Lawyer chief demands lethal accident inquiries for any children who die in residential care

THE head of a main lawyers’ company has required a fatal accident inquiry (FAI) to be vital each time a child dies while in residential care.

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James Wolffe, dean of the Faculty of Advocates, is predicted to give his discussion to MSPs today on Holyrood’s justice board which is reviewing planned changes of the pre-existing procedure of analyzing unexpected deaths.

The Investigations into Fatal Injuries and Sudden Deaths Bill states that an investigation should only be vital if a child has died while in a secure residential unit, however in a submission to the committee Wolffe suggested any death of a child in the care of the state should quickly be subject to an FAI.

Retired senior judge Lord Cullen of Whitekirk stated this recommendation in his assessment of FAI law, which accumulated the idea of the legislation currently going through Holyrood, and Wolffe exclaimed it really should be involved in the Bill.

“Lord Cullen’s advice on this challenge needs to be carried out in full by including within the obligatory categories deaths of children being maintained in residential facilities,” explained Wolffe whom agreed on Cullen’s proposition that a FAI should not be essential if a child passed away whilst in foster care or while being looked after by family members.

“In its July 2014 discussion paper the Government drew a variation in this context around children maintained in residential housing that is not secure facilities and those in secure accommodation, specifically that residential facilities can not detain children against their will.

“We don't take into account that difference is completely convincing to warrant departing from Lord Cullen’s proposition.”

He added: “Lord Cullen considered that the dividing line around cases when an FAI needs to be mandatory pertaining to a child in care should leave out youngsters in kinship or foster care, but should include youngsters in residential organisations. We share his view that this is the proper division.”

An FAI happened in 2011 into the fatalities of Neve Lafferty, 15, as well as Georgie Rowe, 14, who jumped to their deaths off the Erskine Bridge in a dual suicide soon after running away from their residential house in October 2009.

The girls, each from troubled and disturbed family backgrounds, had a reputation of self-harm, attempted suicide and heavy alcohol and drug abuse, including heroin use and uncontrolled drinking.

The sheriff’s succeeding report drastically criticised the Good Shepherd Centre in Bishopton, where they lived in an open unit, for failing to protect them.

However beneath the existing plans such an FAI would not be obligatory since the girls were in an open unit.

Underneath the active law only deaths in custody and at work should be subjected to an FAI and it's also up to the Lord Advocate if an FAI takes place into the passing away of a child in care.

Wolffe agreed with the majority of the other propositions in the Bill, that include provisions to hold FAIs into Scottish inhabitants who have died abroad.

He also supported intentions to have specific sheriffs hear FAIs, taking them right out of the hands of the more junior summary sheriffs, but he talked about considerations that this move might mean longer waits for loved ones of the passed - just one of the vital troubles the proposals desired to correct.

Wolffe stated in his submission: “The faculty considers that there is merit in the power to employ “specialist” sheriffs in FAIs. The faculty has some worry concerning the use of summary sheriffs in FAIs. Although this will allow for flexibility - and might aid in the goal of securing that queries will be held without delay, the usage of summary sheriffs would seem to run counter to the proposal for “specialist” sheriffs.

“Given the restricted legislation of summary sheriffs, there might be a conception that an inquest before a summary sheriff is being addressed with less importance than an investigation before a non-summary sheriff.”

FAIs are a cornerstone of the Scots legal operation and were created in 1895. They are fact-finding exercises completed in the public interest into some non-suspicious abnormal fatalities to locate any flaws in procedure.

A number of residential care senior citizens could very well be living independently

A whole new review by B.C.'s Elderly people Advocate affirms lots of elderly senior citizens are living in residential care that could very well be living independently.

"If you are not in need of that level of proper care, it's really a rather uninspiring experience to live in such a limited community, that is what you require when you're providing the safety for higher acute clients," claimed Isobel Mackenzie.

Mackenzie released the report, Placement, Drugs and Therapy... We Could Do Better, on Tuesday right after looking at health assessment documents from B.C.'s 25,000 senior citizens in residential care and 29,000 senior citizens receiving homecare.

The seniors advocate has worked in home care for Twenty years. She suggests up to 15 per-cent of B.C. seniors at present living in residential care are usually incorrectly housed and really should be given access to assisted living or perhaps community care.

Excessive medication recommended

Mackenzie's review furthermore discovers an unneccessary use of medications as well as a lack of rehabilitation therapy within care facilities.

It states that 33 percent of residential care patients are being prescribed antipsychotic medication, yet only 4 % are generally diagnosed with a psychiatric disorder.

"This excessive use, or incorrect use, or even imbalance of prescription is certainly problematic when you have a look at 50 % of seniors in residential care take 9 or maybe more medications."

Similarly, nearly half of residential care clients are given by doctors antidepressant medication when just Twenty four percent have been diagnosed with depression.

Government not really surprised at findings

B.C.'s Minister of Health Terry Lake claims the provincial government is operating diligently to address these issues.

"We will work hard with various companies that are in seniors' care to reduce the reliance on antipsychotics and prescription drugs in general.

"I think those are a couple of findings that aren't a real surprise to us and we'll be working on to address."

The Office of the Seniors Advocate will release a extensive review of seniors' housing at the end of spring.

Shortage of nursing staff ‘is causing problems in community care’

Royal College of Nursing report says panic drive to fill hospital jobs after NHS scandals has left home based services greatly understaffed

A panicked drive to get medical workers for hospitals, after a number of damning NHS scandals, has neglected an increasing crisis in community care, the Royal College of Nursing reports.

Even after NHS plans to transfer care from hospitals, the community nursing workforce has shrunk significantly during the past five-years at the same time as the amount of nursing jobs in hospitals has risen.

The workforce is down by over 3,300 nurses, including 2,000 district nursing staff who offer care for individuals in their very own residences or residential establishments - a 28% cut to what the RCN says is a vital part of the community workforce.

In a report - The Fragile Frontline - released on Sunday , the college calls on the next govt to improve resources for community healthcare, so psychiatric and physical care may be safely given outside hospitals by a highly trained workforce.

Peter Carter, chief executive and general secretary of the RCN, said: “Whoever creates the next government needs to study this report and act immediately to grow the nursing workforce and make sure it will keep up with need with a lasting and long term plan.

“In contrast to many problems facing the health service, the answer to the nursing workforce is quite easy and is dependent on political will. With a lot more folks wanting to nurse than before, the next government has the power to raise coaching places and expand the availability of nursing staff. If it doesn't, it will be failing a generation of patients.

“As the election draws near there will be a lot of pledges, and many will be neglected. However the next govt can be assured that it'll be evaluated in 5 years’ time on whether we have a adequately financed health service that is fit for the Modern day.”

Right after Sir Robert Francis’s inquest into failings at Mid Staffordshire NHS Trust in 2013, the connection between very poor patient care and dangerous employment levels became a sudden problem for the government to manage.

Trusts began increasing the number of nursing staff on wards all around England to act on recommendations by the Francis report as well as in response to political pressure. Between 2010 and 2014, the total nursing, midwifery and health visiting workforce has grown because of this.

However, the push to renew employment levels was mostly limited to intense, maternity and neo-natal and paediatric nursing settings, it's reported by the RCN. Mental health settings have instead lost 3,986 nursing posts and learning disability settings have lost 1,586.

In 2011 the government brought out the health visiting programme, geared towards raising the number of health visitors to in excess of 12,200 by March 2015. There has been a rise of 2,691 health visitors since May 2010, bringing the total to 10,783 in December 2014. However, after the effect of health visitors is subtracted, community settings like care homes have lost 3,332 certified nursing posts.

The RCN suggests in its report that, whilst it supports increases to the health visiting workforce, this should “not be at the expense of other roles that are integral to patients getting essential top quality care in the community”. Check out Residential Care Homes for more on residential care.

Shadow health secretary Andy Burnham, answering the report, mentioned he was devoted to having much more nursing staff into the system.

The Observer presented last week that the rise in the nursing workforce was achieved by bringing in more than a 1 / 4 of new employees from abroad. Frontline clinical staff numbers went up by 11,100 under the coalition government, the Conservatives declare, and it had dedicated to about 10,000 more community healthcare workers - 5,000 doctors and 5,000 drawn from medical workers and allied health care professionals.

Burnham revealed that on “day one” in power he would increase the training places, with a goal of 20,000 additional medical workers in the following five-years.