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By Spencers Solicitors

  Gemma Agar    
  September 19, 2013

Residential Care Homes: Can we make them safer?

Many people at some point in their lives will see a dearly loved elderly family member go into residential care. It's not a decision that is taken lightly to place let a loved one go into the care system, but it is sometimes a necessity if family members cannot provide the level of care needed.
This blog is not intended to list the horror stories you might hear or read about in the press. There are many excellent facilities that provide a very high standard of care for their residents, and their families are safe in the knowledge that their parent, grandparent, aunt, uncle etc are in good hands. It is of course inevitable that accidents will happen, but what concerns me is that many of these accidents can so easily be prevented.
The residential care industry is ranked amongst those with the highest numbers of injuries caused by slips or trips. The Health and Safety Executive reported that in 2011/2012 alone, there were 22 slip, trip or fall accidents in the sector which proved fatal.
BBC News/Google Maps - Oldfield House Doncaster

BBC News: Doncaster Borough Council was fined £7,040
after admitting breaching health and safety legislation

As recently as September 2013, Doncaster Borough Council was prosecuted after a resident suffered injuries after falling approximately 2 metres into an uncovered sewerage drain at Oldfield House Care Home in Stainforth.
The lady in question was 82 years old and suffered from dementia.  She was able to walk out of the care home into the grounds unnoticed, where she fell into the drain where plumbing works were being carried out.  The works were being carried out by a recently qualified plumber who was clearing a blockage on site. He had accessed the blockage via a manhole outside the fire door, and left it open whilst he went to fetch water to flush the blockage.
Fortunately, she suffered only minor cuts and bruises although did require a night in hospital. Clearly the outcome could have been much worse, but the incident should not have happened in any event.

Health and Safety Investigation

On investigation of this case, the Health and Safety Executive found that the council had failed in its duty to protect residents and staff whilst works were being done, in contravention of Section 3(1) of the Health and Safety at Work Act 1974, which states:
'It shall be the duty of every employer to conduct his undertaking in such a way as to ensure, so far as reasonably practicable, that persons not in his employment who may be affected thereby, are not thereby exposed to risks to their health or safety.'
By simply placing temporary barriers around the open drain, covering the area when not being worked on, or even having someone stand by to alert any residents or staff to the danger would have prevented this accident. Simple and obvious.
The frustrating thing is that when the Health and Safety Executive's investigation was presented at court, it was highlighted that the council had actually got in place an appropriate risk assessment, which had identified preventative measures which should be taken when there were repairs being carried out on the premises, but they had failed to follow their own procedure.
Further to this the plumber who had been sent to the home by the council was inexperienced, had been required to work his own and had not been provided with any safety equipment (such as barriers, signs etc.)
Five steps to risk assessment

 HSE: Five steps to risk assessment 

Risk assessments are not enough

It is obvious that the council had made the relevant assessments and identified proper practices and procedures that were to be implemented. However evidently it is not enough to simply have these ideas and 'best practices' documented if they are not going to be put in to practice.
This brings me to the question of how can these working practices be implemented? The most obvious suggestion is by training staff regularly so that it becomes second nature.  However, something that I come across all too often in my day to day handling of cases, is that training a person in 'best practices' is all well and good, but they need to have the time and the resource to put those practices into place, as without that facility, corners will inevitably be cut from time to time.

All a question of resource?

Put bluntly, if institutes don't have the necessary funding, then they won’t have the right level of staff.  In respect of care homes if you don’t have the staff needed, it becomes very difficult to maintain a safe environment when staff are constantly rushed off their feet.
As my colleague Charlotte Farrell (herself a former nurse) recently wrote in her blog, every healthcare professional considers the wellbeing of their patient or service user to be of paramount importance, but as with any workplace when a team is stretched there is only so much that can be achieved.
So then it is perhaps worrying to learn that another South Yorkshire council are proposing to cut up to 70 jobs at two care homes as part of an effort to save £20 million from its budget.  The media reports that council officials have denied that a reduction in staff numbers would impact resident safety or the quality of care.  But the same council suspended 5 of its residential care home workers in July 2013 after a resident fell and injured herself, and later died.
Perhaps councils and local authorities across the country ought to rethink their decision to cut residential care budgets, and instead consider the real consequences for both residents and their families should these staffing levels be reduced.

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