"Concerned about communication and coordination of care"

Following a long admission to Cove Ward for my relative, I am concerned about the standard of communication and overall coordination of care.  

One of the doctors was very rude and did not communicate well with family and when they did, we felt like they spoke down to us, showed absolutely no empathy and seemed to be not interested in anything anyone else has to say. They also reported facts about the mental health act wrongly with no explanation, and quoted wrong information about the history of care received.

We were offered a carers leaflet 5 months after admission which I found quite disappointing. Documents that were requested (minutes, property sheet) have never been received after asking several times. My relative's phone was 'lost' for over a month and I repeatedly asked if it had been marked in the property sheet and was told it was not logged in nor was it on the ward, several weeks later it was 'found' after already purchasing a new one and cancelling the sim card etc.  

During the admission my relative became very unwell and confused and was worse than when she arrived, I reported many times that the new medication did not agree with her, she wasn't getting better and If anything was worse, yet it continued to be prescribed for 3 months.  A best interest decision was made not to issue any more of one medication, due to falls risk and how sedating it was, yet she continued to be given it for weeks afterwards.

Also, a concern is that the ward were regularly discussing sending my relative to a care home without having carried out a proper capacity assessment or holding a best interest meeting and this would have been against their wishes and the social worker had deemed that a package of care at home was appropriate. 

There was also initially a named nurse on admission and this then changed to another nurse, who we never received an update from in 6 months. Families rely on clear, timely communication especially during long admissions and I hope Cove Ward take steps to review their processes. 

What did work well was one doctor who initially kept us updated for a period but they left so this then stopped. I would like to note that the Physician's Associate and the Occupational Therapist are a credit to the ward but I feel it should not be their responsibility to take on all of this when there is a Consultant Psychiatrist who is the responsible clinician and Mental Health Nurses who have a duty of care for patients.

My relative was given access to cigarettes and regularly went for smoking breaks outside the main doors which is against policy, she did not smoke before being admitted to the ward and had given up some time ago and has COPD, I asked one of the nurses about the policy on this and they said that it was above their paygrade. I was informed my relative had coughed up blood on one occasion and I asked why she was being enabled to smoke.  

On a previous admission to this ward, my relative was outside on a bench in the cold and had to ring me at home to contact the ward to go out and help her back inside as she was unable to stand, when she asked a passing member of staff to help they said they were on a break and left her.   

During this admission, my relative was found wandering near the main road and traffic lights, which is quite concerning that an elderly, mentally unwell patient with mobility issues was able to walk out of the hospital site unnoticed, I am grateful she did not fall or have an accident.