Wendy Afford

“The risk assessment for Mrs [name redacted] in respect of her skin integrity did not record her high risk of developing pressure damage and it was entirely unclear how the risk was assessed in the first place.”

“It is not clear whether body maps were completed as often as required by the carers and therefore there is a concern that they were not monitoring Mrs [name redacted] pressure areas properly.”

“It was not clear whether the carers were properly following the care plan and the records showing whether or not Mrs [name redacted] was repositioned were incomplete. The records that did exist only recorded her position or stated 'repositioned' they did not record whether she was moved, for example, from left to right. The facility within the electronic care record system to highlight the need for carers to reposition Mrs [name redacted], and record the move, were not used reliably and I heard evidence from a”

“The management of the care company did not appear to carry out audits of records and compliance with care plans nor have any other effective means of oversight.”

“Given these numerous difficulties there is a concern that care staff are not properly trained in the use of care plans, record keeping and importance of monitoring skin integrity.”