Mr Rajit Singh 79 year old practising Sikh gentleman and English is his second language. He recently suffered a mild stroke and made a good recovery but his mobility is slow and he is occasionally unsteady and mobilises with a Zimmer frame.

Mr Singh was admitted to the acute medical ward three days ago following a stroke. He is a rather obese gentleman who smokes twenty cigarettes a day and has a right sided hemiplegia. Mr Singh lives with his seventy five year old wife, son and daughter in law in a first floor flat. His wife and daughter in law are his main carers.

Since his admission to the medical ward Mr Singh has become incontinent of urine failing to tell staff he needs the toilet. He is rather reluctant to mobilise and wants to stay in bed and his appetite is poor. He reluctantly accepts support with his personal hygiene only wanting either his wife or daughter in law to assist him.

Two days after admission when being showered, a small red area was noticed on his right hip which was raised during patient handover but was not followed through by nursing staff. By day four a large cavity of about 10cm by 9.8cm and 3cm deep developed on his right hip and was filled with soft yellow slough. He is complaining of pain in his wound.