In November 2024 the Derbyshire County Council approved the closure of five dementia day-centres and eight Council-run care homes including locations such as Briar Close (Borrowash), Castle Court (Swadlincote), The Grange (Eckington) and Lacemaker Court (Long Eaton).
This decision has faced significant backlash amongst existing residents and the local community due to the impact it will have. For many residents, it means moving to care homes that are unfamiliar to them and potentially further afield for family and friends to visit.
When residents are moved, they lose those familiar carers. In a new environment with unfamiliar staff, subtle but important signs, such as changes in appetite, early signs of infection, or distress masked as confusion, are more likely to go unnoticed. This can lead to a significant risk of anxiety and depression within the elderly community.
Disruption to personalised care plans
When residents are moved, they lose those familiar carers. In a new environment with unfamiliar staff, subtle but important signs such as changes in appetite, early signs of infection, or distress masked as confusion are more likely to go unnoticed.
Care plans are intended to follow a person across settings, but in practice transitions can cause unintentional disruptions. Essential details may be overlooked, including medication routines, falls risk assessments, special dietary needs, or behavioural triggers. Due to the number of factors involved, the accuracy and consistency of these routines are very hard to maintain when a move occurs.
This can quickly lead to deterioration in a patient’s condition. Without proper hearing support, an individual may become isolated and misunderstood. Without proper nutrition, they may become weak, confused, or dehydrated. Without accurate risk assessments, they may be placed in unsafe environments.
Increased risk of harm and neglect
Disruption to care significantly increases the risk of harm. We have seen cases where patients have developed pressure sores, suffered serious falls, or experienced medical complications following a change in the continuity of their care. In many cases, these outcomes could have been prevented if information had been properly shared and staffing levels were sufficient to manage new admissions.
Care plans are often misinterpreted or not properly enforced, which can lead to further risk to elderly residents. This is more common when routines change and carers rotate. Patients rely on care plans to ensure their safety is not compromised and that their care needs are clearly communicated to all practitioners involved.
For example, if a care plan states that a patient is at high risk of falls, precautions such as raised bed rails and regular checks should be put in place. If this information is not clearly communicated, an unfamiliar carer may fail to take these precautions, potentially leading to injury.
Older people are particularly vulnerable to changes in environment and routine. A sudden move can cause confusion, anxiety, and disorientation. These risks are further exacerbated for patients living with conditions such as dementia.
It is imperative that care plans and care packages are carefully considered and consistently implemented, particularly where multiple carers are involved. Everyone involved in a patient’s care should understand their specific needs and the reasons behind them. For example, if an elderly patient has poor balance or limited mobility, it should be clearly known that they must be left in a safe position before a carer leaves, to reduce the risk of them attempting to move independently and falling.
Reduced family involvement
When care homes close, residents are often moved further away from home, sometimes miles away. In areas such as Derbyshire, where rural transport options are limited, this can significantly reduce families’ ability to visit regularly.
Families are more than just visitors. They play a crucial role in continuity of care by noticing changes, raising concerns, advocating for their loved ones, and maintaining morale. When family presence is reduced, elderly residents may become isolated and small issues may escalate before anyone intervenes.
Continuity of care is not simply best practice; it is an essential component of safe and effective care. Even with careful management and properly resourced moves, the closure of care homes can have a substantial impact on the continuity of care provided to residents.
Negligent acts may sometimes appear minor, but they can have serious consequences for patients. Changes in appearance, behaviour, or personality, as well as insufficient care, may present in the following ways:
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Increased irritability. This may indicate underlying issues such as the development of pressure sores, which can cause discomfort and distress.
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Increased confusion or low mood. This may result from poor nutrition, insufficient care, or a lack of relationship between the patient and their carers. Elderly patients can become lonely and isolated, and maintaining relationships and rapport with carers is an important but sometimes overlooked aspect of care.
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Falls or other incidents. Care plans are designed to reduce the risk of injury. Repeated falls may indicate inadequate or negligent care. Carers have a duty to follow care plans to mitigate risks, and failing to do so can amount to a breach of that duty.
Due to care home closures, these warning signs can become harder to identify, particularly when distance limits regular family contact.
If you have concerns about care following a relocation or disruption, our medical negligence team can provide confidential, no-obligation advice on your options.