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Insight

Care home funding crisis threatens us all

A report in the Times today that one in six care homes is in danger of insolvency should set alarm bells ringing for all of us.

As costs rise, but local authorities are forced to cut their social care budgets, there is critical funding shortfall that clearly puts the most vulnerable at serious risk.

Around 420,000 people over the age of 65 are currently looked after in Britain's 11,000 residential care homes, including 220,000 of the most vulnerable patients, living in 4,700 nursing homes. What these public institutions need is more staff, more equipment, more resources to be able to care properly for the elderly, not budgets squeezed to dangerous levels.

Plus there is the additional problem that private care-home providers unable to make a profit will simply hand back contracts to the already over-stretched local authorities, making the situation even worse.

When care homes and hospitals lack sufficient staff, the risk of neglect increases, often with catastrophic consequences.

I recently reached settlement for a woman whose husband who suffered with dementia and was being cared for in a home in North Acton. Despite staff being warned that Mr Wright had previously tried to climb out of windows and his explicit statement that day that he intended to do so, he was left unattended for long enough to be able to force the window of a third-floor bedroom and jump to his death on the concrete below. Understandably, the Wright family was distraught that their father had been able to do what he did while supposedly in the care of experts.

A safeguarding investigation by Brent Council admitted that Mr Wright was the victim of neglect and highlighted inadequate risk management at the care centre, unacceptable carer delay, poor communication and a lack of oversight of Mr Wright's situation.

At the inquest into the death of the 81-year-old, the coroner said he had 'grave concern' about patient safety at the care home.

Hospital staff at the Northwick Park Hospital who assessed him that night recommended that Mr Wright be looked after in a nursing home rather than at home to protect him from hurting himself.

Despite recommendations from the hospital psychiatric team for constant supervision, Mr Wright was not restrained in any way at the care home, nor was there any emergency protocol in place to protect him.

CCTV footage taken on the evening he fell shows no sense of urgency in the interval between him telling staff he intended to jump and his doing so. Giving evidence, the care worker said she believed the locked windows were safe.

Two years ago, following the death of a patient who fell from a second-floor window of a mental health crisis house, the Government's Health and Safety Executive issued special guidelines to care homes about window restrictors, saying that although most conformed to current British safety standards, they were not strong enough to withstand the force of someone trying to open them and did not protect vulnerable patients. The Coroner involved in that case advised the Health Secretary that urgent action was needed to prevent further deaths.

Hearing Mr Wright's case at the North London Coroner's Court, Senior Coroner Mr Andrew Walker said it was a matter of grave concern that Mr Wright had been able to force the restraining device fitted to the window. He noted that a Department of Health circular had recommended secondary window catches be fitted to guard against such risks, following the Inquest two years previously.

In his verdict last August, the Coroner said that if those devices had been fitted at the time, it is unlikely that Mr Wright would have died when he did.

The facilities director at the Victoria Care Centre said that he was not aware of the advice. Additional safety devices have since been fitted to windows at the home.

There have been too many terrible reports recently on care homes failing people in their care. Care homes are specifically designed to look after people at their most vulnerable. The Victoria had not implemented specific advice on window restraints circulated by the Department of Health to all care homes and hospitals. It is a tragedy that Mr Wright lost his life as a result.