Shocking neglect uncovered at two care homes in Cornwall

An undercover investigation has exposed shocking levels of neglect at two care homes in Cornwall.

Hidden camera footage filmed by BBC Panorama reporters recorded vulnerable people left unattended, including one left on a bed pan for 40 minutes, an out-of-date prescription supplement relabelled for use by another resident, and the threat of morphine being used to silence a resident.

One of the homes, Clinton House in St Austell, is closing down as a result of safety concerns and the other, St Theresa’s, in Callington near Plymouth, has been placed under investigation by the Care Quality Commission (CQC) and Cornwall council.

Two other nursing homes with the same owners – Morleigh Group – as those featured in Monday’s edition of Panorama are also being investigated.

The four care homes under scrutiny had all previously been rated as “requires improvement” by the CQC, which said it had had “serious concerns with the Morleigh Group for some time”.

The reporter Janice Finch booked into St Theresa’s and Clinton House posing as a resident. She witnessed staff rushed off their feet, compromising the privacy and dignity of some fellow residents. She paid £750 a week for a room where the bin was not emptied, the soap dispenser had no soap and the toilet seat was broken.

Another reporter worked as a care assistant at Clinton House, doing 14 shifts without her references being taken up or a criminal records check being completed.

Secret footage showed a nurse announcing her intention to give morphine to a resident “to shut her up”.

It also showed an elderly resident with severe dementia in a bed with a loose safety rail. The undercover reporter, worried that the resident might hurt herself, was advised to hold the rail in place with her foot.

The resident had a wound on her leg, and staff did not know how she had come by it even though she was supposed to be receiving 24-hour one-to-one care.

Trevor Doughty, Cornwall council’s strategic director for children, families and adults, said: “The health, wellbeing and dignity of residents absolutely comes first; we are shocked and saddened at the incidents reported by Panorama, and are very sorry that this has happened in these privately run homes. On behalf of everybody who dedicates their careers to keeping people safe, and seeing them treated with dignity and respect, I am sorry for what has happened in these homes.”

Andrea Sutcliffe, chief inspector of adult social care at the CQC, said the regulator had brought forward its inspections of Clinton House and St Theresa’s after Panorama had shared its concerns about the homes.

“We are taking tough action against the Morleigh Group to protect the people living in four of its nursing homes in Cornwall,” she said. “This follows a significant deterioration in the quality of care it has been providing as uncovered through our most recent inspections.”

The other two Morleigh Group homes under investigation are Elmsleigh in Par and Collamere in Lostwithiel.

Moreleigh Group said in a statement that investigations carried out prior to the receipt of information from Panorama had “resulted in the removal of the staff involved, together with a thorough review of our systems and procedures”.

Panorama: Nursing Homes Undercover will be broadcast on BBC1 on Monday 21 November at 8.30pm

Shocking neglect uncovered at two care homes in Cornwall

Neglect contributed to teenager"s death in psychiatric hospital, coroner rules

The lack of resources for children’s mental health services in the UK has been described as a “national scandal” after a coroner ruled that neglect and “continuing failures” at one of the largest mental health trusts in England contributed to the death of a teenage boy.

Christopher Brennan, 15, died after being found unconscious at Bethlem Royal hospital in south London in August 2014. He had been admitted to the psychiatric hospital’s adolescent unit six weeks earlier as his family and local mental health services felt unable to keep him safe at home.

Christopher had a history of harming himself, and a deterioration in his mental health over the two years before his death led to repeated hospital admissions.

The coroner found that no formal risk assessment was carried out during his stay at Bethlem hospital, which is run by South London and Maudsley NHS foundation trust, and there was no care plan in place, according to the charity Inquest, which is supporting his family.

South London coroner’s court heard he was also allowed access to a number of items in hospital which he used to self-harm.

On 31 August 2014 Christopher was found unconscious in a communal toilet and later died after suffering a cardiac arrest.

Handing down her ruling on Wednesday, the coroner, Selena Lynch, said: “Christopher’s actions were in part because of cumulative and continuing failures in risk assessment and management. His death was contributed to by neglect.”

The hospital trust offered its “sincere apologies” to his family and said it had reviewed its practices. A spokesman said: “Areas of learning for the trust were identified through a serious incident investigation and we have carefully reviewed our procedures accordingly.

“More recently, the service has been inspected by the Care Quality Commission and care was found to be of a ‘good’ standard. We hope this offers some reassurance to the family that lessons have been learnt from this very tragic event.”

Following the inquest Christopher’s family said: “Losing our beloved son and brother when he was just 15 years old was so painful. Losing him as a result of the hospital’s failure to protect his life is unbearable.

“Chris will never be forgotten and no other child should be allowed to die in this way.”

Christopher was one of at least 11 young people to die in psychiatric units in England between 2010 and 2014, according to Inquest.

Deborah Coles, the charity’s director, said: “Sadly, Chris’s death is not an isolated one. Incredibly, we find that no single body is responsible for collating, analysing or publicising these deaths and that these deaths are not being independently investigated.

“The lack of resourcing of child and adolescent mental health services across the country is a national scandal. The only possible response to this case and the growing public outcry and disquiet around mental health services for children and young people is for an urgent independent review. We call upon the government to now take this necessary step.”

Neglect contributed to teenager"s death in psychiatric hospital, coroner rules

Western nations" "neglect" eroding fight against Aids

HIV prevention providers for drug injectors are dropping out due to “changing donor policies and national government neglect”, the report warns. Photograph: Chris Youthful/PA

The global try to end Aids is becoming undermined as western countries, including the United kingdom, pull funding in the locations that require it most, according to major well being groups.

On the eve of the 20th Global Aids Conference, held in Melbourne, authorities are warning that funding for HIV prevention for folks who inject medication is in crisis. They say that attaining an “Aids-cost-free generation” will be extremely hard without concerted action.

Harm Reduction International, the International Drug Policy Consortium and the Worldwide HIV/Aids Alliance – which is mourning the loss of many colleagues who died in Thursday’s Malaysia Airlines jet crash – will publish a report that confirms HIV prevention companies for drug injectors are losing out due to “shifting donor policies and national government neglect”. The report warns that a failure to offer funding will carry a large rise in HIV transmission, which in turn will result in additional expenses to government well being sectors.

UNAids, the joint UN programme on HIV/Aids, claims that $ two.3bn is needed in 2015 alone to fund HIV prevention between people who inject medication. But international donors have invested only $ 160m – roughly 7% of what is required.

The Division for Worldwide Improvement has been pushing for the Global Fund, the principal distribution mechanism for HIV remedy programmes, to focus on minimal-earnings countries. However, the report demonstrates that 75% of folks who inject drugs reside in middle-cash flow countries.

“The cost effectiveness of harm reduction interventions in stopping new HIV infections is well documented,” explained Catherine Cook, senior analysis analyst at Harm Reduction Worldwide. “In numerous middle-earnings countries, much more than two-fifths of new HIV infections are amid individuals who inject medicines. But donors are nevertheless withdrawing due to their middle-revenue status with no responsible exit techniques in area.”

As a result of the reprioritisation, half of the 58 nations that have previously obtained harm reduction funding are now either ineligible for support or have not been assigned any “new” HIV money.

“We’re facing a ideal storm of donor retreat, national neglect and substantial overspending on ineffective and frequently counterproductive drug enforcement,” stated Susie McLean, senior adviser on drug use and HIV at the Global HIV/Aids Alliance.

Western nations" "neglect" eroding fight against Aids

3 nurses charged with wilful neglect

South Wales Police confirmed Lauro Bertulano, 44, Clare Cahill, 41 and Rebecca Jones, 29, have been charged on suspicion of falsifying patients’ notes at the Princess of Wales Hospital, contrary to Area 44 of the Mental Capability Act 2005.

A complete of 13 nurses have given that been suspended, such as the 3 who have been charged.

A dozen of those are from the Princess of Wales Hospital, with the remaining one particular from nearby Morriston Hospital in Swansea.

The hospital spokesman said: “Over the last 15 months 3 nurses have been arrested and provided police bail in connection with police investigations at the Princess of Wales Hospital. We are mindful that the three have now been charged.

“Clearly this matter is now sub-judice and therefore we will not be commenting even more at this stage. We continue to assist South Wales Police with their investigations.”

A police spokesman said the three nurses are scheduled to seem prior to Bridgend Magistrates’ Court on July 28.

The hospital had previously confirmed that its internal programs picked up alleged anomalies final 12 months relating to the record-retaining of a modest variety of nurses.

A complete of 13 nurses have given that been suspended, which includes the three who have been charged.

A dozen of individuals are from the Princess of Wales Hospital, with the remaining 1 from nearby Morriston Hospital in Swansea.

The hospital spokesman explained: “In excess of the final 15 months 3 nurses have been arrested and provided police bail in connection with police investigations at the Princess of Wales Hospital. We are aware that the 3 have now been charged.

“Plainly this matter is now sub-judice and for that reason we will not be commenting further at this stage. We proceed to help South Wales Police with their investigations.”

A police spokesman stated the 3 nurses are scheduled to seem before Bridgend Magistrates’ Court on July 28.

3 nurses charged with wilful neglect

Will criminal sanctions for wilful neglect shield individuals?

There are several flaws in the government’s proposals, says Nick Clements, which are not in line with Don Berwick’s suggestions to the NHS. Photograph: Bloomberg through Getty Photos

In a submit-Mid Staffs planet, the government’s programs to introduce criminal sanctions for healthcare experts who wilfully neglect their patients at first appear realistic. Surely nobody could object to a new law designed to shield sufferers against currently being unwell-handled, specially one aimed at staying away from the deaths at the centre of the Mid Staffs scandal?

It can be argued that there is probably a gap “wilful neglect” could fill. There is a criminal offence of neglect and sick-therapy in the Psychological Capacity Act (MCA) but this applies only to adult sufferers who lack capacity and not to neglect of a competent grownup. Additionally, the existing law on offences towards the man or woman is aimed at real assaults, so several things that would be described as “neglect” or “sick-therapy” – such as leaving a patient for a long time with out food or drink, or in a soiled bed – wouldn’t be covered.

Yet this attainable advantage can’t hide the a lot of flaws in the government’s proposals which, contrary to Don Berwick’s recommendation, won’t need that a patient really suffers any harm as a outcome of the neglect or ill therapy.

The most worrying element of this proposed new law is that the definition of wilful neglect can be broadly interpreted. In truth, virtually any choice about how to allocate scarce resources, which patient to deal with initial, or even regardless of whether to investigate or to begin a remedy now or up coming week could potentially volume to wilful neglect. Wellness pros have to make tough judgments and selections of this kind on a everyday basis yet there is no proposed defence of, for example, “reasonable exercising of clinical judgment” which wellness specialists can seem to. Instead, the new law proposes leaving such issues to the discretion of the investigators and prosecutors: an technique probably to end result in inconsistencies and depart healthcare specialists afraid and uncertain as to what may be criminal.

Of program healthcare pros who wilfully neglect or unwell-deal with their sufferers need to be held to account, but there presently exists a robust regulatory, disciplinary and criminal framework that is efficient at making sure physicians face the consequences of their actions. If a neglectful doctor is not deterred by these, then they will not be deterred by this new proposal.

It is critical to remember that central to the Francis report was a call for adjust of culture in the NHS. Nonetheless, cultural change cannot be mandated by legislation and measures such as the proposed criminal sanctions could do a lot more to exacerbate the really climate of concern the government is keen to end. Certainly, investigation performed by the Medical Protection Society in November 2013 discovered 65% of hospital physicians surveyed believed that the government’s programs to introduce these criminal sanctions would heighten the culture of concern in hospitals.

Healthcare professionals are appropriate to be worried. As these proposals stand, the act of exercising clinical judgment, specially in hard circumstances, might depart them vulnerable to criminal expenses, and the risk of conviction, imprisonment and the loss of profession and livelihood.

Needless to say, the risk of prosecution will do minor to promote the government’s other post-Francis measure – duty of candour. Right after all, would a healthcare professional be sincere and open about a real blunder if they knew it could depart them subject to criminal expenses?

The NHS wants an setting in which personnel are skilled and supported in admitting mistakes and learning from errors – an open culture of understanding and improvement rather than 1 of blame.

If the government must proceed with the introduction of this new offence, it should make certain it is made up of additional safeguards to safeguard clinical judgment, selections about resource allocation and to avoid criminal allegations arising as well effortlessly from civil proceedings. More importantly, it must, as advised by Berwick, make certain the legislation covers only serious incidents to steer clear of impairing daily clinical judgment. If not, they risk jeopardising attempts to generate the transparent studying culture the NHS demands.

Nick Clements is head of healthcare providers at the Medical Safety Society

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Will criminal sanctions for wilful neglect shield individuals?

Do not neglect to wash your hands, nurses advised

“Infections are a costly and avoidable burden. They hinder a patient’s recovery, can make underlying conditions worse, and reduce quality of life.”

The guidance says more must be done to reduce the amount of antibiotics being prescribed, in order to stem resistence of infections which resist antibiotics.

Earlier this year Dr Sally Davies, chief medical officer for England, expressed concern over a steep rise in the number of patients who do not respond to antibiotics, amid incresed resistence levels.

Officials said the scale of such infections had become a matter of “national concern” with 600 cases reported last year, compared with just five in 2006.

The quality standards state that the most common type of infections include pneumonia, lower respiratory tract infections, urinary tract infections and surgical site infections.

These infections can occur in otherwise healthy people, especially if invasive procedures or devices like catheters or vascular access devices, are used, Nice said.

“Although there have been major improvements within the NHS in infection control, particularly in relation to Clostridium difficile and MRSA bloodstream infections in the last few years, healthcare associated infections are still a very real threat to patients, their families and carers and staff,” Dr Leng said.

Carol Pellowe, senior lecturer at Guy’s & St Thomas’ NHS Foundation Trust, a member of the committee which developed the Nice guidance said: “This quality standard will promote best practice in infection prevention and control and by providing key areas for action, encourage organisations to sustain their efforts in ensuring patient safety.”

Do not neglect to wash your hands, nurses advised

Proposed wilful neglect law may see up to 240 health prosecutions a yr

The Division of Wellness says the criminal offence will send a sturdy message that poor care will not be tolerated. Photograph: Altrendo Pictures

There could be up to 240 prosecutions a yr alleging wilful neglect or unwell-therapy of patients below a new criminal offence to be introduced in England following the Mid Staffordshire hospital scandal, the government says.

Folks could face up to five many years imprisonment and/or £5,000 in fines, says a consultation paper and impact evaluation on proposed new legislation. The organisations that use them could encounter far stiffer economic penalties.

Such a law would act as a deterrent and match penalties that previously exist for those who ill-deal with individuals with no mental capability, says the Division of Overall health. “This offence will also send a powerful message that poor care will not be tolerated and guarantee that wherever ill-remedy or wilful neglect takes place, people accountable will be held to account.”

The price to the criminal justice technique is estimated at £2.2m a yr, despite the fact that in a minority of situations defendants will be essential to fund their own fees at about £400 a time. Other costs, though not quantified, will be incurred by police and organisations taking actions to minimize threat of prosecution. There might also be reputational harm, says the division.

The recommendation for an offence to apply inside the NHS came from an advisory group chaired by Don Berwick, an international skilled of patient security, in the wake of Robert Francis’s damning verdict on Mid Staffs. But ministers feel it should apply far much more extensively, such as in personal hospitals, nursing houses, regardless of whether below NHS, local authority or personal management, and in the voluntary sector.

The figure of 240 prosecutions a yr is a very best, if guarded, estimate based mostly about prosecutions presently brought beneath psychological wellness legislation. But with an estimated 10.8m customers of overall health and social care every single yr, the department estimates offences beneath the new law would have an effect on a single in 45,000 sufferers towards the a single in three,800 individuals affected by situations governed by psychological well being law.

Ministers say real mistakes or accidents should never ever lead to prosecution but utilized as a way of learning to improve the quality of companies in future. The care and support minister, Norman Lamb, explained: “Our healthcare method is the envy of the world. The NHS is total of caring and compassionate staff delivering the ideal care for individuals. But the Francis inquiry showed that often the common of care is not very good ample.

“This is not about punishing trustworthy problems – it is about closing the gap in recent laws so that this sort of bad care can not go unpunished. The proposal is portion of a package deal of measures after Francis to ensure greater protections for individuals, far more support for NHS workers and better transparency and openness in the NHS.”

Peter Walsh, from the patient safety charity Action against Medical Accidents, broadly welcomed the proposals, specifically the criminal offence relating to organisations. He mentioned: “It is essential to remember that this is about wilful neglect – not errors or lapses. It is intolerable that individuals guilty of this kind of wilful neglect can presently not be held to account. The effect assessment demonstrates that the DoH estimates several are keeping away from that. Nonetheless, the principal emphasis need to be on supporting good good quality care. An acceptance of compulsory minimum staffing levels would have aided that.”

Proposed wilful neglect law may see up to 240 health prosecutions a yr