The Overwhelming Risk of Safety

At the end of the meeting, Steve, who said he was the Chair of the meeting, said he needed to sum up. Smiling sympathetically at Susan, and sitting perched on the edge of the settee that she had led him to when he had knocked on her door and shown her his badge just an hour earlier, he cleared his throat and began. 

“I am going to try and use words that you will hopefully understand, Susan, because this meeting has been about you and what will happen to you. So, although we don’t think you will understand everything that I say now, I want to go through it all with you anyway. We believe the evidence provided by people at the meeting today is overwhelming. The sensors on the door, the care alarm records, the diary of events kept by your son-in-law, the reports from both the police and the taxi firm, they all confirm it. We know you don’t remember what happens but I need to tell you. You get up in the middle of the night when you’re confused and you wander, which means that you go for walks outside. You leave your house and you usually walk towards town. What very often happens is that because they know to look out for you, taxi drivers often stop for you, and they either drive you back home or they take you to the police station. The police then contact the Emergency Duty Team at the Council and you are transferred to a care home overnight and then you return home the next day. The people in the meeting today, including the doctor, has agreed that this is very dangerous for you and that you are likely to come to harm. The assessments show that you lack capacity to make decisions in regards to your wellbeing and safety and also in regards to where you need to live to receive care. We think that it is now in your best interest to move into a care home for your own safety. The evidence, Susan, is overwhelming and it’s our job to keep you safe”. 

Susan waited for them all to go until she was left with her daughter. They were both in the kitchen washing the cups from the tea she had brought them during in the meeting when it had got too complicated.  

“Do you think I need to go into a care home, Jenny? I mean, I’m only 88. Jean didn’t go in one” 

Jenny flinched slightly. “I do mum, yes. I think they know what they are talking about. I am just amazed that no-one has attacked you when you have been out at night and I can’t cope any longer. It isn’t safe”.

Susan thought for a bit and then said “But I don’t think I do go out at night like they said I do. I mean, I know I go to the shops or sometimes I go looking for your dad but its hardly Roaming in the ruddy Gloaming, is it?”. 

Jenny smiled and wiped her eyes. “No, it isn’t mum. But it isn’t safe for you either. I want the best for you. As you are now, I am able to talk to you but when you’re confused, like Dr Bhenwizee says, you don’t understand the risks. I love you mum. Let us keep you safe, eh?”

Eighteen months later the Safeguarding Adult Review was completed.  Jenny was sat at home when it arrived. She hadn’t been expecting it and in truth, she had forgotten about it. She was usually around when the postman called because she hadn’t been back to work since it happened. She hadn’t talked about it much to anyone either, not even to Pete and definitely not the children. In fact, the only conversation she can remember having with anyone after the trial collapsed and all three of them had walked freed, grinning and hugging, had been a quick conversation with the person who the Council had brought in to write the report. “It’s a chance for us to remember your mum, and protect other people like her, Jenny” was all she could remember hearing. 

So she read the report. Some of it was similar to the information she had seen at the hospital and down at the police station, and most of it had been used in evidence in court. It also included some new words. ‘A catalogue of missed opportunities’, and ‘a chance to learn from this and improve as a system’. The report did at least mention the harm in one bit. Jenny read that part again, now so immune to the pain it didn’t impact like it used to. ’A grade four pressure sore on her sacrum. Unexplained bruise to her right temple. A fractured wrist, thought to be where she was defending herself. Teeth marks on her shoulder, highly likely to be a bite, and what the judge had called ‘mysterious bruising on both of her inner thighs’. Jenny remembered that bit. Yeah, mysterious only because the police failed to consider it was… well,  one of those types of assaults… Anyway, it didn’t mentioned what had really killed her, which was the shock. 

The author concluded with a list of recommendations which went over two pages. The closing remarks caught Jenny’s eyes. Paragraph 78.3 subsection 2 in the summary, “Prior to the placement at Care Home A, Susan was a vivacious, outgoing woman. She had lots of friends and although the multi-disciplinary team felt that there was significant risk in regards to her wandering at nighttime following her diagnosis of dementia, it is notable that although clearly at risk, Susan never came to any actual harm when she was outside her home at night, although she did take up a significant amount of police time and she was a worry to her family and those who cared for her”. 

Jenny thought about this before putting the paperwork away in the cupboard, alongside her thoughts and feelings in her mind, locked away. There wasn’t actually any overwhelming evidence that her mum was in danger at night like they had said she was. The only overwhelming evidence Jenny had seen in the two years since her mothers death was that the care home and the system for caring for her mum were the most violently unsafe of safe things imaginable to people. She lit up a cigarette.