I warned care home bosses my mother was violent. Weeks later another woman was dead: Daughter of dementia patient who attacked fellow resident says bosses stopped giving her mother one-to-one care to save money

In October 2019, Nina Douglas received a phone call which would change her life forever. Her mother – who suffers with dementia – had pushed a fellow care home resident over, resulting in a fractured hip. 

Several days later, the resident passed away during surgery for a replacement. 

‘I tried so hard to warn everyone,’ Nina, 50, said. ‘It was just awful. When you know what the risks are, when you know what’s going to happen – we were just left waiting for something bad to happen.’

Despite the tragedy and desperate pleas from the care home, Nina’s 73-year-old mother remained a resident for a subsequent four months, in which time there were at least nine further incidents of serious violence against residents and staff.

A catalogue of failures has meant Nina’s mother remained in a care setting which could not cope with her behaviour, despite repeated warnings and pleas from family members and carers alike.

Nina Douglas, 50, pictured with her mother, 73, who is not named to protect her identity, before the fatal accident

Nina told MailOnline the care system ‘writes off’ anyone diagnosed with dementia and desperately needs reforming

But instead of acting to ensure the safety of Nina’s mother and her fellow residents, authorities instead quibbled over whose responsibility her care was and how much it would cost the local council.

And Nina, who has even offered to have her mother return home and care for her herself, fears her family is far from the only one to be stuck in a similar position.

She told MailOnline: ‘Lots of people will be in the same position and it makes me feel so sad and think about what if I was older.

‘All these husbands and wives will be trying to deal with this when they are in their 70s or 80s.

‘It is so easy to just say dementia and then effectively write someone off. Once someone loses their capacity, they [the social care system] can do what they want. They have no respect for us at all.’

She raised concerns for the staff having to cope with unpredictable behaviour like her mother’s in facilities which do not have the resources to do so: ‘There is a lack of respect for the people, the staff who have to deal with these situations. 

‘It feels like a diseased building, the whole system is crumbling.’

MailOnline has seen extensive notes about Nina’s mother’s care from officials in charge of her case.

After living at home with relatives for two years as her independence began to wane, Nina’s mother was briefly sectioned after running in front of a car in an apparent attempt to take her own life.

She was discharged into a care home on an EMI placement (elderly and mentally infirm) under Cumbria County Council, now Cumberland Council, just a few months before the fatal tragedy. 

Social worker notes show that Nina’s mother should never have been discharged from hospital in the first place because her then-social worker did not agree with the decision and believed she needed further treatment.

Around three months later, Nina’s mother’s unpredictable behaviour had left a resident dead.

Nina became increasingly frightened and worried about her mother, and suffered from crippling anxiety. 

‘I was completely horrified, I was so worried about the other people’s safety and my mam’s. 

‘I used to be so jumpy, any time the phone rang I thought it would be the home with bad news.’

Nina, pictured with her mother and grandchild Amelia, cared for her mother for two years

Social worker notes in the days following the resident’s death show that the care home initially put Nina’s mother on a one-to-one care plan, but advised they were ‘not able to sustain’ that level of staffing.

NHS and social care staff said they were ‘unsure what to do’ after the care home manager refused to keep caring for Nina’s mother out of fear for the rest of the residents.

‘We may have no other choice but to admit back to hospital,’ notes read.

Yet over the following weeks, the same notes show that the focus shifted from the safety of residents to the cost of keeping Nina’s mother on one-to-one care as council workers and NHS representatives quibbled over who should foot the bill.

At a meeting involving a social worker, health professionals and Nina and her daughter, notes show Nina was told that the care home manager again ‘advised she is not able to fund the extra staff member or find the extra staff.’

The cost of one-to-one care was noted as being £800 a week, and the social worker noted that Adult Social Care ‘will not fund’ one-to-one support because it ‘is a health need, and not a care need’.

Documents show how the local authority ‘explained’ to the care home that ‘all [Nina’s mother’s] care needs are being met’. 

A month later, Nina’s mother was still at the same care home with no one-to-one funding when she hit two members of staff. 

Days later on November 14 she became distressed and hit a window before pushing another resident over.

Fortunately on this occasion a carer was able to intervene to prevent any harm, and the resident ended up on the floor after they were caught  and safely lowered to the ground.

After this incident the care home manager again contacted social services and informed them they were ‘unable to maintain the placement with [Nina’s mother] displaying this behaviour’. 

At this point both Nina and the care home manager raised concerns for the safety of fellow residents, yet the social worker’s notes state she informed the home: ‘There was no adult at risk because the carer intervened.’

Authorities declined to register the incident as a safeguarding concern, and repeated warnings from the care home that it could not ensure the safety of residents without urgent support went ignored.

Three months later in February 2020, notes show there were four incidents over a single weekend, including several which saw Nina’s mother slap carers.

It also included pushing a resident who fell and was left with a fractured hip, and shoving yet another resident, who fortunately received no injuries.

The resident with the fractured hip required surgery, but fortunately this time all went well and the they were discharged to make a full recovery. 

In total notes show there were nine major incidents within four months in which Nina’s mother was described as ‘the alleged perpetrator’ – but not one was registered as a safeguarding concern.

She was eventually readmitted to hospital, but only after the relatives of one of those injured told staff they refused to allow their relative to return to the home while Nina’s mother was still housed there.

According to notes Nina’s mother was then discharged into a second care home in July 2020, at which point it was noted she had been diagnosed with ‘mixed vascular, Alzheimer’s Dementia with profound PTSD.’ 

Even at this new home, which has one-to-one funding for 12 hours per day, between August 2020 and January 2021 alone there were at least 18 documented incidents of violence. These included hitting other residents on the face and head, throwing objects, spitting at and kicking members of staff and smashing crockery on the floor. 

Nina hasn’t celebrated her birthday for six years because she doesn’t feel as if she deserves to

Nina spoke to MailOnline as she vowed to ensure that no other family faces a similar situation.

She said she blamed herself for the death of the care home resident, despite warning healthcare workers of her mother’s violent behaviour.

‘There are so many people like my mam,’ she said.

‘There is a whole generation of women who are now just going through the system. It’s awful care; they’re written off.

‘I haven’t celebrated my birthday for six years because it’s on International Women’s day.

‘Who am I to celebrate on that day when this is still being allowed to happen? I feel I have failed.’

Nina’s father died when she was young after being given infected blood, leaving her mother to campaign for decades as part of the infected blood scandal. 

Despite herself now fighting for three years to get her mother more suitable care, Nina fears it is too late – but she still wants to highlight the impersonal nature of dementia care for future families.

‘I am not saying we are going to be the last people to go through this but I am going to make sure we are among the last families to go through this,’ she said.

‘This is distressing for everybody. There’s [no care] there for anybody. If this is the best of the best we have got a terrible situation.’

A Cumberland Council spokesperson said: ‘Improving the health and wellbeing of our residents is at the heart of everything that we do. When people are vulnerable, our services will support them to live well. 

‘We hold a strong commitment to those who use our services and take our responsibility for investigating concerns seriously, including any concerns about care delivered by the previous authority Cumbria County Council. 

‘Families wishing to raise concerns relating to the care of their loved ones are encouraged to do so. However, we can only discuss individual cases with those concerned and authorised representatives.’

Nina’s mother’s NHS trust and the care home at the centre of the incidents declined to comment.

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