Care home health and safety is a crucial aspect of providing quality care to residents. However, there are many potential health and safety breaches that can occur within a care home setting. Here are some of the most common ones:
- Inadequate risk assessments – Risk assessments are a key element of ensuring a safe environment for residents and staff. They should be conducted regularly to identify any hazards and assess the level of risk they pose.
- Inadequate staff training – Staff need to be trained in a range of areas, including manual handling, infection control, and safeguarding vulnerable adults. Failure to provide adequate training can lead to accidents and injuries.
- Inadequate personal protective equipment (PPE) – PPE is essential for protecting staff from infection and injury. Failure to provide adequate PPE can result in staff contracting illnesses or being injured in the course of their work.
- Inadequate management of medication – Medication errors can have serious consequences for residents. Care homes must have robust systems in place for the ordering, storage, and administration of medication.
- Inadequate management of falls – Falls are a common occurrence in care homes, but they can have serious consequences for residents. Care homes must have appropriate risk assessments, preventative measures, and management procedures in place.
- Inadequate infection control – Infections can spread rapidly in care homes due to the close proximity of residents and the vulnerability of their immune systems. Care homes must have effective infection control procedures in place to prevent the spread of infections.
- Inadequate food hygiene – Poor food hygiene can result in residents contracting illnesses such as food poisoning. Care homes must have effective food hygiene procedures in place to prevent this from happening.
- Inadequate record keeping – Care homes must keep accurate records of all incidents, accidents, and medication administration. Failure to do so can result in poor care and inadequate monitoring of residents’ health.
- Inadequate management of violence and aggression – Residents with dementia or other cognitive impairments may become violent or aggressive towards staff or other residents. Care homes must have effective management procedures in place to protect staff and residents from harm.
- Inadequate management of fire safety – Fire safety is a crucial aspect of care home health and safety. Care homes must have appropriate fire safety procedures in place, including regular fire drills and staff training.
It’s important to note that these common health and safety breaches can lead to serious consequences for care homes, including regulatory action and reputational damage. Therefore, care homes must take appropriate steps to ensure that they are meeting the necessary health and safety standards.
To avoid these potential breaches, care homes can seek support from a company that can provide care home health and safety services. We can offer guidance on issues such as barrier nursing, handling sharps, managing violence and aggression with vulnerable adults, PPE, and more. By working with us, care homes can ensure that they are providing the best possible care to their residents while also meeting their regulatory obligations. Get in touch to discuss care home health and safety with us.
Examples of Prosecutions for Care Home Health and Safety Failings
Managing risk to residents and staff from other residents There have been a number of prosecutions from both the CQC and the HSE which have focused on physical assaults of residents and staff by other residents. Many organisations support people who sometimes act in unpredictable ways which can put themselves and others at risk of harm. It is therefore extremely important that providers assess and mitigate these risks properly.
Risks to Residents
A Cheltenham care home provider was fined £460,000 for failing to protect its residents from avoidable harm following prosecution by the CQC. In March 2017, a person living at the home assaulted two of the agency care workers and later locked themselves in a room with another resident. Staff attempted to break down the door, as it was apparent that the other resident was being attacked, but were unable to do so. On the evening that the incident happened, the home was short-staffed. The staff ratio should have been two agency staff with one permanent staff member to support, who would have known all the bedroom codes and where the bedroom keys were.
A Nottinghamshire care provider was also prosecuted by the CQC and fined £363,000 after a resident was sexually assaulted by another resident. There had been 79 separate incidents documented where this resident had displayed inappropriate verbal and physical sexualised behaviour and assaulted people. The CQC found that the provider had not managed the risk posed by this resident or escalated the concerns appropriately.
A third care provider was prosecuted in January ’22 and fined £66,000 after a female resident was attacked by another resident with known mental health issues and suffered a head injury. It was found that the provider did not have adequate systems and processes in place for assessing new admissions and did not carry out proper checks to mitigate the risk to that resident or others.
Risks to Staff
While the focus of the CQC’s enforcement action is on failures in the provision of care, the HSE retain primary responsibility for enforcing the obligation to ensure the safety of staff. The HSE brought a prosecution against a Liverpool care agency after an employee was stabbed by a resident during a regular visit. The employee had been left alone in the kitchen with the resident, despite the care plan stating that this resident always required the attendance of two care workers.
The HSE’s investigation found that the provider did not take account of the care plans and risk assessments that were in place, which clearly indicated the high risk that the individual posed to themselves and others. However, the risk assessment and care plan failed to identify the triggers for violence and aggression, and how the risk could be managed. The HSE also commented that the need for 2:1 supervision and triggers should have been highlighted more effectively to employees before visits.
A different care provider was prosecuted by the HSE after a female employee was abducted and sexually assaulted by a male service user. The HSE’s investigation found that the provider had failed to carry out a suitable and sufficient assessment of the risks to the safety of their female employees posed by this service user. Notably, there was evidence that indicated that concerns had been raised by support staff about their safety with this service user from as early as 1994. This incident happened in 2018.
Key Messages
It is essential that providers not only carry out a full risk assessment addressing the risks to those being supported and to staff and put in place a care plan for each resident, but also ensure that the mitigations identified in the documents are put into practice. Concerns should be recorded and investigated promptly. Where it is identified that a certain number of staff are needed for supervision purposes, this information should be provided to and shared with all relevant staff. Arrangements should be made to ensure that a sufficient number of staff are on shift at any one time, which may require careful planning given the sector’s staffing difficulties.
Providers should also ensure that staff have completed any training which may be needed to support individuals with behaviour that presents a risk to themselves and others. When an incident does happen, it is important to seek advice as soon as possible. We are able to provide practical advice and support to care providers when an incident has taken place. We can even have a health and safety consultant out to your site for crisis management.
Choking
Recently, a large care home company was fined following an incident where a resident choked to death on a jam doughnut. The resident was known to be at high risk of choking and was consequently on a minced and moist diet. The HSE found that the staff who gave out snacks had not received proper training and were not aware of the food that was suitable for each diet. Food was regularly given to the resident, which was not suitable for her diet, which was found to be in breach of the risk assessment.
We have also seen the CQC raise issues around staff training in enforcement action. The national staffing crisis has made it difficult for providers to recruit experienced staff and this can increase the risk of an incident occurring. Nevertheless, it is important that all staff receive sufficient training before starting work and that providers can demonstrate the steps they have taken to ensure that staff have read and understood training materials/care plans, risk assessments, etc. Whilst the provider’s response on the day to the choking incident was not at issue in this case, providers should also ensure that they have clear policies on choking and that staff are aware of what to do should an incident occur.