What can you do if you think a care home is negligent?

Our population is ageing and the need to find suitable care facilities for our elderly loved ones has never been more prevalent. They need somewhere that will provide the right standard of nursing care and fulfil their needs.

The Care Inspectorate website provides an excellent resource for families, allowing them to identify Care Homes in close proximity to the family home and also insight into the quality of these homes. Furthermore, National Care Standards have been created to try to promote a baseline standard of reasonable care amongst care homes.

Although the majority of Care Homes thankfully meet or exceed these standards, a minority fail to provide a reasonable standard of care to residents.

The majority of complaints regarding elderly care facilities relate to the provision of healthcare and welfare, which results in injury to residents.

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Most common types of negligent care in care homes

Falls in care homes

Falls are the most common type of injury in elderly residents within care homes.

Falls due to negligent care arise through a combination of factors including:

• Lack of supervision
• Failure to properly risk assess a person’s risk of falls
• Lack of knowledge amongst the care staff 
• Failure to implement preventative strategies to minimise the risk of falls.

If you are concerned about a falling injury to a relative, you should advise them to discuss the matter with the Care Home Manager or Nurse in Charge.

Enquiries should be made about the following aspects of care:

1. Has a falls/mobility risk assessment been completed?
2. What is their relative’s level of falls risk?
3. Do they require an assessment by a falls risk team?
4. What is the level of supervision required by their relative to mobilise?
5. Is behaviour being monitored to establish if there is a pattern to the falls?
6. What are the circumstances of the fall?
7. Was the fall  witnessed or un-witnessed?
8. Where did the fall occur?
9. What time of day did the fall occur?
10. Would alarms or pressure pads be of assistance to alert staff that their relative has moved?
11. What other equipment is available to minimise the risk of falling? (Such as hi-lo beds, crash mats, medication reviews and the involvement of physiotherapists to improve mobility).  

Pressure ulcers caused by neglect

Whilst it is true that most pressure ulcers are preventable, there will always be a small number of individuals who will develop pressure ulcers due to their underlying medical conditions.

This can be difficult for families to accept because the belief is that pressure ulcers should generally not happen.

If you are concerned about pressure ulcers then you should ask to meet with a senior nurse or Tissue Viability Nurse and review:

• Care plans
• Risk assessment tools
• Wound care charts.
• Enquire about what strategies are being implemented to reduce pressure such as; the use of mattresses, cushions pressure reducing boots, repositioning charts, nutrition/hydration charts.

Ask these questions regularly to establish if there has been any evidence of improvement. If there is no improvement, then you should see changes in the care plans to reflect   that different strategies are being tried to try to encourage healing and prevent further ulcers developing.

Entrapment in care homes

Entrapment generally arises when a resident who is cognitively impaired attempts to move from their bed, which has cot sides in an upright position. They then become trapped between the rails.

Entrapment associated with cot rails/bed rails would be considered negligent in most cases, as the gaps between bed rails have been reduced in order to prevent entrapment of the head.

If you have concerns about entrapment injuries you should make enquires to the Care Home Manager about the make and model of the bed that is being used and what risk assessments have been completed to assess if the equipment is fit for purpose.

Drug administration errors

Most elderly residents can have multiple underlying conditions such as heart disease, diabetes or Parkinson’s disease, and rely on the correct dose of medication being administered at a specific time.

If their medications are not administered as prescribed this can result in devastating effects.

For example, failure to administer oral hypoglycaemic medications to diabetics can lead to raised blood sugars, infections and confusion. Failure to carry out regular blood checks oradminister warfarin correctly to people with heart problems can cause strokes, heart attacks and blood clots.

If you have any concerns that medications are being administered incorrectly to your relative, you should ask to meet with the Nurse in Charge and request to:

• Review the medication charts to see what drugs have been prescribed and what times the drugs have been administered at; and
• Ask to meet with the GP to have a review of medications.
• If your relative is prescribed warfarin you should enquire about their blood results which should be checked routinely.

Sadly, there are care homes in Scotland that provide unacceptable levels of care, and residents may be injured as a result of this negligence. There are signs to watch for and questions you can ask to ensure standards are upheld.

Often when relatives ask Care Home staff about the care of their relatives they are dismissed and advised by the member of staff to speak to someone else as they do not know about their relative. Do not be put off by this comment. Arrange to make an appointment to discuss any concerns with the Nurse in Charge.

It is also useful to prepare a list of questions in advance that you wish to ask and take someone to the meeting who can take notes of what is discussed.

If you or a loved one has been injured due to negligent care, you may be able to pursue a claim for compensation against the care home and help prevent a similar incident happening to someone else. We would encourage you to seek expert legal advice as soon as possible as there are time limits to bringing a claim forward.

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