Grade 3 and above Pressure ulcers - safeguarded

Response to this request is long overdue. By law, under all circumstances, Wandsworth Borough Council should have responded by now (details). You can complain by requesting an internal review.

Sylvia Rushbrooke

Dear Wandsworth Borough Council,

Freedom of Information Act Request
Some of following information requested below was sent to the Wandsworth CCG
they have said they do not hold the information and advise the request is made to Wandsworth LA as follows
This information may be held by the London Borough of Wandsworth in their capacity as local safeguarding coordinators. Details about asking them a freedom of information request can be found here: Thank you for your request under the Freedom of Information Act. This response is provided on behalf of NHS Wandsworth Clinical Commissioning Group (CCG).
I am unsure why the CCG would not hold such information when they were funding all NHS funded care for some residents at that care home and care is supposed to be MDT and the LA shared such information with them .....

How many grade 3 PUs were identified in Wandsworth Care homes and in which homes in 2014 - 2015?

How many of those grade 3 PUs were raised as safeguardings?

Please can the council answer the fllowing regarding York Court care home Battersea that closed itself due to poor care and neglect Dec 2015

1. How many grade 3 pressure ulcers were reported as a serious incident to the
appropriate authority and relatives in 2014 and 2015?

1a and complied with the duty of candour reg 20 eg relatives informed a serious incident had occurred ?

2. Those that were not reported by York Court to the CQC as a serious incident that the LA were aware of what action did the LA take?
and what action was taken against York Court for breaches?

3. As MDT is a PU issue -serious PUs are attended to at the care home by NHS trust TV nurses. Grade 3 PUs in 2014 and pre April 2015 were classified as a NHS serious incident and obligatory to report as an external serious incident by the trust - how many were reported in this way by the Trust? who say the CCG is automatically notified of such serious incidents

4. How many grade 3 pressure ulcers were raised as a formal safeguarding in 2014 and
2015 at York Court

5. How many overall serious incidents were reported by York Court care home in 2014 and
2015 to the LA and CQC?

Yours faithfully,

Sylvia Rushbrooke

Freedom Of Information, Wandsworth Borough Council

Request for Information - 2017/15089 - Pressure ulcers in care homes

Thank you for your request for information received on 21/06/2017.

This will be processed in accordance with the appropriate access to
information regime.

Regards

FOI and DPA Officer
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Freedom Of Information, Wandsworth Borough Council

Request for Information - 2017/15089 - Pressure ulcers in care homes

 

I refer to your request for information received on 21/06/2017.  Please
see the information below in response to your request: -

How many grade 3 PUs were identified in Wandsworth Care homes and in which
homes in 2014 - 2015?

 

Over 18 hours (Section 12 Exemption)

 

For the Council to provide the requested information for this request it
would require going through approximately 152 records. We calculate each
case will take approximately 15 minutes to review.

 

 

How many of those grade 3 PUs were raised as safeguardings?

Please see above

 

Please can the council answer the fllowing regarding York Court care home
Battersea that closed itself due to poor care and neglect Dec 2015

 

1.  How many grade 3 pressure ulcers were reported as a serious incident
to the appropriate authority and relatives in 2014 and 2015?

This information is not held in a retrievable format

 

1a  and complied with the duty of candour reg 20 eg relatives informed a
serious incident had occurred ?

See response to Q1

 

2.  Those that were not reported by York Court to the CQC as a serious
incident that the LA were aware of what action did the LA take?

and what action was taken against York Court  for  breaches?

If LA did not receive any reports by York Court or via CQC/CCG, then we
would not know about them to take any action.

 

3. As MDT is a PU issue -serious PUs are attended to at the care home by
NHS trust TV nurses. Grade 3 PUs  in 2014 and pre April 2015 were
classified as a NHS serious incident and obligatory to report  as an
external serious incident by the trust - how many were reported in this
way by the Trust? who say the CCG is automatically notified of such
serious incidents

For CCG to respond.

 

4.  How many grade 3 pressure ulcers were raised as a formal safeguarding
in 2014 and

2015 at York Court

10 safeguarding concerns (formerly known as alerts) relating to Neglect in
2014-15 in York court.  

 

5.  How many overall serious incidents were reported by York Court care
home in 2014 and

2015 to the LA and CQC?

This information is not held in a retrievable format

 

 

 

 

I hope this information meets your needs. If you do not understand the
information provided or wish to discuss anything further, please feel free
to contact me and I, or another member of the team will be able to assist
you.

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Room 149, Wandsworth Town Hall, Wandsworth High Street, London, SW18 2PU

If you are not content with the outcome of the internal review, you have
the right to apply directly to the Information Commissioner for a
decision.  The Information Commissioner can be contacted at: 

 

Information Commissioner's Office, Wycliffe House, Water Lane, Wilmslow,
Cheshire, SK9 5AF

 

Regards

 

Nicholas Taylor

FOI & DPA Officer

Serving Richmond and Wandsworth Council

020 8871 7202

[email address]

www.richmond.gov.uk / www.wandsworth.gov.uk

 

 

show quoted sections

Sylvia Rushbrooke

Dear Freedom Of Information,
I have rcvd the following from your office that in part seems contradictory please clarify

I refer to your request for information received on 21/06/2017. Please
see the information below in response to your request: -

How many grade 3 PUs were identified in Wandsworth Care homes and in which
homes in 2014 - 2015?
Over 18 hours (Section 12 Exemption)
For the Council to provide the requested information for this request it would require going through approximately 152 records. We calculate each case will take approximately 15 minutes to review.

SR
As these are probable safeguarding matters/alerts it should not take as long as suggested to supply the information
Please advise of cost to supply this information so they I may have the choice to pay for the information

Grade 3 PUs were at this time classed as a NHS and CQC serious incident/wound - PUs of this severity are a sign of neglect and likely safeguarding issue - a per safeguarding threshold guidance
http://www.wandsworth.gov.uk/downloads/f...

The Cost to the Patient of PUs from https://www.england.nhs.uk/wp-content/up...

Can be life threatening

Can lead to severe disabilities/amputation

Infection and osteomyelitis

Extended hospital stays

The need for surgery or prolonged immobility

Along with exudate and leaking dressings,
possible malodour and embarrassment but
most importantly pain and suffering

The Care ACT (2014)
‘A pressure ulcer (or other forms of skin damage) may have arisen as a result of poor practice, neglect, acts of omission or deliberate harm and therefore have to decide whether to make safeguarding alert in line with
the local multi agency Safeguarding Policy and Procedures

How many of those grade 3 PUs were raised as safeguardings?

Please see above

SR This information is readily accessible and would be easy to find out from safeguarding? who keep such records of alerts made by authoroties and relatives please supply

Please can the council answer the fllowing regarding York Court care home Battersea that closed itself due to poor care and neglect Dec 2015

1. How many grade 3 pressure ulcers were reported as a serious incident to the appropriate authority and relatives in 2014 and 2015?

This information is not held in a retrievable format
SR
I believe it is as it would involve safeguarding alerts and safegarding threshold guidance would have been applied for such serious wounds at this care home as it was under investigation by the LA from June 2014 for institutional negelct and abuse - so the LA would have been aware of such wounds on site at the time of their investigatios and would have recorded that information as part of that investigation and elswhere

1a and complied with the duty of candour reg 20 eg relatives informed a serious incident had occurred ?

See response to Q1
SR
This is not an answer to the question as the LA were investigating this home re serious service level matters they would have known about any grade 3 PUs would be obliged to apply safeguarding threshold guidance nand obliged to inform relatives LPA of any serious incidents they were aware of during this investigation

2. Those that were not reported by York Court to the CQC as a serious incident that the LA were aware of what action did the LA take?

and what action was taken against York Court for breaches?

If LA did not receive any reports by York Court or via CQC/CCG, then we would not know about them to take any action.
SR
The LA did recieve reports of grade 3 and did recieve multiple request to raise as a safeguarding as I was one of those who reported multiple times and was ignored
The LA were aware 23/1/15 in a MDT meeting recorded that at least one resident at the time had a grade 3 PU I repeat
2. Those that were not reported by York Court to the CQC as a serious incident that the LA were aware of what action did the LA take?

and what action was taken against York Court for breaches?

3. As MDT is a PU issue -serious PUs are attended to at the care home by NHS trust TV nurses. Grade 3 PUs in 2014 and pre April 2015 were classified as a NHS serious incident and obligatory to report as an
external serious incident by the trust - how many were reported in this way by the Trust? who say the CCG is automatically notified of such serious incidents

For CCG to respond.
SR
This matter is a MDT issue all involved with the care of residents would have known about grade 3 PUs - all are responsible for safeguarding as per website safeguarding is everyones business

4. How many grade 3 pressure ulcers were raised as a formal safeguarding
in 2014 and

2015 at York Court

10 safeguarding concerns (formerly known as alerts) relating to Neglect in 2014-15 in York court.

SR
Please confirm if these were related to PUs?

5. How many overall serious incidents were reported by York Court care
home in 2014 and

2015 to the LA and CQC?

This information is not held in a retrievable format

SR
The LA cannot deny it has any record of injuries and serious incidents at York Court it was investigating this home from June 2014 until it closed itself Dec 2015 - as part of any meanigful investigation this information would have been known and recorded ?

Yours sincerely,

Sylvia Rushbrooke

Chris Warner,

3 Attachments

Dear Ms Rushbrooke

 

I was asked to carry out a review of the above request.

 

I attach my review letter.

 

Kind Regards.

 

Mr Chris Warner

Assistant Head of Law 

Litigation, Housing & Planning Team

South London Legal Partnership

Gifford House, 67c St Helier Avenue, Morden, SM4 6HY

DX 161030 Morden 3

 

Direct: 020 8545 3470

[mobile number]

Fax: 020 8545 3244

 

 

 

Sylvia Rushbrooke

Dear Chris Warner,
Many thanks
The letter response you attached is illegible please resend

Yours sincerely,

Sylvia Rushbrooke

Chris Warner,

1 Attachment

Dear Ms Rushbrooke

I attach further copy of the review decision.

It is a typed document and appears to have scanned OK and so I am unclear why the first one was illegible.

I can always post a hard copy if this further scanned copy is also illegible.

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