A care home has been slammed for failing to put necessary safeguards in place to ensure the safety of vulnerable residents.
Oxford Crown Court, sitting on 22 January, heard that a disabled teenager died from injuries caused by scalding water after being lowered into a medical bath. Yelena Hasselberg-Langley, 18, was paraplegic, epileptic, and registered blind, and required 24-hour care at Lifeways Community Care Home in Oxford.
On 27 August 2007, Yelena was lowered into the bath by two carers who were not trained to identify scalding risks. A special valve on the bath, designed to prevent scalding, was not set, and the bath was filled with scorching-hot water. One of the carers checked the water temperature by hand, but she was wearing a glove and didn’t realise the water was excessively hot. Yelena suffered severe burns and died in hospital four days later.
An HSE investigation found that the care home’s parent company had a bathing policy in place, which required staff to check the water temperature by hand without wearing gloves. It also stated that staff should check if the safety valve was set to a suitable temperature.
But none of the staff at the care home had been made aware of the firm’s bathing policy, according to HSE. Inspector Nina Judkins said: “Everyone involved with the care of vulnerable-service users must ensure that they have the necessary safeguards in place. Cases like this are completely avoidable if the correct guidance is followed.
“It is difficult to imagine a more vulnerable resident than Yelena. The risk of scalding to people who are so vulnerable that they cannot prevent harm to themselves is a well-known danger in the care industry.
“The consequences of scalding can, in addition to causing excruciating pain, be fatal — as so shockingly seen in this case.”
Lifeways Community Care Ltd, which runs the home in Oxford, pleaded guilty to breaching s3(1) of the HSWA 1974. It was fined £100,000 and ordered to pay £45,000 in costs.
In mitigation, the firm said it had no previous convictions and has now made all employees aware of the bathing policy, and trained them in line with it. In a statement the company said: “We apologise unreservedly for this tragic accident and reiterate our sincere condolences to Yelena’s family and friends.
“The tragedy was largely the product of human failings, not our systems. We have taken the judge’s comments fully on board and we are pleased to note that the court recognised that we have, and always had, a sincere commitment to high and exacting standards of care and safety.
“This was an isolated lapse and it is important to recognise that the judge said that there was no cause to doubt the organisation’s high standards.”
To view HSE guidance on the risks from hot water in health and social care, click here.
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