We all understand that the UK population is ageing and more and more people will require additional assistance in later life. The NHS is one of the more prominent subjects of the current general election and this in turn has highlighted the standard of care homes across the UK. Unfortunately, there is sporadic press coverage of staffing issues and failing standards although thankfully these are not industrywide. There is no doubt that caring for elderly, often frail residents brings its own unique challenges for staff, management and care home owners.
Number of Care homes in the UK
A government report in 2017 confirmed there were more than 11,000 care homes for the elderly in the UK. This is an industry now worth £15.9 billion a year and involving over 400,000 residents. The sector contains a mix of local authority funded and self-funded beds. The average cost for a self-funded bed in a care home was nearly £44,000 a year back in 2016 with local authority funded beds costing around 25% less. So, what level of service can elderly residents expect in care homes across the UK?
Care home injury statistics
To give you an example of the current situation with care homes in the UK, it has been reported that National Records of Scotland show that a care home resident dies every two days. This is usually as a consequence of an accident, fall, poisoning, self-harm or assault with 187 deaths recorded in 2018. When looking at injuries in general, there has been a 50% increase from the financial year 2014/15 (882 recorded injuries) up to the financial year 2017/18 (1325 recorded injuries). These figures may be a little misleading because Scotland has one of the more ageing populations of the UK although this is a UK wide problem.
A recent report from the Royal Society for Prevention of Accidents also gives a little more detail with regards to care home accidents across the UK. We know that:-
- Between 20% and 30% of falls involving care home residents aged 65 years or over will result in some form of injury
- Of those injured, 30% will be admitted to hospital as a result of hip fractures
- 60% of residents aged over 85 living in nursing homes are at risk of falls on stairs/steps
The Care Quality Commission regularly inspects care homes and where applicable will take legal action to close down substandard facilities. A report in 2017 suggested that one in four care homes in the UK were “unsafe”.
At this juncture it is also worth noting the number of injuries received by staff working in care homes which we will cover in more detail later in this article. We will now take a look at injuries sustained by residents and signs of neglect and potential abuse.
Common accidents suffered by care home residents
As you might guess, there are a number of common accidents suffered by care home residents often as a consequence of their fragile nature. Some of the more common accidents include:-
- Slips, trips and falls
The often fragile nature of elderly care home residents can make them more susceptible to bone fractures as a consequence of slips, trips and falls. While it is impossible to remove all potential dangers from the immediate vicinity, issues such as raised carpets, broken floor tiles and similar dangers must be addressed as soon as possible.
- Inappropriate handling when taking residents to the toilet
Many residents will need help when using the toilet and other bathroom facilities which will involve a fair degree of physical assistance. While the majority of care homes have an array of mechanical devices to lift residents in and out of bed, there will inevitably be a degree of manual manoeuvring. It is therefore vital to train staff who will be handling often fragile and delicate residents.
- Prescription/medication errors
While there are strict procedures with regards to the administration of prescription/medication, unfortunately, mistakes do occur. By law, care homes are required to have qualified nursing staff in charge of administering medication. Negligence may include a lack of training, poor record-keeping or simply inexperienced staff placed in challenging situations.
Dehydration can be a major problem for individuals of any age but for older care home residents this can be a potentially life-threatening issue. It is therefore imperative that residents are regularly supplied with liquid and any significant change in their appearance or actions noted and addressed immediately. If left untreated, dehydration can be a killer!
- Sores and ulcers
Pressure sores and ulcers tend to occur when residents remain in the same position in bed for a prolonged period of time. It is imperative that residents are “turned over” on a regular basis to reduce pressure on one particular area. Something as simple as a sore/ulcer can very quickly become infected and lead to a whole array of other medical issues.
As a consequence of these fairly common accidents, residents may suffer an array of medical issues such as:-
- Cuts and bruises
- Bone fractures
- Severe facial injuries
While the vast majority of medical issues will be dealt on site we are seeing more and more care home residents admitted to hospital. Unfortunately, some of the more serious injuries can result in death often due to medical complications.
Care home staff
Under the Health and Safety at Work Act 1974 it is the legal obligation of all care home management to ensure the well-being of not only care home residents but also their employees. Some of the issues covered under the act include:-
- The provision of appropriate and safe equipment
- Initial and ongoing training
- Clear guidelines with regards to employment roles
- Whistleblowing facilities
- Detailed emergency procedures
- Appropriate health and safety signage
- Provision of a safe working environment
- Regular maintenance of equipment
- Supply of appropriate safety attire
While this list is by no means exhaustive it does give you an idea of the obligations which care home managers have towards not only their residents but also their employees. Some of the more common injuries experienced by care home staff occur when:-
- Lifting and moving patients
- Assisting with toilet/bathroom functions
- Tripping and falling over obstacles
- Attacked by residents/family members
On occasion the media have reported attacks by staff on residents often resulting in legal action. While not always highlighted, it is worth noting that attacks by residents/family members on care home staff are more commonplace. Even though some staff will dismiss this as “part of the job” this is just wrong. Remember, employers have a legal obligation to protect employees as much as they do to protect residents.
Aside from the general aspects of the Health and Safety at Work Act 1974, and the legal obligation employers have towards staff and residents, there are strict health care guidelines across the UK. In the event of an accident brought about by potential negligence it can sometimes be challenging to gather clear and concise evidence. Many victims may not be in a position to assist with any investigation into possible negligence. However, thankfully many care homes have an array of cameras and record-keeping obligations which can often help.
In the event of recurring injuries across numerous residents of a care home, red flags should be raised with regards to potential health and safety issues. Is staff training and support fit for purpose? Do these injuries involve particular members of staff or do they occur when carrying out particular procedures? In the event of an accident, a pattern of recurring injuries can be useful when taking action for personal injury compensation.
In many instances of abuse/negligence in care homes it can be difficult to collect definitive evidence. Cameras are not commonplace in resident bedrooms and other private facilities – very often it will come down to a whistleblower to report abuse/negligence. As we touched on above, employers are required by law to acknowledge and investigate the concerns of whistleblowers.
Unfortunately, while whistleblowers also have a degree of legal protection this is not always fully appreciated in the workplace. It is the obligation of an employer to ensure that a whistleblower is able to retain their anonymity and they are not subjected to any backlash as a consequence of raising their concerns.
Approaching a personal injury claims solicitor
There are two potential parties who may be eligible for personal injury compensation as a consequence of negligence in care homes. We will now take a look at the evidence required from residents and employees who decide to take action by starting a care home injury claim.
Care home residents
As some residents may not be able to participate in evidence gathering, it is important that as much information as possible is gathered at the scene of an accident by connected/third parties. This may involve anything from photographs to witness statements, raised suspicions in the past to a pattern of similar accidents. It is also important to ensure that the victim is examined by a doctor/medical practitioner as this report could prove vital when pursuing compensation.
Care home employees
Those working in care homes are regularly exposed to physical and mental pressures many of which do not occur in traditional employment roles. It is the legal obligation of all employers to ensure the physical AND mental well-being of their employees. Any negligence in this area, resulting in injuries, may result in a claim for personal injury compensation. Again, there will need to be an array of evidence to support any claim such as photographs, witness statements, proof of negligence in areas such as training, staff apparel and general safety in the workplace.
There is no doubt that physical, mental and financial pressures exist in the care home sector. In reality there are few employment roles which involve such extreme pressures on a regular basis. However, care home managers have a legal obligation to protect not only residents but also their employees. Evidence of negligence can lead to significant personal injury claims and in some instances care homes have been closed down.
Unfortunately, this issue is going to become more acute in the years ahead as the UK has an ageing population and growing demand for care homes and additional assistance in later life.