Human Rights Day is held annually on the 10th December to promote and protect the rights and dignity of all people everywhere. Read about how POhWER supported Paul to have his voice heard. It relates to the right to health (article 25 of the Universal Declaration of Human Rights) and also the UN Convention on the Rights of Persons with Disabilities (also article 25, which begins: States Parties recognize that persons with disabilities have the right to the enjoyment of the highest attainable standard of health without discrimination on the basis of disability).

Paul's story

Paul is a 53-year-old gentleman who has a severe learning disability, epilepsy and cerebral palsy. He is non-verbal and lives in a care home. Staff at care home called to make appointment for him to see a dentist as they were concerned about his oral health when he first arrived in their care – staff referred to an offensive smell emanating from client’s mouth, finding blood on client’s bedsheets apparently coming from a tooth, and also finding teeth in his bed which had fallen out.

Paul had an initial appointment in February 2019 and a referral for an IMCA was received from the senior dental officer. POhWER IMCA undertook visit and submitted the report. POhWER IMCA identified that it would be in client’s best interests to have dental work under sedation, including general anaesthetic if necessary. Report included a number of recommendations regarding client’s preferences for treatment and care. Dental officer acknowledged receipt of report in April and stated that client was now on the list.

POhWER IMCA followed up with care home twice in May to see if dental treatment was carried out – it had not been carried out. POhWER IMCA then wrote to query what was going on and received no response. In discussion with the care home, staff reported that Paul was still in a lot of pain, bleeding on his sheets and losing teeth.

The care home also called the dental surgery to advise that client had been self-harming to the extent that he had caused injury to himself with a severe outcome. The dental receptionist advised that Paul was one of many people waiting for priority treatment and he would have to wait his turn. Manager advised her that client had been waiting a long time and an IMCA was involved and this was now neglect as client was clearly in pain. POhWER IMCA then followed up with a call to the dentist in June. POhWER IMCA provided an addendum report to the dentist who then advised an appointment had been booked for the client with a view to having treatment within 6 weeks.

Following this Paul had appointments in July, and August which had to be cancelled due to dentist sickness. During this time POhWER Advocate contacted the dental practice directly to confirm their involvement and the previous reports sent and updated the care home manger about this contact. The advocate also signposted the care home manager to the NHS complaints process delivered by a different advocacy organisation and ultimately the manager submitted a formal complaint to the Divisional Director of Operations.

The advocate continued to liaise with the relevant clinicians in order to confirm her involvement, the remit of her involvement in signing consent forms and highlighting additional elements which would make the process as least stressful as possible for the client.

Unfortunately a third appointment had to be cancelled because Paul had a fall and was admitted to hospital but eventually he had his oral surgery under sedation completed. He had 7 teeth removed and has 5 left. His health now appears to be better than it was when he first arrived at the care home.

The care home manager also and received a response to her complaint from the Trust acknowledging that the Trust had been at fault in a number of important respects and indicating how those lessons would be learned.