rh. said that it
rvlth me since last Saturdar.. becausesbe has-been?sleeprvhirst
"iehr;;';;#ffii*"u"
l3s.Tanuary.20lI
Nght staffnoted a superficial scratch
to Doresn's lelt upper arm. It showed
?0mJanuary.20l l blood and was about tlree inches rong
probably caused by nail.
D_oehad a three inch scratch on her ieft
thigh whioh showed blood.
22"o January 201 I
wealunderherleft breastoaused
throughthepegrubebeingleft therewhenshe
ry": F:*friJff hasbsentumed.
to b"d it ,u?snoticedthatshehada raisedarea
onherripfit legbelowtheknee(shin)with some
skinscraped
offit.
l;$Tl"1ffiTilfil-"tfftack
scratch
abovethekneeofherleft leg,toofardownto
ffi*:fffir-ch havebeencaused
by herownna1s.
Doe had blood on the side of her nose
and also aa inoh long quarter inch wide
10* March 201 I brood covered scmpe on her toague.could
ha'e been done on teeth cleanurg?
p-rynad three deep red scratches on her left
arm near the elbow.
l2e \4arch 201 I
Doe had a further two scratches on
her arm just below the prer'ious ones.Julie
25'March 20i I said that Does was on her refi side
with one arul across the other,
onthetoporthetoe,
goingback
ontothe'aiaarea
or&eroot.Looks
ffffi"*:'ffirH:Lt"#:tJif#iliff'*t asthoughithas
been
l)-' August 20ll
cuton[:neepossiblyceused
throughcontactwirhthecrossbaronthesranchion
fftrH$6i?* of rhehoist.
ft:?*?:T?il1.!1iTf,H#:,n*T;l"Hharrwavbetweenrootandreftknee
couisionwirhhoist?
i 9- November20il
f}re centimetrecut on right knee(collided
with hoist?)
 25 March 2011Photo7ft

Thereasonfor needingthreestaJfontransfers.
This occurredin hospital.
 ID
Elderholme
(C.LATIERBRI
tX}E I I(}sPITAI-CRoUNDs}
CLATTERBRIDCE ROAD
BEBINCTON
WTRRAL
CH63 4JY

TELEPHONE: 0t-5| 3&t 0200

"*"_. F A X : 0 1 - s t3 4 3 t 3 l z

Mr L Beddows
7 WealdDrive
Little Sutton
SouthWirral
CH664YW

l0 June2010

DearMr Beddows

I understandfrom Mahon that you areunderthe misapprehension

that Elderholnereceivesan
enhanced paymentfor your wife.

WhenDoreencameto us we did receivea marginallyhigher payrnent. However,about

two
Iears ago her paymentsweneremovedfrom Arowe Park-andtut"* over by the primary Care
Trust. Sincethen Elderholmehasreceivedcontinuinghealthcare basicpuyr*, for
Doreen
i-denticalto many other patientsreceiving_continuing
h'ealthcarenursinginti paia throughthe
Social Servicesasagentsfor the primary CareTrust.

poreenwasrecentlyreassessed by the ContinuingHealthCareTeamandthey foundher careto

be absolutelycomectandthat shedid not q,ralifylot anyfigther enhancedlevel of paynent.

If you want additionalcareat Elderholmeie abovewhat shecurrentlyreceives,then

I suggest
you make out a caseand submit your findings to the Primary Care Tnrst
as the p*"hiiog
authority.

Hopefully,this clearsup any ambiguityyou mayhavehad.

Arc e'ti

B Woods

DIRECTORS: Rltrurlvlitq.it hurrmtt'..\lriRl-lottlrl'r<cl'huinutu4, l)r".1-at'('!iltnt,r tit;oxrxtE&1,

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Esq..Dr H Traq. R. ltrirxJ-s
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 neeting Re Elderholrne
b
Furposeof the Melins
A meetingwas held on th l1ul June2008 at 9130am at gudingtonllouse Crosbyto dtscussthe
ongoing cgncernsof Mr Liversageand Mr geddowsand the future rsle of FARE.

The followlng peoplattended:

Ann Ford- BRM-F,terseyside

Office CSCI

Mr Rourke-ChairmanWirrelderly

Flr Woods-CompanySecretaryWirrelderly

Mrs ChrtsuneWhiteside-Registeredmanagr- Elderholme

Mr L. Beddows- relative of resident at plderholmeand reoresentativeof F.A.R.E

Fir E. Liversage- relative of resldent at Elderholmeand representativeof F.A.R.E

loanne Revie' RegulatoryinspectorCSCI

Tne outcome af the meeting liyasas follows:

In responseto the incorrsistentand not always umely responseto complaintsr

\i,
T' co_nflmedthat the pmcedurefor dealing wlth comptatne had been strengthened
TSlltI:
so tnat he would overseea[ investigationsand outcomes.
r There would be.improved monitoring of action taken as a result of complaintsand accurate
recordsavailable6orInspection.
r Mr Uverasgand Mr Beaddowswould meet separatelywith Mrs Whitesldeto discusstheir
concernswith a vlew to early resolution.

In responseto the cscIs concernthat the managementstructure in the home was fragmented
and
unclear

r The bord have dlscussedthe managementstructrre of the seruice at length and

pmduced a flow chart, which shows ttrat ttre structure now reflects the have
exp-ecta$snof cscl.
r In Addition, the board atso confirmed thar:

- thatrhiswould
betimety
+'
"",:ff;i:*
| : I:lhll,t_li*]'tthlteside.wlll assessdependencylevels on each of the peoptewho live at the
-,n w.hitesidewlll coniact csci to arrange a vBit io the horne. Ann Ford and lffinne
# loT*. T.F
Revie will visit the servlce and discussthe possibleirnpllcationshr changingth;
'/ staffing structure, t.;;;i

rt vtasacceptedthat if all complaintswere resolvedvia the internal complalntsprocdurc

would be no need for F.A.R.E.to con$nu in its presentfiormat. that there

Fou'.eYer,it was also agreed thgt g: many relatlvesare intercsted in the progress
and developmentsf
the home a rlatlves meettng should stlll occur six rnonthly. rh|s forum isutd
popleabout any changesin th serviceand any tuture ddverop*enG, - be used to consult wlth

r It was agreed that the organisationvrould.share the changesthey have made

with people by
Mondaythe 16thof June' This would enable peoprJwiri-u5J, ulrit or work at the
srvic to
feel involved.

loanneRevle
Regulatory
Inspector
c.s.c.I.
 f 4 4 . - {

ttr Fg
<J'
Elderholme
(CLATTERBRIDGE
IIOSPITALCROUNDS)
CLATTERBRIDGE ROAD
BEBINGTON
WTRRAL
CH63 4JY

-fr:t TELEPHONE: Ol-5133 0200

FAX: Ol5l 343 t3l2

Mr. L. Beddows
7 Weald Drive
Little Sutton
Cheshire
cH66 4YW

30* June2009

Dear Mr. Beddows,

I acknowledgethe safereceipt of your letter dated 22"dJune2009-

As you statedthere are parb that you feel are accurate. On readingthe letter, there are obviously facets
which we feel are a totally inaccuratereflection of events.

However, after our meetingwith Dr. Meyer and his discussionswith you, it was agreeda "line would be
drawn in the sand". and we could all move on from the past.

Therefore it is pointless in respondingto the numerousdetails of your letter which all occurredprior to the
discussionwith Dr. Meyer.

Yours sincerely

.,ltL/d*4
H. Ward
Matron

lisq. (Clhuirman),Mrs R Ltoyd (Vice Chairman),R WoodsEsq. (('ompunySecret1ry)

DIRECTORS: B Rourl<e
-
MrsJGreen..M.H.MiddletonEsq.,,ECO*"ntiq.,HParsonageEsq.,DrHTraty,Patron:DrJAArtkenMBChB.FRCP(Ed)'DTM&H REGISTERED
MRRELDERLYTSA COMPANYLTMITEDBY GUARANTEE CHARITYNo 70012I
RegisteredNo.2l20lgEnglmd
lr\
S Y
\r-<.ty
N6TOR N PEOPLE
 0@
7 WealdDrire,
Little Sutton,
South Winal,
Cheshire,CH66 4YW
Brian Rourke,Chairman,
ElderholmeNrusing Home'
ClatterbridgeHosPitalGrounds,
Bebington,CH63 4JY 1lfr Septernber 2009

Dear Brian,
from Matron Heather ward'
I write to make an official complaint about the treatment that I have received
out problerns whioh' she
d F;;;h";""t""t"a -y i"if"'s G.P.,Dr. Meyer, and asked him to come to the Home to help sort
ihe staff wer" haing with *". O' th" tu-" day she told me that Dr. Meyer wanted to see me about my wife's diet
oful*"a,
"to a11ayyour fears" on 12* MaY.

wife's diet. Heather had not told me about auy

The Doctor had not asked to see me and had no conments to make about my
problems that the staff were r"ppo."a to be having with me.Correct procedure would have been to discuss them with me fust' It
is my wrderstanding that she asked certaifi nurses to make oomplaints about me
is not usual to involve the G.p.'ii such matters. It
continenoe nurse and the dietician had
to Dr. Meyer and even suggested what they night b;, Dr.' Meygr wL ako. told.that.the
which they wished to pur119 This had
also made complarnts abouime,saving thati hai stopped them from following direotions
oontinence nurses and the dietician have confirmed to me that they did not make
also not been discussed wi& me and both
oomplaints against me and, indee4 followed the oourse of action which they wished.

126 May she said _that my presenoe vr'as

I was not told the true rcason for the meeting until it started .At the meeting on
detrimental to my wife's care, that I was preveiting the staff &om nursing my wife as they wanted gnd-tfr| nurses. felt that they
should be resticted so that I
rro longer oare for my wife. She wtted Dr. Meyer to agree that my presence with my wife '.foblers"
"orla no time aa she to furd a solution or oompromise to t!^e which she
was not pr"rLt d*ing nursing and care.At fr
I was interfering with staff. l{ad she really had my wife's best-interests in mind
perceived or present any prope"r evidenoe ofhow
calm and reasonable manner'If she
then she would have discussed these matters with me as and wlien they had arose and in a
hale been detrimental to my
haj succeedeOin convincing Dr. Meyer that my presence should be restricted her aotions would
wife's care and happiness.

permission and that I insisted on

She told Dr. Meyer that I had instructed the staffthat they were not to oontact him without my
fusing fresent on his visits.This was not true.

She spoke about several items lrom the Care Plan as if I was unreasonable and in insisting thatthey are underiaken'
including entering the tum and fluid charts. The care plan has been agreed over a long period of time with all relevant parties
including the long lerln care team at the NHS, and should be adhered to as they are paying for theso services to be performed'
There isi ralue added element and it does not make sonse to try to avoid ilrisking a reduction in fees'

acousations, sayrng "I'm

She conducted this meeting in an aggressive marmer, talking over my attempts to respond with further
at four o'olock in the
talkhg,, and ending with -" io t uiJ It *us so stressful to me that all these modhs later I am still waking
to anticipate what
*;*g feeling sici and apprehensive and rmable to sleep. I am close to tears all the time. I can't stop trying
f,rc n"x to o|trit her objective of restricting my access to my wife. There is no logioal reason why she wants to
rt"pr *fi" *uV
follow this course ofaction.

whioh have been

I enolose a letter from Dr. Meyer whioh confirns that the complaints made against me are serious aoousations
Dr. Meyer bas provided confirmation tbat her statements were rmtrue and has
bome out to have no basrs of truth. Fortunately
confirmed that he feels that I support my wife and my actions are in her best interests.

has been given and

The events of 23'd October and 2?e 1{arch detailed ia the minutes of the meeting of 12e }day which Matron
that has no
which she no doubt disoussed with yor! show that these rocent actions were part of a oontinuing patiem ofbehaviour
her actions or provide
reasonable explanation. Sinoe May i2fr'she has made no attempt what so ever to either,apologise, explain
more than two dozen
any kind of evidence,or try to pui matters right in a construotive and honest response.She has not spoken
words sinoethen.

in any relationship
I have a very good reiationship with all of the staff. I have no complaint to make against any of them' As
the matron's
involving so niny people, there are bound to be the oocasional differences but there has been nothing that warrants
other way round
behaviorir -The difierence between how I have been txeated after words with a nurse than vl&en it was the
amourts to victimisation.

a senior nursing
The Home has a duty of care to me as a relative as well as to my wife as a resident. I am entitled to expect that
vt'ith dignity,
employee of the Home will treat me in accordance with the NtrrtC cod" of conduct but I have not ben kffi1ed
there has been no attempt to promote my well being; matron has not been open and honest with either
,"rp""i o, kindness;
impartial in her
myself or Dr. Meyer and has cerlainly not acted with urteCnty or in a professional-marmer and she has not been
of what she is
aotions. It is essential that a matron i; truthfirl with a G.P. and should not involve him with out concrete evidence
saying.

I will resist
I can only assume that Heather was pursuing a firanagement objective in restricting my prsence but it is one which
this aim
with the L"6 of uU agencies availabli to me. I would iike you to confrm that there-will be no more attEmpts to achieve
be trea:ted with the co1nmon courtesy which I have experienoed in the past. I must insist that you ensure that my
and that I will
wife,s care plan is followed to the letter,that she is looked at hourly and and that charts are completed accordingly.
 B-LF

Mr L Beddows
7 WealdDrive
Little Sutton
SouthWinal
cH66 4YW

I October2009

DearMr Beddows

I now respondto your letter of complaintdatedalmost four monthsafrer the date of a

meetingrryhichobviouslyannoyd pu-
wst
The reasonthe meetingwith your wife's GP was called was Yery simple' You
the Home and the
-I queryingufr q,roii"*ng the care of the professionalsat
continually
hospital. also re-ceived'aletter Jf complaintfrom an RGN, who was not on that
eonidor,with regardto yopr questioaingofbim andthemannerof that que$tioning'
to
A*er the varisus RGNs bad set out your querieswith Dr Meyer he seemedhappy
you of l8
confirrnthat you wife's catt was in oider andthaf in the termsof his letterto
May, hopefullythis hasput the matterto rest'

With regardto Matron's demeanourat the meeting,the atmospheremayat times have

may have
beenraticr tense,but I am satisfiedthat Matronwasnot rude. Sheadmitssbe
hardly rsgad this as
said,when intemipted"xcuseme Len, let me finish", but I would
rudeness.
patient in
I appreciate!'our concemis for Doreenonly. Our concernis for every
at"-say,5'30
Elderholmein equalmeasure.Whilst you want 1'ourwife to bc put to bed
pm eactreveningor checkedeveff hour.rre r*ill anemptto meetthesefargets'However'
the same
other demandson the corrirjor can y)metimescausea delal'. We receive
and
amountof palmenr for Doreenas ]!re do lbr c$e+.other patienton the corridor fcr
care
*rereforeour carernusttr realisticanl proportionaie.I doubti: rhc qualit-r'of
iou freeto ransfer her if
Doreenrr-ouldhe ixner in an1otherHomehut..,fc{lu:s ere
professional
from thecsrs*"ntinterferingwith-the
you wil des.ist thenit shourdbe
,:m; *"se':*tioo
care
Cafe OI youwire
or you *: H;#;,i-P::1C--l-:'"X{*
wlrE 4us 'rv-'- r' - -
GP.
the MatrononlYand' if thouglnt fit, DOra*nrS
il;t.td;

YourssincerelY
n
/fl {t*"-,
{llw-,/ t/
B Rourke
Chairman
Scribd.Notesfollowing meetingwith ElderholmeVice ChairRoseLloyd and
GeneralManagerPamMarr 5e iuly 20l0

l) We discussedfees and Mr Rourkescommentin his letter of 8e October2009 in which he said that the Home
receivedthe samefeesfor everyoneon the corridor. In May Heathertold me that shewas stoppinghourly checksas
shehad discussedit with severalmedically trained peopleand decidedthat it was not necessary.I then got a letter
from Mr. Woods aboutenhancedfees.He confirmsthat for eight years,when extra serviceswere not beenprovided
,the Home DID receiveextra payment.Mr Woods also referredto not being paid for additionalcarein his letter of
June20l0.The accountslady Mrs Stebbingsbroughtin her files and confirmedthat Elderholmedid is facir. receive
an enhancedfee for caringfor Doreen.

2) The NHS CHC Review nursehad written in the ProfessionalVisit Reportthat sherecommends that Doreen's
Doctor be askedfor a referralto seeDr. Pinderwho is a consultantneurorehabilitationdoctor.A monthlater she
askedme if I had heardfrom Doreen'sdoctor. I telephonedhim and he had not hadthe requestfrom the Home. He
telephonedHeatherand was told that shehad discussedit with severalmedicalpeopleand consideredit a wasteof
time so hadnot askedthe Doctor for the referral.

3) When I receivedMr. Woods letter. I told Pam Marr that all that I was askingfor was what is in the CarePlan.
This conversation was on l1ft June.Iwas then surprisedto note the unilateraldecisionthat appearsto havebeen
madeby a memberof the Bank StafqJeanetteRussell,to amendthe existingCarePlan 7 on l1* June20l0,the
sameday as my conversationwith Pam.The effect of this change wasto removethe hourly checksaad indeednot
to specify any frequency for checking .All that I have been seekingto achievefor my wife is demonstrable
evidencethat the CarePlanhasbeenadheredto

4) In the CarePlan there is a documentaboutthe Mental CapacityAct. On page3 '?etermining Best Interests"
you set out the legal position. It states,inter ali4 "Take accountof the views of family and informal carers" and
"demonstratethat you have carefully assessedany conflicting evidenceor views" and "provide clear objective
reasonsasto why you are actingin the personsbestirterest." The documentthengoeson to recitethat the records
shouldshow:-I. What was the decision?2.Why the decisionwas made.3.How the decisionwas made.The Care
Plan is the documentwhich identifieswhat my wife's needsare and how thoseneedsare going to be met. The
changingof the CarePlan is, therefore,a highly significant eventand I would be grateful if you would answerthe
following questions:

Question1. What eventprovokedthe changeof the CarePlan?2.Who authorisedthe changeof the CarePlan?3.In
what way havemy wife's needschangedin orderto motivatethe changeto the CarePlan?4.It is now suggestedthat
hourly checksdo not needto be doneor do they needto be donebut they do not needto be recorded?5. Ifthey are
not recordedhow can you be satisfiedthat those checkshave beenundertaken?6.Can you demonstratethat your
own proceduresunderthe Mental CapacityAct were followed in relationto the changein the CarePlan?Surelyit
must be in the interestsof the Home, if anythingdid go wrong, to haveobjectivecontemporaneous
evidencethat my
wife was regularly observed.

5) The diet is written on a sheetpinnedto the noticeboard.On2nd March 2009 AssistantMatron saysno water
neededbeforefeedingasthereis enoughin the feed.On3'dMarch at feedtime thereis a differenceof opinionasto
what happenedbut both agreethat there was a discussionabout fluids with Nurse John. Therewas no disputeor
argument- just a chat.It my be helpfulin understandingwhat occurredto seetheNurse'sCommunication Book for
this date,toseewhat messagepromptedaskingthe dietician for a review.On4ft lMarch staffrequesteda review of
Doreen'sdiet from the dieticianwho wasunderthe impressionthat shewas askedto reducethe fluids becauseDoe
was passingtoo muchurine. Again this is deniedbut if not true why askfor a reviewbecausethe careplanrecord
showsthat BMI at this time wasconsistent, therewasno increaseor loss in weightandherrisk is low. Heathersays
that therewas confusion- if so why not just follow the diet sheet?TheElderholme NutritionalRisk Assessment,
CarePathwayand ScreeningTool in the CarePlan statesthat a low risk shouldreceivemonthly monitoring and
only a high risk needsa diet review.Furthermorethe fluid balancecharts are never completedproperly so how
would anyoneknow if shewas passingtoo muchurine. Thereis no mentionin the carefile aboutany diet problems,
Howeverwho ever spoketo the dieticiandid not tell them about Doe's history of constipationproblemsand
vomiting.Doreen'snamednurseswerenot consulted.There is no mentionin the MentalCapacityAct recordof any
discussionwith me or indeedanythingat all abouta diet review.In any eventfluids shouldnot havebeenreduced
BEFORE getting a review (2nd March for example)
6) Becauseof my concernaboutreducedfluids causingconstipationon 12frApril I askedJohnif I could seethe
figuresthat he hadusedto showthat Doe was gettingtoo muchfluid. He saidthat he hadjust addedup that day's
charts.After speakingwith the dieticianon 30'April I askedJohnwhat symptomswas my wi{e showingwhich
promptedhim to believethat shewasgettingtoo muchfluid. He saidthat therewerenone.On 3'oMay I told John
what I thought hadbeensaidand he recollectedsomething different but we agreedto differ andthat wasthe end of
the matter.Thesearethe only two questions which I directedto nurseJohn- I wasnot constantlyquestioninghim as
statedin Mr. Rourke'sresponseto my complaint. AnywayDoreenexperienced severeconstipationandher fluids
hadto be returnedto their previouslevels.
It was three dayslater after John and I had agreedto differ that we had words and he put in a complaintabout me.
John spoketo me in a mannerthat was out of character(asfar aswith me) and my responsewas,manto man,based
on word association - no morethanthat.

7) When shegot John'scomplaint,Heathertold me that Dr. Meyer wantedto seeme to "allay my fears" about
Doreen'sdiet. Shetold Dr. Meyerthatthe nurseswerehavingproblemswith me. Shetold the nursesthatDr. Meyer
was coming becauseof problemswith me and did they haveany that they wantedbringing up. One nursewho said
shedidn't haveany wastold that shecould saythat shedid not like havingme in the room.(Heatherlatertold me
that th directorshadtold her to arrangethe meetingbecauseof my connectionwith FARE! ).John'scomplaint-
which I have never seen- was flimsy on its own so Heathersort to makemattersmuch more involved. I have no
doubtthat her intentionwas that Dr. Meyerwould be convincedthat I shouldnot be so involvedin Doreen'scare.
Howeverit backfired. At the meetingshetold the Doctor that they could not telephonehim without my permission
and I insistedon beingpresenton his visits. Shetold him that the continencenursewantedto take the catheterout
permanentlyandI would not let her andI alsodid not want herto leavea sore'\ryet".Shesaidthat the dieticianhad
complainedabout me. Dr.Meyer in his letter confirms what was discussed that all of thesepoints were not
true.(Alsoconfirmedby the continencenurse'sreportHe also confirmsthat shewas rudeto me.NMCguidessay
that elderlypeopleincludesthe relativeas well as the patient.Heather hasdriven a bus throughthe NMC codeof
conduct.

8) Following the negativeresponsefrom Mr. Rourke. I decidednot to pursuemattersfurther and offered Heathera
truce,whichsheaccepted.Six monthslater shedecidedto stophourlychecking.It is no good sayingthat peopleare
passingby to look in on Doreen.Sheis not eventurnedeveryfour hours.TakeThursday shewas turnedat 0500
andnot againuntil 1100- six hours.The fluid chartshowsno fluids between0430and 1600so it can't be saidthat
shewas checkedby a nurse. The occasionwhich startedthis hourly businesswason a SaturdaymorningwhenDoe
wasnot turnedbetween1030and 1830- eighthours.
OverallDoreenis at risk becausethe Home is not adheringto the CarePlan - not alwaysthreepeopleand not
turned,nevermind checked,and decisionsarebeing madeabouther care* diet, stoppingchecking- without taking
in to accountthe Mental CapacityAct.

9) At the meetingwith CSCI in June2008 Mr. Rourke undertookto overseeall investigationsand outcomesover
complaints.A properinvestigationwas not doneover my complaintwhich after all was madebecauseof the way
Heather handleda complaint againstme. In his commentsin his letter of October 2009 responseto me about
everyonepaying the sameand getting the samecare and Heather's commentsto Dr. Meyer that my wife would
receivethe samecareas everyoneelse illustrate that this hasnot beentakenon board.The meetingalso statedthat
the matronmustreceivemoresupervision(from the Board).Isthat happeningnow?

10) ThereforeI refer you to my letter of the l1tr September2009 in which I indicatedthat I wishedto makean
official complaint aboutthe Matron, HeatherWard. I note your reply of the 8ft October andI would be grateful if
you could confirm that this reply amountsto your full investigationof my complaint.I would alsobe most grateful
if you couldforwardme a copyof your ComplaintsProcedurenow that CQC do not handlecomplaints.

ll) The Long Term Care Team are arranginga review meetingwith Social Services.Surely it would be in
everybody'sbestintereststo revertto the plan that was inspectedby the CareTeamand ensurehourly checkingand
recordingof sameis re introduced.Ensurethat threepeopleattendtransfers andensurethat the fluid balancecharts
are enteredproperly and balancedand that any other alterationsare discussedwith myself properly in accordance
with the MentalCapacityAct. It shouldthenbe possibleto assurethe variouspartiesnow involvedthat Doreenis no
longerat risk from decisionsbeingmadewhich arenot in her bestinterests.

12)Copiesof all relevantdocumentation

in supportof the mattersdiscussed
abovewasgivento RoseLloyd andshe
promisedto revert.
 tcL.{f Ih:R}fRllxl}. t l{).\PtrAI- fi R{)uNrSl
{:I-ATTERBRIDCEROAD
BEBINCTON
WIRRAL
CH63 4JY

TLLEPH0NE: 0 I 5t 3-1+O?U)
F A X :{ ) l 5 l 3 4 3 l 3 ! ?

L. Beddows,EsQ.,
7, WealdDrive,
LittleSutton,
SouthWirral.
cH664YW.

17frJuly,2010.

DearMr. Beddovvs,

Lloyd'scopyof
I am writingto informyou that I havenow receivedRosemary
your notes,etc.for the meetingheldon 5'hJuly2010.

After discussionof the contentsof thesenotes,etc. with my fellow Board

members,I shallcontactyou againto addressyour concerns.

Yours
a.'
I

B.Rourke. ..
Chairytan.

illRE'-ClORSrl) llonrkc lk1, t('hnrntuil), ltre R Lltttt lI'ice ('huitaan). l)r.,/, 0'(irilhor ii G {tu'cnl:n1.,
H Panotage gJt1.,tlr H l"raq, B. Ll'oodsEq., Potron: Dr,l A ,lirken,ltt tAB. F&,{f (Edt- l)1'tl&tl,
r.y tSA (rgr{pANy t.tulr[D BY cu.\RANft t:
lf rl{RELDrR RICI9TERED
RcgstauiNo ll!(rlFl England ('HhRll'Y i\o l00l:l

t"/\ t
t-t'.3- J
QI.mBEruEE
 @
Scribd. Notes following MEETING WITH ELDERHOLME DIRECTORS 10.12.10

At the meeting with Rose and Pam on 5h July I raised severalquestions

1) FEES
Can we fust deal viith the letter from Mr. Woods regarding fees which followed my meetmg $rith Heather during which she said she was stopping
houriy cheoking saying "and we don't get paid for it".
'When
Doreen came to Elderholme the "marginally" higher palment which you received was l27o more than your average fee*. By 2006 it hrd
reached 41Yo more - a mind boggling t10$00 pa MORX, than the average. When Social Services took over it was lowered to the same rate as
everTone else gets cn continuing eare , If you take in to account tbe higher fees paid on Woods Wing this is still 127o above the average fees
just as it was at the beginning. Doreen does not use any catering facilities so that adds alnother 822 per week to her net refum Talking of nci
returnsrbetween200land200gtheHomepublishedanetprofitoff,5TTk -Doreen's netcontributionwasastaggering&S2k-or9o/o - ofthe
total nef. Doreen actually requires little care compared to others. I arn happy with Doreen's health - everything seemed to be working so why is
Heather intent on altering something tlat was working for no other reason than to impress her authority.You say that if I want additional care above
what she currently reoeives then you suggest I make out a case to the PTC. Wlat additional care did rratron tell you that I was asking for?All I have
asked for is that tire care plan be followed and you provide the care that you are paid for - the PTC agree with me that this is not r.rreasonable. Do you
now agree? Will you withdraw that letter and send a copy to matron.

2) REFERR,A.L TO SEE DRPINDER

Who were the "medically trained people" with whom Heather disoussed this decision? Why did she not include me in her discussion? Why was the
decision not entered on the Mental Capacity Act decision record in the oare plan?

3) CARE PLAI{-Three stafron transfers

At the original meeting Heather had complained to Dr. Meyer that "he wants tlree staff and houriy ohecks". Dr. Meyer said that they are in the care
plan and if they need rttering it should be done with the agreement of all parties Six months after we had agreed a truoe Heather withdreu' howly
checking. Heather has had a bee in her bonnet sinoe she arrived about Doreen needing three people on transfer and about hourly cheoking.. I said to her
that if she did a new risk assessment which showed that three were not needed then that would be aoceptable. A new risk assessme[t was completed
and is in the care plan and calls for three peoplel So why is it not done - because it intederes with staffing levels.

4) C,ARI PLAII-HourIy Checks

Checking hourly is not onerous. Heather said that Doreen would be checked the same as other residents and people looked in on passing. At the FIHS
review meeting, see minutes, it was rgreed that Dorreen would be checked hourly and it would be recorded" The ohart shows that she was only
checked half of the time with regular two hour gaps and sometimes up to five hours. Brian's letter of 6fr August states that &e minutes of the NHS
'
meeting will be incorporated in the care plan They have not been.Will you enter on care plan 7 Staff to check Doreen for signs of pain or
discomfort hourly and make an explanatory note on the chart in the room"

5) ALTERATION OF CARE PLAN

After I spoke to Panr the care plan was altered by Jeanette Russell without following the c.orrect paperwork The old plan should have been left
in the file with appropriate notes. It contravenes the NMC code of conduct for care of the elderiy seotion 10 page 85 and 87 and &e Care Home
Standard 2001 item 15. Inoidentally, after I had spoken with Rose and Pam, the Fluid Balance Chart was altercd to read Fluid Chart with no
place for outputs at all On her last visit the dietician said that recording output was more important than input because that should be the same every
day.How come defensive changes are done immediate\,yet response to my oomments takes for ever?

6) MY COMPLAINT -Diet
My complaint was about the way matron handled a complaint rrade against me by nurse John, who (although I have never been shown his letter)
matron claims said that I was viotimising him and shouting up and down the corridor.Elderholme did telephone the dietician the day afterwards and say
that Doreen was passing too much urine. Why did Elderholme speak to the dieticians - the frst time a diet review had been requested in over eight
years ? It was an arrangernent by which someone sort to justifr Vicki's oomments that Doreen was getting too much water when I asked if the diet
sheet could be followed.I did not question John until a month later and we bad agreed to differ three days before we had words so the matter was onoe
again put to one side. After a1l, I trusted the dieticians to do the right thing so that.was not the issue. When we had words it was because Jeanette
Russell had said to leave Doreen in bed but John was looking after the floor. On 3'o May when we agreed to differ I told John that I had been very
worried about past experience ofconstipation through too much fibre in the diet and insufficient fluids, hence my oonoern- Three days later' why dirl
Jeanette Russell do a rectal digit examination ofDoreen after she had oleared her bowels and then say to me that there was no sip ofconstipation?
This was the same day that she told staffto leave Doreen in bed tili later .Why, three days after John and I had agreed to differ, did John say (after we
had words) that the dietioian had telephoned to say that there was no way that one can get oonstipa.tion from too muoh frbre? The dietioians have no
record of such a oall nor is it medioally oorrect (ask Dr. Pinder). Jeanette and John seerned to be overly concemed with a patient for whom they were
not ramed nurses.

7) My COMPLAIIIT - Meetingwith Dr. Meyer

Besides Jobn's oomplaint matron made a further nine complaints about me to Dr. Meyer. Four were items in the care plan to whioh she objected but
which had been reviewed monthly and accepted for nearly three years, one was uridentifred oomplaints which she would not speciff, and four were
complete lies i.e. I had not forbade staff from contacting the dootor, I had not stopped the continenoe nurse from following the directions that she
wishe4 the dietician made no complaint about me had and I was not being dekimental to my wife's care in Dr. Meyer's opinion.
This was abizane thing to do, to involve a Doctor in a minor complaint. I am convinced that Heather asked for the review because nurses had not
followed the diet sheet and a reduction would r,alidate their comments. This was not neoessary as staff often forget parts of the feed routine and no fuss
is made, Even after all this John asked me several times how much water to gir.'e Doreen or what is the flow rate eto. There was no pa.perwork
completed to prove dietary claims. The dietioian had told the Home to monitor urine output oarefully when they did the revievr, but the Home did not
do this - oould it be because they knew there was no real problem? When John oomplained Heather saw it as a firther opportunity to disoredit me and
asked other nurses to make complaints and then arranged the meeting with Dr. Meyer to make it look as though I was being a nuisance in all sorts of
matters when in fact it was onlv over the diet review request.
E) BRJAN ROIJRKE'S RESPONSE TO 1l{r COMPLATNT
Para 1: I have explained that the meeting nearly destroyed me.I was not merely amoyed.
ParaZ:Ihave explained that I was NOT continually questioning the care of the professionals at the Home and oertainly not the hospital where we have
had no contact for several years. I have not seen the letter ofoomplaint to which you refer, but I asked two relevant questions in a polite manner and
the RGN WAS on that corridor.
Para 3: Various RGNs did not set out my queries with Dr. Meyer .I had no queries. Heather set out complaints which had no formdation. What he
hoped had been put to rest was the nurse's "complaints". He did not mention anything about confirming that he thought my wife's care was in order.
Para 4: Why was the atmosphere tense? The matron never once oalled me Len; she addressed her oomments to the Dootor except wheo she told me to
be quiet as she was talking; there was oertainly no mention of "excuse me" the more that her comments were shown not to be true the more in a
ternper she got .Dr. Meyer confirms in his letter that matron was insistont on her views and stopped me from talking.
Para 5: I have never requested my wife to be put to bed at 5.30. I am told when she will be put to bd. All I asked for was that the care plan be
followed; I never complain about delays. You do NOT receive the same amormt of payment for Doree,n as for everyone else on that oorridor. The
oomment about moving Home is threatening ie oontinue to make a oompiaint and you can go elsewhere.
Para 6: I have never interfered with the professional care of my wife. I have given you evidence that aknost everything that the matron said at the
meeting was false. If you had investigated my oomplaint properly ie by speaking to the dieticians, reading the continence report, peaking to Dr. Meyer
and reading his letters and asking Jeanette Russell why she had told the dieticians lies about urine output and even asking me for my side of things you
would not have reached this conclusion.

After the meeting I gave Heather the minutes with my explanations to which she replied that she was not going through every point and Dr. Meyer had
said to draw a line rmder it. I appologised to mrse John ifl had upset him. I spoke with Heather and said that we should oall a truoe and she agreed and
then denied almost every*ring that she had said at the meeting.

What out come do I want:

Why did she say that Doreer was passing too much urine when there was no evidence to support this; why not just ask for a review rather tlun a
downward review, leading me to question the need. I have no problem with whatever the dietioians decide upon but they have to be given evidenced
information.Why was the diet pathway not followed if there was concern over urine output.

Referr{ng to your letter in respor*e to my comphint about lleafter, do you now acc*pt my version or not If you do then a proper explrrnation
is wrranted. If you don't agree, what pointr need morc evidence

Do you accept that Doreen's fees have been above average and certainly cover what you should supply under the oare plan. Ifnot why.

An entry should be made in the care plan mental capacity chads as to the reason for lot passing on tle referral request. Who are the medically trained
people with whom the referral was discussed and why wasn't I oonsulted.

Care Plan 7 to be amended to show ; Check every hour and enter on chart to monitor expression ofpain or discomfod or intervention provided.
FEES RECEIVED AT ELDERHOLME AND FEES PA]D FOR DOREEN SHOW]NG HOW COMPLAINTS BY ELDERHOLME OF BEING
I]NDERFLINDED ARE NOT BORNE OUT BY TT{EIR PI'BLIST{ED ACCOIINTS:

2001 2002 2003 2044 2005 2006 2407 2008 ',49

Fees 836,000 888,000 982,737 1,088,923 1,170,442 1,366,749 1,182,229 1,577,217
Total
Costs 817,000 860,000 s 1 2 , 7 4 8 1 , 0 1 3 , 8 2 0 ' , t , 0 2 6 , 5 7 41,261,331 1,51I ,130 1,549,477
Total Net Profit 19,000 28,000 80,463 89,683 159,130 134,004 8,802 43,405
Average Fees: 17,417 18,500 20,473 22,685 24,384 22,779 24,703 26,286
D.Beddowsfees: 19,500 20,800 23,400 26,000 32,764 32,764 32,760 30,783

Average Profit: 396 583 1,458 1,565 2,597 1,757 -483 462

D.Beddowsprofit: 2,480 2,883 4,385 4,880 11,373 11,738 7,575 4,959

2009 TOTALS
Fees 1,642,570 11,034,867
Total
Costs 1,636,279 10,588,359
Total Net Profit 15,074 577,561
Average Fees: 27,522 204,749
D.Beddowsfees: 29,073 247,836
1.5To ot
Average Profit: 251 8,986 net
D.Beddowsprofit: 1,802 52,475 9% of net
Department of Adult Social Services

SAFEGUARDING ADULTS
#FWIRRAL
ESCR26
AlerUReferal Recordi ng/Monit<lring ReportForm

CONFIDENTIAL

Start date: -O4rc1n}11l

Referraldate: - 13{tA2g1A

person completing this form: -

ResponsibleCare managementTeam:-
BirkenheadAccess Team
SWIFTnumber 157t,69 number{if known}

Nameof Vulnerable Pereon:lrllrs.DoreenBeddows

* Dateof Birth: 10{}3/1945
Ethnicity: White British

ress: hlderhorne Nurstng l*lome, glatterbridge Road, * GP Details: Dr. IUIeyer,Nestcn

Bebington,
Winal..
Post Gode: CH634YJ
TelephoneNo: 0151334 0200
ClientCategory:{regardless
of agei'
Frail*^orillness
Gontact
ResidentialCare Staff
i nsed approp rlate text)
has triggered increased anxietytdistressfor this lady's husband.tUtrs.
Beddows is in a
virtuat ': vegetativestate" and unable to communicate,
llr Beddows has expressed" $uicidal thoughts' to a Care worker tfiat he would hann himself and thoughts of
ending his wife's life.
He Beddoursvisits his wife daily, spending long periods with her.

Statr had been advised as to how they coutd managethese contacts to reduce "Risk" as far as possible for
e.g. Leiving the door of the room open {iltr Beddows had been in the habit bf ctosing it}.
Relationshipsbetweenlir Beddows and care staff ari strained due to his demandinl nature.Ttreyfelt this
would be further exacerbatedwere he to know of the refeffal-
CHCTeam werc to bE contacted as they know the family well and may be able lo discuss heatth concerns
with him.
tt is not known who Hr. Beddows GP is^

MainGetegoryof allegedabusePhysical Potentialfor, if Mr Beddows becomes inineasingly

distressed about his wife's condition.

Location - lffherc abuse is allegedto have occurred -

Date lncident occumed:

1/6
Allt/$ACtSAdoc/Od09
 ttu

Doct tlp vufnonbh paran wlnt ta mlb e formrl compf*iil to thr Policr? tlo

tthd d+flrc tldr po*ron la r vulnanrbtr sdult l.o. Direbll*l re: Vul*rirbtc In pcrtrtrnt vlgrtrtlvr r|rt* -
no egrrmrnicdion

Arc_lhcrueny yrrtou* lileidfirt* of notr lor tillt vutncnbk rdult? Ytl

lf6. lf 'YES'pllr*r Frovidr {htrilt- Adult Pmtrckr conclm rucordod tle Orcrrnb* 20fO" $he her boan I
perfihmnt nc*Cpr$ In El&rhdme Nll for a rnonrberof yarrr rnd admitled in ffiO. Sho ir ine virt'at
vtgdrft* rttk and umbb ts co'ttttfunlcafr. Hugbrnd vFitr.vrqr dry rnd ttryr rlf dry, l|. ie hoping ahe
rllf mrl* r full r*mvrty.

Ticrt hrr bcclt lotr of tcmtsn brtiltecn *tl|l llrrl llr Beddo*r er hc c<xrtfen{y frrn* edsntlon for hll wlfc
e*d unforluneEfy In thi lxt co$pb E{wmkr h+r mndttlon hs dc{ortqr*rd lnd GP h|n inf+rm+dhtrn fhs
rhc b detor*or$ngl

OrlglnrU GP dld fiot wrnt 3otrll hfm hrt hl phonad OP hirmrtl - Or f,ryor. lsrlon. [h Seyw herl toH hirn
ttrrt rhr ir &tario*ti$f efid hr ir guitl dir*trsamd.

Untortu*drty mr Boddom &or trs{ lno* t}rd tic hcml lnm lhlt hNtsr rpolren to tt}s GF. He w*tf not
*ps*l wi$ rlrmbsr S thr homc rnd ihr honte i* vq csffielned rbo$l him,

A nuillrbcr oil rrelta rgc ho et$ndeil tfts u*tr*lsfrclr tcttatscrrlent ecnre rlth hoqrct phyrt* *nd hGarid to
t|lr phyrlc 6r*t if t* hrd . gun hr would rhact hiil*ett *nd hlr ryFc. tt thfu &ne hdr conditon tred no{
ddsioretsd.

$e hr'**det thr milguitod thotqfiff tfi*t rnfi*r*r h qrir*t him hd thh nat to, lf. ** rrpncing ttrf to 8rr
phytb- Shc raeefrred hirn thrt Slb *es not thr csc. Ovrr thr vrrohnd lhry lc<l sbf Chrhtsn* paty and
dbcwrcd concirfta lor hwband Len and or $undry plryt*o pfron d cfcrror at lenrc to rNt lB hrd
crpngatd * so$do ol wrlhr rgo ruhHrl thaughtr rnd thougrhErbout ffidtn0 hir rtfot ltfi.

Atklng urgent inlavoldon aEconcsrnpd ltor theru both. llr l* nst rrrrre of tl$ rrfrml
 !CL^ITEnBRrr)(;E I l{)SprTAL CiROUNOS!

rTrr CLATTERBRIDCE ROAD

SgSINGTON
WIRRAL

& CH63 4JY

TELEPHONE: 0!_5I 3i4 0300

3d March ffi FAX:0tit 34-11313

Mr HotrrardCooper
Oirec{or
Oepadrfltof Arlutt Sooat SerubEs
VtJestmin$ler
f-louse t 7 ilAA?|Jtl
HamiltonStreet
Sidcnhesd
Wrral
CH41sFN

DearSir

Ra llrr Ooreen BeddoualTtlp Oorothy Liversege

As you will be eilare from yourrecordsEHerhdrneCare Homehas

had Mrs Doeen tseddoA.sas
ContinuingHealFrcareresider{ sirne 13octoler 2000 arld Mrs oorothy
Lawrsagea$ a nursingresident
since 18 December2tD6

since tnir arival at EldgrhokrcMrs Beddouc'husbandand Mrs Lirersages'son

hara placed
L unrsonaue dernandsuporiEtderhottne. way h excessof the nornat high sandardsof 6;tfe $re
undertale for otrr 58 otharreskl,ents.

Therehave been manyomplsitb tnadby Mr Eeddorvsand Mr Liversage

that iave a[ been
invest$alecl'sotrctitnes anternasy
eod sornetinesinvotvingyourdeprtmen1 Desprree11guslive
l inv$tbalions no0*g *rbsrar{ive ra ftnrodto lhr} detrirnentof
E6erhdme. or lhe wdfare of any of gur
resdents. and 'ndeedwhenpfessdMr Beddowsha$stated that ryould
he noruranthis rryifelooked
afteranprtrere else.

withanl going into dteil8sod actr incirH t}re.Bosttecent maior

wnddnt madeby llr Liversage
Mr Beddors resrdtedin l. and my fellw director/tnstse Brianyr/oods
4I "* beingsummonedto a
mctingwith your predecessor,withor.*agendaor aim, as 'esull
a d a sptrjfE complainla*rressed b
Mr Urcrsages'and Mr Bectdorstocd Mp. Alison ttilcGovem-

l'finrever' at lhat meetingand stbseqrentf the natne d the

1 condair{ has neverbesr rnadedear to
J me. my felbws Directorsor any member
of slafi al E&rhokre.

lllRECli)L\ li-&..rr*a&9.ti'trumrani.^tNp!!an!ft-rr.lnLnraau,i)r..,ir.{-rmrr,.[(;(]ierE\,1.
N,*RELDE*Ly Lsq..B- tt'cttalsfs1.
fs ^coMF.Ny uA{rrErrrro,,^*^,Sf,I*"
{carecd ltr : i:rcl!4 !ng{&d nEtilsrFrED
Cf{.rRTt't6 ?c&i:l

{-}
ffiu'leu
 'tt
,

treoday socialsefvicesinspctionby two of your

Elderhslne was ther subjectedlo an unanncnrnced
inspectionby one of your offcers' Noneol these inspecdions
(; offrcersfolloued up by a tuttharone day
our resldents'
found anythingbut the highestslandardsof care for all

rheefieEtofdea|ingwithsrere|ativesofthesetworesiden|shashadamalor
expense'time and troublefor Eklerholmes'
efed on El&rhdrne and has causedsgnrficant:extra
'nanagementanddetrimentateffectsonstefimofe|eandaconsequentiatreduotioninthetineavai|ab|e
{or our other 58 residents'

by explainingto Mr Beddowsand Mr Liversage

wnal eocialservrceshas nevefofleredus any support
Jq, thatt|Birdemandsandcomp|ainbareinthevastmajontyofihetimeunreasonab|e'indeedthe|ltanner
them to seekfurthefaftefitionand lake up more of
t in whicfi lou have dealtwih themhas encouraged
nalurethis typeof controllir ard demandirgbehaviour
our stafi time than s reasonableBy its very
58
consequencereducgsstafftirneavailableto our other
has a detrinental effecl on staff moraleandrn
well cared for residentsand feir satbfiedfamilies

social selvicesMr BedovS nOWreceivesdady e-

owing to continuingpressr.reand involvemenlof
fegtmeend he and Mr Liversagetake up inordinate
?) maileditemisedrpoftsabouthb wifes care
with their on going uniustlFeddemand'!for attenlion'
amonrotsof staff and managementtime dealing

two tesidentsh our dutyand pleasurebut managtng

we are a non profil makingchanty.caring lof lhe
to
and with the new frnancialpressurebeing brought
these two relativeshas nevetbeencost efteclive
lo we no longetieet ebtelo cafryon dealingwith the
bearby the localcounslsandPCT'swe sefve
'e|at|veso{tsetu,oresiderrtswithinthe|eespaidtousbythepub|icbodbgconct'ff}ed.

h the edra administrationof Mr Beddows

Therelorerre will in futurePasson the extramsts invo*ved
andMrLiversages.de'na.ds'qwkrequledasaresullofanunreasonab|ecomp|ainlhacktothe
It will
fate of e40.00per hour per prson.Minimumdrarge
sosal servicesdopartmenlof lhe coureil at lhe
be lor halfan hour'

this
to the MP and subsequentmeetingattendanceand inspsctbns
In the instanceof the c(xrrplaanl
IL uould have amosntedb a biil for C1080'
 l3 Wewillnot dis$nbtls ttrcresftrenti*ill*n ourcare es ttrdr welfare
bof pararnuntimporbnce to us
atdil'e rquststlpporl fien l&rel gcid servicegin (Htrgrith
lhesetrc reryd.iftcult rcsirlent
rebliYei

Yours sinerely

V
B. Rqn*e
(Chainru

r c.,
Rt.Hm. Frar*fHHp
AilgdaE6gleMP
Atlsonll@orsnltp./
EslherlkVey lfp
ANSWERS TO ALLEGATIONS MADE BY ROTJRKE IN TilS LETTER
MARCH 2011
Para 2 and 3: My wife is a continuingcarepatient so her needs areset out in a comprehensivecareplan which the Homewere
awareof before she arrived and for which they negotiatedan increasedfee Iiom Wirral NHS. I have never askedfor anything
that is not in that careplan .It hasnot beennecessaryto pressme in orrderto confirm that when the careplan is carriedout then I
am happywith the serviceat Eldertrolme.Ihavemadetwelve complaintsin elevenyears.Sevenwere aboutthe careplan not been
followed mainly due to a lack of stafr.Four were over inappropriatebehaviourby managementand one was about the non
availability of essentialprescribeditems.Of the twelve complaintsfive receivedno rsponsewhat so ever,six were upheld with
lettersof apolory received.The last one is the one for which I did not acceptthe responseas my complaintwas not investigated
propcrly and remains outsfanding.Examplesof "the high standards"mentionedare, at different times, I have gone round
ClatterbridgeandArrowe Parktying to borrow catheierbags,a feedingtube, and evenadhesivetape(we hadto usecellotapefor
a dressing).Inaddition the Home has run out of giving sets which are necessaryfor my wife to receive her feed, and bladder
washoutsolution which sheneedsfrequently.Although the letter claims that * nothing substantive"was found ,the Home did
apologisefor neady causingmy wife to have an unnece$sarygeneralaenesetictlrrough not checkingcommunications,and
taking unnece$arybloodsafter beingtold by the hospitalnot to do it.

Para 4 and 5: The meetingwas called by Mr. Webb, then director of Adult Social Care, at his office in order to bring to the
attentionof the directors&at there were concemsof victimisation and ignoring complaints.Theseare professionalmen - did
they not ensurettrat they were awareof the ned for the meeting and what it hopedto achieve?Theseare basic management
skills.

Para 6: This was a normal suppliersinspectionand someconcemswereexpressed"particularly regardingvictimisation.Thereis

no mentionanywhereof the Home"having the higheststandardsof care".The roport is mainly basedon informationprovidedby
the Home without veri$ing its validity. For examplethe complaintspolic,yquotedstates" refer to CQC" but they do not deal
with individual complaints.The satisfactionsurvey result shows all are satisfredwith managerialperformance but I entered
"very dissatisfied"on the form and this commentdoesnot appearin the result summary.What happenedto forms denotingsome
criticism of the Home?

Para 7 and 8: Any matterbetweenmyself and the Homehasbeenasa result of their own actionsor correspondence since2009.
The need for rny only complaint since 2009 was managcments'de,cisionto call a meeting when there was no need and thon
refuseto investigatemy explanationsfor their false accusations.Many of the Inspectionreportsfor the Home particularly stress
the high morale of staff. Care$aff have always beenfriendly towards me and my wife, eagerto help and we have generally
eqioyeda good relationship.Why would experiencedmanagerialpersonnelneedany supportfrom Social Servicesin order to
investigatg within it's own organisation,and according to its own complaints policy, one ftlly evidencedand witnessed
complaint.

Pafa 9: Elderholmeintroduceda computerisedcareplan systernin which all interventionsarenotedwhenperformedby all statr

for ALL residents,not just my wife. As it is not possiblefor relativesto read*om the computer,relevantentrieseanbe emailed
or printsd offon request.I receiveda weekly attachmefitto an email- two minuteswork per week.

Para l0: Quote from chairmanof Elderholmein a letter dated27ft NovemberZAMf Sincewe commencedthe Home in 1989
everyyear has beena netprofit)'When my wife arrived at Elderholmethe Home negotiatedwith the NHS to receivean extra
f.75 per week becauseof her additional needs.This gave.theman additional l7Yo overthe averagefeesreceived.By 2006 this
difference had increasedta 4lo/o - my wife's fees were f,183 per wosk above the average!(Source: CompaniesHouse).
ElderholmeaskedSocial Servicesfor an increaseand so brought the fee to the aftentionof the Service.It was reducedto be
more in line with other continuingcareresidents.Following the reductionthe Home startedtheir campaignto reducemy wife's
care -Quote from letter dated l0th June 2010: "You are ander the misapprehensionthat Elderholme receivesan enhsnced
paymentfor your wife. Ifyou wart additional eareyou should makeout a caseto the PTC" and quotefrom their lettsr dated23
Decernber20l0uAs Doreenreceivesmeditationfour timesper day....sheis seenon a regular basif'when stoppingcheckingher
everyhour asper the careplan.

Para l1 and 12: When cateringcostsarc deductedbecausemy wife's specialfeed is provided on prescription,the differeirce
betweenher net profit to the Home and other residentsin 2010 was still f.4472 (Sauree:CompaniesHouse).Thisdifferential
morethanpaysfor any * extracosts",

Para 13: Welfarewasso importantto themthat they issuedeviction noticesagainstboth residents

 --
4f

EXTRACTS FROM INSPECTION REPORTS

CSCIInspection
ReportonElderholme
February2006states:
"Thefe is no effeetive cqre m(magementat this home due to a lack of leadership, guidance and
supervision,tvhichcompromisesthe health,safetyandwelfare of residentsand staff."
"Thele are seriousdeficienciesin the nursenansgementof resident'sc6re records."
"There is no formal supemisionof care staff in place. The managerrequestedclarifrcation
from the
inqtectoras tawhatformal supewisionmeant."
Th report endedwith a list of 30 statutory requirementswhich the Home neededto make before it
cwplied with the National Minimum Standards,The Care StandardsAct 2000 and the Care Homes
Regulations 2001.TheCSCI Report for 2007showedthat sevenof thesestatutoryrequirementshad still
not beenmet.

The CSCIlnspectionof March2008states:

"Pfe raised seriousconcerrrs...We issuedan immediaterequirement,which is a warning notice which
requires the Home to addresstheseconcernsin a short timeseale.This notice is the first step in our
enforcementprocedureand if not compiledwith can result in prosecution".
,+
One of the nine StatutoryRequirementslisted in the Report states: "The managermust be supportedto
resolveall concernsso that people's expectationscre met and gaad relationshipsare promoted between
fo*ily and staff'.

In June2008 CSCI called a meetingwhich I attendedwith Mr. Liversage,representingover 30 relatives

andresidents,the then matron Woodsand Rourke.The minutesread:
"ft wQSagreedthot: fn responseto the inconsistentand not alwaystimely responseto comploints,
c Mr Rourkeconfirmedthat the procedurefor dealing with complaintshad beenstrengthenedso
that he would overseealt investigationsand outcomes.
t Ihere would be improved monitoring af action taken os a result af complaints qnd cccurate
recordsavoilablefor Inspection."
This was ignoredas evidencedin:
The SocialServicesInspectionreportof December2010andFebruary2011revealed:
'oTherewere in excess
of 100 complaints....complaintswere evidencedby fficers...only one seemedto
have been deolt with effectively. Both the present Manager and the Board of Directors felt these
complaintswerenot dealtwith effectivelynor did theyfotlow the Home'scomplointsprocedure." I
Furthermorethe sarnerport statesthat:
" thepresentmanagerhas anly reeeivedfivecomplaintssinceshearrived .Atlfive complaintshsve been
recordedand dealt with effecttvelyin accardoncewith Elderholme'sdueprocess"It is thereforeevident
that he hasNOT beeninundatedwith complaintsfrom myself but is my complaint logged?Apparently )(
not.

Mr. Webb, having himself recognised victimisation at his meetingwith Alison McGovern et al, called
the directorsto seehim to bring this to their attention.His letter of confirmation states"I exptainedottr
wish to work with Elderholmedirectors to resolve the matter (of victimisation\.Wedkcussed with the
direetors the needto resolveall matterswithout the needfor firther involvementof CQC or a refetal
fromyou (Alison McGoveml to the Secretaryof Stae".

Despite this warning several months later the Social Services Inspection Report says inter alia:
"Elderholmedo not currentlyformally recard allegedcaseof victimisation. Victimisationis not formelly
covered in Elderholme's safeguardingpolrcy. ru Sofeguording Trainer hod not had training on
recognisingand dealingwith allegedvictimisatian."
 ,W.
I,IST OF COMPLAINTS MADE TO ELI}ERI{OLMS

2000 No complaints
2001 Nocomplaints
2AAZ Nocomplaints
1)2003 13frApril Catheterchangeand bladderwashoutprocedurenot followed accordingto
coasulantsinstructions.I
2)2W 8fr August: Catheterbag fastenedabovelevel of body resulting in constantbypassing
d faecesleft on siderail bumpersin sight of wife.I
2ffi5 No complaints
3)2006 31" Octoberi No staffavailable to provide t}rreeon transfersas called for in careplan.

4)200620e November:Staff shortager.- promisingadditionalstaff shortly

/ 5)2006 12h December:Complaint to Pam Marr about a memberof staff discussingmy wife's
dipity needsin apublic meeting.
6)20072l't_July:No feedingtube(PEGi;tailable when needed.-
t 7)2007 28m September:Due to a mix up at the hospital the Home received a letter of
appointmentfor an operationunder a generalaenesetic. The letter was not shownto me -if it
had of been I would have been alert to the error.It becameapparentwhen we arrived at the
Hospital. The operation was stoppedand the Home were told NOT to take bloods the
fo[owing day as it was no longer necessary.The Horne still took bloods.l
I
r 8)2008 18ft February: Complainedthat therewere insufficient staffto carry out the agreedcare
plan and a risk assessmentcalling for three staffto transfer to and from bed was not been carried
replied that they had been experiencing
high levelsof staffsicknessleave.

cdif outbreakcontraryto infection control guidelines.

and promiseto infroduce

hourly checkingandrecordingof same.
and misinforming GP about my wife's
F

CarePlannot followed | 2 ll and Staffnot available 3 4 8 9

Inappropriatebehaviour 5 7 r c n
Shortageof prescribeditems 6

Five no responsereceived
Six apologiesreceived
Oneresponsenot accepted
 ggold Bt*rd6rds,*'
rra rneworK

THIS PA:TIEI.ITt llt0T FSR RE$U$C|TAT$il

Pleaserefer to policy and cPR decision form when cornpleting

we..fayeI potty in ttis
,,,i.r. r'ilt:il .iic iiitic-aiiidcs, 'f"'e *1ii Al;aw paiieni; iO nave a naiUia! a,-d peaC#Ul
'^A'dAd^ t h;^ n^-Fi 3L-r..'L^- aL^ al-- =--i.,+^ ..,^ ...irl -lt-.., --t:F^a- t^ L^..^
::;:':"j :j:jj:=-:,,
dgqth',3ssymBt*m poseible,
1*. i" providing but uithoutunwanted inierventionu ot intG"^, lrli,fi"-il;;;
wish'Wearecommittedto a highqualig,of careatalltimes, *irirai11.fv'til"t,
sr reguscitialepatients if they ".0 i"jii.tii"
have any .r,evgrsible.conditionthat reguires activ rnanagenfsnt,
.u:**o*l: if they developany eonditisnthai,ieirievcrsibleand we feerthaiiu*val ts mr*<ery:inJthat
interventionmightcausemoreharmthangood,ourpolicyis to aa in tfreG.t int"i*"r;ilt"
andwe vriflnotactivefu
resuscitate, ffi;;
or caflenrer-qency
sglvicrsfor hospitaf
aOmission.

Thig4lecisionhas beenrnadebecause:(pleasetickthe appropriateboxesi

'
- lll""lflienfs
,..-f conditionindicatesth_at resuscitation
s unlikelyto #sucoessful or effective,
likely to be follo*nedby a tength of stay and guafityof lffe tira{ wsuki not be acceptabie or is
patienL ts the
' Resuscitationil n?j in accord with the recorded,
sustainedwishesof the patient (who is
mentaflycompetent)

COMMUNICATION:
The decisionhas beendiscussedwifr the oatient
I

The decis_iont'as only been discussed.wtth the person closest to the patient
t

because...?l+..\*+..$s..l+,,\t$ra+l*,io'. Gr.& c**^Jr'r*r*"*',o \"; ;;L".

' This hae nct been digcr.ssedwith
knolvn,& may causediatressto diseues.

**th rf q.lr*'. F[ \^!]J']J,'*\

c.F
Reviewdates{e.9.at G$F

[: $NARremains
il FNAR cancelled

fl Dru*n remains [: DNARcancelfed

Decisioncommunietedlo: {tic* boxesappropriate}

DN OT services tf t: Hospi,ee
0P/DS t:
Macs Plrysiossryicast: t: Horpi*alspeeialist tf
GF surgery Ambufanqe tf
service tf Other tl
CErersat agenry
Family
flirlnlql'
Outsf hoursDrs

*lric
H ir* illra fran* *rf *lra r":r**lan*t*
t:
qrnC
rtlrrcll,ran llD na**s
 ,-\ r" '-
/n /d rffi\ i
|I l// L ii / ) 7 / l l It : i
t<*at

/
Departmentof Adutt sociat s"rv
HowardCooper
Director

Beb-ington
LocalityTeam.
BebingtonTownHallAnnexe
CivicWay
BebingtonWirral CH6BZpT

Strategy Meetin relati

held on Fridav { I Egddows
gvember2011at GirtreliC
Present: Jayne Marshatl,PrincipalManager,Adult
socia.lseMces (chair)
Lesfeyweston, ActingTeam Mtin*ggr,Aorit
s"","r services
BernadefteHegarty,sociarwo*er, ndurt sociari;;;;t-""
y."l pl!F, prrncipaiManager,Contracts
Steve'Khan,.CHC
\_- HeatherWard, Matron,Elderholme
Lawson$tebbings,Director; Elderhofme
' : John cadden,
Merseysidepotice,Mctim support unit
The meetingtoday has been cailedfotlowinga :
meetirtgheld last week on 4tr
November2011 at whichconcernswere raised.
Elderholme,wherirMrl"nkoo**
hasresided forthe$ast11.vears
in v"g"taiedstate,h";;;,d inlt'ii,"li,li#-
issuing
noticeonMrsBeddows due"ronJrd;;;dr ffi;ffi:
' demands overtheyears.c11cer1s_ andunreasonabre
' *"r* nigrrrigfted
asto whgttheimpact would
be if this noticeis served,bothon MrsBeoJiwsbeing
past11years,andwhetherMrsBbddows *ui*t*oT*m,herhsmeof the
i* nt *nouei;il;;h'; move,and.atso
the reactionof Mr'Beddol^/s on receivingthenoticeretter.
The NursingHomehasreported thatrthasnottakenthe decisionto servenotice
lightlvandit fouows11ve,arq of whatErderhorme ;;;;";;;;J#L= uno
iffationalcompraintsfrorn'Mreeouowsto th"-h;;;;;iin
Matron,whoMr Beddowsh". r"ru*d p"rti*rar, Heatherward,
,vrg. M,6tJuuii.,g* **nt o" io saythat
thesecomplaints, "t
*li"h havegotwoo".gu*r irt"'p"riiis yearsarenotrationar
are libellousagainstthe Matron;Mr Beddows and
has,"c" rr.tr,ercompiaints to his
MF' cQc' the LA andalsothe Nursing rvriowilery
qld iouncil andalsoaccusedthe
i?
Iglfl:::,H_ni_*.*ll :lol:s; i# rner,orne-t6JJtn,e
isharassm
entandMr
,me*:1"*i=ffi
*irrr,"u*
lT:X?fflj:"0"":::l"f1*Ii:pt19:,*
Mr steb ioil"J"*,"care
ofErderhorme
bings
saidthathis*n ru*i ror
alsothestaffthere-
Heisalso "i" tiliffi;;Jjfir$I;:,;'ff
no-*tffi;ffi-Jrirl"ito
T'r'n
notice letter. "on"*rnrJ"b";t tnu
steve Khan.fomcHC re-ported thatafternumerous
Beddows,stafffromcHC visitedrrarsBealo* n complaintsmadeby Mr
completea Review.They
reportedno concernsin the wayMrsBeddovvs,lr";Gru;;j;,
needsarebeingmetthroughhercunentcareplan and say her
' cHc andElderholme.cHb received whiclinasGen agreed between
a l*tt*irror Mr eedo;r;-,:nRugu*traising
concemsab'outth.eway his.wjg*"oo"insilreo
Beddowssavingtheir rlport statedno for. steve KhanwrotebacktoMr
bliriri!'i#il;- with Elderhotme
andcHC therehasbeenno evidence "o,i"u*r.
to sugfestthatftirsB"d;;;;';;qrtrJ'i"rrrv
wrvw.wirral.gov,uk
 turns, as Mr tleddowsinsisison. When HeatherWard took over as Matronshe
Quesiionedihe hourlychecksas she felt theywere not neededand not in the
originalcareplan,whichhas beenreviewedregularly.

Lawsonarid Heathertold of one incid'bnt.which had occured. Mr Beddowshad

been'toElderholnreto visit his wife. After leavinghe calledthe hometo say he had
left his mobilephole thereand couldstaffcall as soon as it was found. ThL pFrone
was foundwedgedbehindMrs Beddows'back,rn her bed. As Mrs Beddowsis
immobile,stafffelithis Wasa test from Mr Beddowsto fihd out whentheywere next
turninghis wife. Staffreportedthat lhe phonehad left an indentin Mrs Beddows'
back. This incidenttook placepriorto Lawsonand Heatherbeingempioyedby
Elderholme.

Last De#mber Mr Beddowsnladea commentabouta shotgunsayinglhat he

would kill himselfand his wife. This commentwems to have beenair isolated
incidentand has not beenmentionedsince.

At a meetingin 2009withMr Beddows,Elderholme advisedhimthat if he was not

l.tappywith the levelof carethey were providingto his wife,then he couldtake her
out of the home- Therehas b.eenno recentconversationr,ri,ith Mr Beddows
regardinghis unreasonable behaviour-

Elderholmedo notfeelthatMrs Beddowsis too frailto beimovedto a new home

and saythat her husbandtakesher on dailyvisitshomeoncea weekby bus.

John Caddenfrorn MerseysidePolicewas askddif he thoughtany crimehad been

committedby Mr Beddows.He statedthat no crimehad been committedbut
advisedthat if they are beingpresentedwith a challenging'individual,then the law
is thereto offersupportif theyfeel they are being.harassed,
but it wouldneedto be
from themas an individualand not from their prJfgssionalrole as a ernployeeof
Elderholme-John saidthat the HarassmentAct would coverthis if Heatherwished
to pursue,butthat the Policecouldnot get involvedin CareManagement issues.
Mal Pricefrom ContracisDepartmentstatedthat it is extremelyunusualfora home
to servenoticeon a clientbut underthe contractthey.are withintheirrightsto serue
a 28 day notice.

JayneMarshallhas askedElderholme to not sendthe noticeletteruntilthe

fpllowingactiop havetaken.place,which Lawsonand Heatherhaveagreedtg do.

Asgsrs
Meetingwith Mr Beddowsto take place week comrnencing
14111f2A11to let Mr Beddowsknowthat his behaviouris
unreasonableand cleartyexplainthe situationto Mr Beddows.

To clarify at meetingif Mr B holds Enduringor Lasting pOA

. ' ProtectionPlanto be put in ptaceat meetingto supportuntil

the end of the placement

Lawson sfebFings and Heatherward to beadvised of date of

meeting

www.wirral.gov-uk
 ivlentalCapacityAssessmentio be completedwith Mrs Beddows BH,.LW

ContactOfficialSolicitorre POA LW

Reviewof Mrs Beddowsto checkif she is robustenough.tobe moved SK

* researchand advise

To go to Policeif harassmentsituationbecomesuntenablefor.support HW,LS

Contact Jay Glover at Alison McGovern'soffice LW

DASS/CHCto feedbackto Elderholmefollowingmeeting Afi

Once meetinghas taken placeand Elderholmeadvised,Elderholme LS,HW

to serve notioe
:
Seek legaladvicefrornLegalDeparlment DASS.CHC

Nextmeeting to be held in 3 weeks timeto Review situation(Ginata organiseand

advrse all attendingof date andtime). .
,

Minutestaken by
-
Team SupportOfficer
BebingtonLocality

Ynrur-wirral,gov.uk