The sad case of Audrey Peace has recently received some press attention. It would be dangerous to dismiss the case as being irrelevant to privately owned care homes, even though the litigation that followed Mrs Peace’s death involved Durham County Council (the Council) and Durham and Darlington NHS Trust (the Trust).
In December 2011 Mrs Peace fell at home and fractured her arm. She was admitted to University Hospital North Durham and was discharged to Mendip House, a care home managed by the Council.
Mrs Peace was a resident at Mendip House for six weeks. During that time she developed severe pressure sores. While at Mendip House, district nurses employed by the Trust visited her to manage the more severe healthcare aspects of her care needs.
There were failures on the part of both Mendip House and the district nurses to treat and document pressure sores. One sore on her elbow was completely overlooked until it was identified as being in need of treatment at an orthopaedic outpatient appointment.
Mrs Peace was discharged from Mendip House in February 2012. While at Mendip House she had been receiving 24 hour care, but at home she initially received four 30 minute visits daily. These were subsequently increased to four one hour visits daily.
Mrs Peace’s health and condition declined rapidly and she was re-admitted to University Hospital North Durham on 11th February 2012 where it was noted her pressure sores were infected. Such was her condition that she died on the 25th March 2012. Her death certificate stated that the primary cause of death was “large infected pressure sores”.
Before her death, Mrs Peace had brought a legal claim against the Council and the Trust. Following her death, Mrs Peace’s daughter Mrs Armstrong took over the legal claim which addressed issues of poor nursing care in relation to the pressure sores.
Subsequently, Mrs Armstrong complained to the Parliamentary and Health Service Ombudsman and the Local Government Ombudsman with regards to how the home, the Council and the Trust had provided care to Mrs Peace during her lifetime, and how the bodies had addressed complaints and safeguarding alerts while Mrs Peace was alive and living in Mendip House.
In addition to the legal claim, Mrs Armstrong then made a claim under the Human Rights Act against the Council and the Trust. The case was settled without a formal hearing in July 2016, and damages were received by Mrs Armstrong at the end of 2016.
Points to Not
1. The legal claim in relation to poor nursing care leading ultimately to Mrs Peace’s death was brought against the Council in part because it owned Mendip House.
2. The Human Rights Act claim against the Council and the Trust was in part founded on the poor management of the complaints, and in part on the failure to recognise Mrs Peace’s right to a reasonable quality of life while at home and in Mendip House.
3. The care records at Mendip House were sub-standard as was the care of pressure sores. District Nurses placed too much reliance on care home staff to identify problems, and care staff rely too much on district nurses to be responsible for and to document the healthcare issues and in particular the pressure sores.
4. It is a point to consider whether the care records at Mendip House indirectly contributed to the sub-standard care Mrs Peace received at home. On discharge, social services placed reliance on the care records when settling the care package Mrs Peace had at her home.
5. There was no dispute between the care home owners and the Council as to who was responsible for the sub-standard care Mrs Peace received, because the Council was responsible for both.
A care home cannot rely on district nurses who call in to be entirely responsible for identifying all healthcare needs and treatments. While district nurses may deliver the actual healthcare this does not reduce the obligations on the care home to fully monitor and document a client’s care needs in their entirety. Be aware that the care records may be relied on by social services when making an assessment as discharge support. Inadequate records may leave you liable. If those records are then disregarded, the consequences become the legal and moral responsibility of the Council who provides post discharge care.
The Health & Social Care Team at Harrison Clark Rickerbys have extensive experience in advising care providers and service users on issues arising out of quality of care.