Care home health and safety warning

EHOs have warned that confusion over the Care Quality Commission’s (CQC) new role in enforcing health and safety law for care home residents could lead to serious risks not being investigated.

The CQC became the lead inspection and enforcement body for safety of residents at registered residential and care homes on 1 April. Local authorities and the Health and Safety Executive (HSE) retained responsibility for employees.

The CQC has now claimed that it should only investigate when there has been an incident involving a resident and that a ‘general breach’ of health and safety would be referred to councils or the HSE.

But Helen Atkinson, a senior EHO at Wakefield Council who recently prosecuted a care home for unsafe window restrictors, said this was ‘simply not true’, and referred to HSE guidelines on responsibilities set out in a Memorandum of Understanding (MoU).

‘They would not be able to refer a similar situation to us – the lack of suitable window restrictors - as they are the enforcers.

‘Now the CQC have taken responsibility, we will see how many prosecutions arise from their interventions and if they are as successful as environmental health in addressing issues of non-compliance.’

Govind Mandora, team manager at Leicester City Council, said the authority has had similar issues and had been in discussion with the CQC and the HSE both at a local and national level over concerns that it was slow in investigating and enforcing health and safety issues.

He said: ‘The CQC doesn’t have the same health and safety understanding that the HSE and local authorities do.

‘We have raised these concerns and the response has been “we know there are problems with the MoU and this need time to bed in and will be addressed over time".

'This puts this and other unitary authorities in a very vulnerable position, if we can’t now investigate accidents in care homes and the CQC for any reason are not in a position to action these issues, we’re in a difficult position when it comes to an authority placing people in care homes where we know there’s a problem, particularly if further (or more serious incidents) incidents occur at the home which could have been avoided or prevented by quicker action.'

Wakefield Council prosecuted Care Homes UK Ltd, the owners of Stockingate Residential Care Home, after Ms Atkinson discovered broken and unsafe window restrictors at the premises. She described it as 'one of the worst care homes I have seen', with urine-soaked carpets, rotten windows, water dripping a ceiling onto a resident's bed and water from taps coming out at over 60 degrees.

Concerns had been referred to the council by the CQC in June 2014, before the rule change splitting responsibilities between CQC, local authorities and the HSE came into effect this year.

Window frames were in a bad state of repair, and some had no restrictors and were opened wide. The company pleaded guilty to the offence and was fined £3,300.

The fact that the regulator had been visiting the home since 2012 and not brought up the concerns previously was used by the company as mitigating circumstances.

A CQC spokesperson said: ‘Should a similar situation arise now we would still refer to the local authority due to there being a general breach of national health and safety guidance.’

Deborah Westhead, CQC deputy chief inspector adult social care north region, added: ‘CQC inspectors visited Stockingate Nursing Home in June 2014 and identified a number of concerns regarding the safety of the premises.

‘We referred our concerns immediately to the local authority EHO and issued Care Homes UK Limited with a warning notice requiring they take action to address the safety issues as a priority.

‘As a direct result of our findings and subsequent referral, the local authority EHO visited the home and served four Improvement Notices under the Health and Safety at Work Act.’

‘Ensuring that care is provided in safe premises and that security arrangements are such that people are safe while receiving care is of paramount importance. This has always been a key area that we look at when inspecting and we will continue to do so with the same scrutiny.

‘Where we find evidence that this is not the case we can and will take action to ensure the safety and welfare of people using services.’

Falls from unsecure windows at care homes are a major concern that has been highlighted by the HSE. Local authorities undertook nearly 40 prosecutions against residential care homes between 2008 and 2012.


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