Time and again, caregiving staff in services for older people describe scenarios where they believe fundamental safety and care processes have broken down. Across the many care homes we work with, six concerns surface repeatedly.
What Care Home Staff Are Reporting
1. Inadequate pre-admission assessment. The resident’s care needs and previously reported challenging behaviour or violent incidents were not assessed properly prior to admission to the home.
2. Inappropriate supervisory instructions. The directions from supervisors were not suited to the person’s actual needs, leaving staff without a workable care plan.
3. Unactioned risk reports. Newly identified risks arising from developing behaviour patterns are reported but not acted upon. Staff flag concerns that simply go nowhere.
4. Staff concerns not taken seriously. For example, with a resident who spits at staff, often no risk-control measures have been put in place for the risk of infection — despite repeated reporting.
5. Agency staff integration failures. Agency staff are not taking the time — or are not given the time — to become familiar with the residents they are working with. This lack of familiarity actually causes issues with aggression and violence later.
6. Complexity outstripping training. Staff often feel that some residents’ needs are far more complex than their training or experience is sufficient to deal with. Examples include severe learning disability, sexual disinhibition, or significant dementia.
Staff often feel that some residents’ needs are far more complex than their training or experience is sufficient to deal with.
When Management and Staff Perspectives Clash
Staff have reported to our training teams that they feel the words and actions of managers are at odds with the principles of person-centred care — or of staff safety. This gap between what staff experience on the floor and what management communicates from above creates a dangerous disconnect.
As soon as risks to the health and safety of staff are identified, it is incumbent on management of a care home to respond in good time and in a suitable and sufficient way to reduce those risks — as far as is reasonably practicable.
The risks of physical injury from assault are serious risks and therefore necessitate a rigorous risk-versus-cost analysis when management consider the appropriate steps required to control them.
⚠️ Warning: If the incidence of violence and aggression is frequent and severe enough that staff are being bruised or experiencing muscle strains and joint pain, these incidents warrant serious consideration by management under health and safety law.
The Legal Framework
Care home managers and supervisors carry statutory duties under multiple pieces of legislation. The key laws that apply to staff safety in care settings include:
- Health & Safety at Work Act 1974 (Section 2, Section 7)
- Management of Health & Safety at Work Regulations (Section 3, Section 8)
- Health & Safety Offences Act 2008
- Corporate Homicide Act 2007
- Human Rights Act 1998 (Article 2 — the Right to Life)
It is important to note that a lack of resources does not mitigate the responsibilities of management under these statutory duties. Managers and supervisors at care homes should be made fully aware of their obligations under health and safety law, guidance, and regulations.
Without this awareness, the “near misses” and management of residents’ distressed or challenging behaviours may result in criminal or civil cases involving negligent liability.
📊 Stat: A lack of resources does not reduce management’s legal responsibilities. The statutory duties under the Health & Safety at Work Act 1974 remain in full force regardless of staffing levels or budget constraints.
About the Author
Gerard O’Dea is a conflict management, personal safety, and physical interventions training consultant. He is the training director for Dynamis, a specialist provider of personal safety and violence management programmes, and the European Adviser for ‘Verbal Defense and Influence’ — a global programme which addresses the spectrum of human conflict.