A Liverpool care boss has been suspended after creating false records of a terminally ill cancer patient using discontinued medication days before he died. Catherine Inguyi Ngaira ran Mossdel Healthcare Ltd on Long Lane, Fazakerley and provided care for a man referred to as patient A in 2020 following his discharge from hospital.
Care Plan and Medication Discrepancy
A Nursing and Midwifery Council (NMC) fitness to practise committee was told that when the man was discharged from hospital in August 2020 he was given a care package in which his specific medication had been discontinued and converted into a syringe driver to be delivered by a district nurse. However, Ms Ngaira continued to give the tablets to patient A.
The NMC report established how the care manager created a medication administration record (MAR) confirming when the medication was taken despite having no knowledge as to whether this had occurred. Patient A, who had metastatic pancreatic, lung and liver cancer at the time, still had capacity to take medicines himself.
Role and Responsibilities
As the owner and manager of the company, Ms Ngaira was commissioned only to undertake tasks such as washing, dressing and making food for patient A. She had only registered the company with the Care Quality Commission in December 2019 and was providing care to patient A's wife.
The report said when patient A returned home from hospital with the Mossdel care package in place, it was alleged she administered or helped patient A to take the discontinued medication. This involved popping tablets out of their blister packs into a tub, despite this not being part of his care plan.
Panel Findings and Suspension
The NMC panel could think of no reason for Ms Ngaira to have created the MAR. Officials took the view she had believed the document was important and heard from the care manager directly she had created the log as a reminder to patient A that another one of his medications was reducing. However, this was deemed to be highly unlikely.
The report said during the time patient A was under the care of Ms Ngaira, she was operating under CQC guidelines. Her competency around handling medications had expired and she was required to take a fresh course. However, a charge that she had been dishonest in creating the records to provide misleading times was not found proven.
Despite this, the NMC panel did find Ms Ngaira had been dishonest in claiming patient A had self-administered the medication when she in fact had provided it to him. It was said she also failed to inform Knowsley Clinical Commissioning Group and/or the District Nursing team that patient A's needs as set out in his care plan had changed in that he needed support with his oral medication.
Suspension and Review
In moving to issue a suspension to the care chief, the NMC panel found she had "put a patient at an unwarranted risk of harm to an extremely vulnerable patient towards the end of their life, suffering with a terminal illness." They added how Ms Ngaira had acted "outside the scope of her commission" as she had not been commissioned to administer any medication whatsoever in this role.
The panel was not satisfied that Ms Ngaira had shown full insight into her actions and her dishonesty, and it could not be satisfied that should any issue occur in the future, she would not be dishonest when dealing with it. As a result, a suspension order was imposed for a year with review. At the end of the period of suspension, another panel will review the order. At the review hearing the panel may revoke the order, or it may confirm the order, or it may replace the order with another order.
