Care home owner and staff criticised by coroner for ‘dehumanising and warehousing’ the elderly

A coroner has criticised the care given to residents who died at a scandal-hit nursing home as he highlighted a withering catalogue of failings – accusing managers of “dehumanising” and “warehousing” the elderly.

Assistant Gwent Coroner Geraint Williams said the deaths of five residents at the Brithdir nursing home in New Tredegar, South Wales, were contributed to by neglect.

He accused the owners and staff at the home of a “gross betrayal of the trust” placed in them by families of the residents by keeping them in the dark over the poor standards of care.

Mr Williams recorded narrative conclusions for June Hamer, 71, Stanley Bradford, 76, Edith Evans, 85, Evelyn Jones, 87, and William Hickman, 71. He said Stanley James, 89, died of natural causes.

They all died between 2003 and 2005 and suffered dehydration, malnourishment and pressure sores on their bodies.

“The view of Margaret Moody, the nursing expert, and Professor Malcolm Hodkinson, the consultant geriatrician, was that the attitude of the staff at Brithdir was that residents were being ‘warehoused’,” Mr Williams said.

“They explained this as a situation where the residents were simply kept and were being fed and watered with the bare minimum being done and then the staff going home.

“I accept without hesitation that description of the philosophy.

“What is worse, in my judgment, is that even the feeding and watering, to use Prof Hodkinson’s phrase, was inadequate given that some of the residents were admitted into hospital suffering from dehydration and malnutrition, and that the bare minimum was resolutely below any acceptable standard.

“Such philosophy I find led inextricably to a neglectful and abuseful attitude on the part of many of the staff at Brithdir, which is clearly evidenced by the practice authorised and sanctioned by Peter Smith when he was the manager of changing the incontinence pads of residents in the lounge in the presence of other staff.

“He justified that practice on the basis that as the residents were suffering from dementia, they would not know what was happening to them.

“That practice I consider was one by which the residents were dehumanised and is perhaps the lowest point in the story of the Brithdir nursing home.

“I have no hesitation in confirming as an unequivocal fact all these matters contributed significantly to the deaths of Stanley James, Judith Hamer, William Hickman, Stanley Bradford, Edith Evans and Evelyn Jones.”

Residents were often unkempt and dirty, care plans would be ignored, documents falsified and residents would be humiliated by staff.

One former staff member said she saw a care worker draw a moustache with a permanent marker on the face of a female resident.

During the inquest, several Brithdir staff apologised for the “shocking lack of care”, which was “bordering on being negligent”.

Others said there was a “systematic failure of the system” at Brithdir, with staffing levels “dire” and carers having to provide their own PPE.

Brithdir was part of a group of 24 care homes owned by local GP Dr Prana Das and his Puretruce Health Care company.

Temporary embargoes on new residents were placed on Brithdir, regular inspections were carried out and improvements notices issued but it was not until 2006 the home finally closed.

Dr Das was known to be “very rude and offensive” with social care inspectors and would often launch legal challenges to decisions of regulators.

Social workers also failed to carry out regular assessment of the residents being funded by Caerphilly County Borough Council.

Police launched the Operation Jasmine inquiry in 2005 following the death of an elderly resident at another home.

The inquiry lasted nearly a decade and cost over £11 million with detectives looking at 63 deaths.

Charges were brought against Dr Das and the Puretruce chief executive but the trial collapsed in 2013 after Dr Das suffered severe head injuries in an aggravated burglary at his home. He died last year aged 73.

Dr Das had been the subject of complaints about his homes dating back to the mid-1990s and there had been a long history of involvement with the authorities.

Mr Williams did not criticise any individual from social services, the local health board or care watchdog but said there was a “focus on system and process” which meant the needs of residents were not always recognised in a “timely or appropriate fashion”.

He said the authorities should have taken more significant action against Dr Das in the autumn of 2004 following the deaths of Mrs Hamer and Mr Hickman.

“I find that the legislative and regulatory framework hampered significantly the steps which needed to be taken,” he said.

“However, and through no fault of their own, their very proper protective actions created a significant and possibly insurmountable hurdle to achieving what I have no doubt was a genuine desire to deal with the delinquent and abusive behaviour of Dr Das.

“In my judgment it was a plain as a pikestaff that in October 2004 there was a serious risk to the life, health and wellbeing of residents at Brithdir.”

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