It used to be the case that whenever I saw a blue light ambulance, I thought that they were en-route to save some poor soul. Nowadays I think that they are rushing off to raise a safeguarding concern about some poor care providers. Really? Yes, really.
Now don’t get me wrong, the guys in green jumpsuits often do a great job in difficult circumstances. What I do know is that in recent years, the most common words uttered are “safeguarding”, not “sepsis, UTI or Covid”. What I am seeing is ambulance crews demanding an escort from care staff at the care home to accompany a resident going off to A&E. If you dare refuse, then safeguarding is threatened. Cue things going South.
A Case Study
This example is from May 2025. Imagine a really warm sunny day. You know those days when care homes are too warm, residents are sleepy and enjoying ice creams and cold drinks and staff in heavy tunics are sweating a lot and moaning more. You know you will need at least one agency carer for tonight as the BBQ and some alcohol is better than coming to work at 10pm.
A male resident, George, (not his real name), collapses in a lounge and is on the floor not looking too clever but with a pulse and a bit of a grey pallor. The staff make an easy decision to phone 999 and request an ambulance. Obviously, a priority call, no drama and all sensible.
Two paramedics arrive, are met at the door and taken directly to George who is with another carer keeping an eye on him and monitoring pulse and breathing. Paramedics do their thing and decide George may have arrythmia and needs to go to A&E.
Paramedic 1 – “Right then, we need 2 care staff for George to go with him and sit in A&E”
Staff – “er, why?”
Paramedic 1 – “He’s got dementia and A&E isn’t staffed for dementia care so who’s coming with us?”
Staff – “er, no-one. That would leave us short staffed and unsafe”
Paramedic 1- “Ok. I’ll safeguard you if you don’t send someone”
Staff – “why? “
Paramedic 1 – “’cos you have to and I said so and A&E will want it.”
Staff – “no”
At this point there is a bit of “argy bargy” and raised voices, flushed faces and head scratching. There is now a stand off. Poor old George is still not looking too clever and couldn’t be difficult in A&E if he tried.
Enter the Registered Manager, just in time to get shouted at and again threatened. RM responds with a very sensible, short explanation of safe staffing, CQC and Regulations. Paramedics stick by their guns. RM sticks by his guns. George still unwell.
Paramedics observe the RM notice that the room is being cooled by a portable fan and that the lead is slightly sticking out from between two chairs. He instructs a carer to adjust the position. Just note that George didn’t trip and the hazard was really low risk, but non the less noticed and immediately made safer.
After a continued bit of heavy staring, paramedics huff and puff and convey George to A&E.
So the question everyone wants answering is what happened next?
Well, the RM gets contact from the Local Authority Safeguarding Adults Team with several concerns and a list of demands and evidence requirements. Oh, and a bit of an attitude and some pre-conceptions thrown in for good measure.
- Room was not well ventilated and was hot
- Fan wire was a trip hazard
- Fire doors were propped open
- Two staff members were required to accompany the resident to A&E
Initial Contact was from an allocated Social Worker. Now, this one must have been a new one. Nothing wrong with that in theory, but in practice, not much right with it either.
The gist of the initial contact was along the lines of :-
“Hey care home, you absolutely, cannot, never, ever, ever, never have a fire door propped open. It’s not safe. Explain to me why this was done”
“Trip hazards are not allowed and I want to see your risk assessment paperwork, reviews and evidence”
“Why was the room too hot. Explain and justify.”
“Why did you refuse to send staff to accompany George to hospital? The paramedic told you that he required that and needed 2:1 care. A&E isn’t the place for people with dementia. The hospital cannot be expected to staff that. You must send me all of George’s paperwork and demonstrate to me that he does not need 1:1 or 2:1”
Now as an RM, you will either laugh, cry, shout and swear or exhibit a combination of these emotions. I am angry myself and I am writing this!
The upshot of this was that the Social Worker left the call with a list of demands and requirements and an urgent need to “speak with my manager”.
Concluding this, the RM in question presented a cohesive, balanced and well thought out email to the Safeguarding Manager who sensibly closed this down without the need for Sec 42 to be invoked, people to be ceremoniously shot, or any harm to anyone.
The fire door in question was on a hold open device linked into the alarm and covered in the Fire Risk Assessment.
PS – George is fine.
Support?
The RM in question is one of “The Care Guys” and is an experienced safeguarding expert. In fairness, he learned from the best – the other “Care Guy” who owned that particular Care Home.
How confident would you be as a Manager responding to this set of allegations?
Do you know when a Sec 42 would be appropriate and necessary?
Would you notify CQC in this case?
Would you worry that this would snowball into a visit from Fire and Rescue, Contracts and Commissioning and the local Quality Monitoring Team, oh yes, and probably CQC?
Would you like to phone a friend ?
Well, the good news is that “The Care Guys” offer a Safeguarding Support Service on a pay monthly basis, together with all sorts of support for RM’s and Providers. Friendly, affordable and real life advice and support.
Contact us by email : Peter@thecareguys.co.uk or Tom@thecareguys.co.uk
Visit our website : www.thecareguys.co.uk