'The care system failed my daughter twice'

A woman whose daughter was treated at two facilities where patients were subject to abuse and neglect by staff has said she has lost faith in the care system.

When Alicia Fox was discharged from Muckamore Abbey Hospital her mother Catherine was hopeful of a new beginning.

But that happiness was cut short within months when Alicia was moved into a different facility that is not connected to Muckamore, where according to her mum her care was at times unsupervised and neglectful.

Muckamore, an institution for adults with severe mental health needs and challenging behaviour, is at the centre of the UK's largest-ever criminal adult safeguarding and abuse investigation in NHS history.

A public inquiry into what happened began in 2022 and its final report, findings and recommendations are expected to be published in June.

Alongside the inquiry, criminal proceedings involving staff continue.

Alicia was admitted to the hospital in County Antrim when she was 25.

When she was finally discharged her family were told she would be moving into supported living accommodation, but instead she ended up in residential care.

Catherine said she felt lessons had not been learned from what happened at Muckamore, where Alicia was a patient from 2015 to 2018.

"My daughter once went to college and had friends.

"At 36 she now lives in a different facility with little independence or choice and has become institutionalised for the second time. Have lessons not been learnt from Muckamore?"

At Alicia's new residential home, River House in Belfast, there was more neglect and unsupervised care.

Catherine and two other families whose adult children were Muckamore patients said they were shocked by this.

Catherine described events as cruel and said Alicia had been failed twice.

Complaints about the patients' care were made by the families and some members of staff at River House.

Alicia's records in her new care home reveal that she was subject to 42 separate adult safeguarding referrals and all relate to neglect.

Among the complaints raised were:

• Assessed levels of supervision not being provided, which led to one service user (not Alicia) swallowing a battery
• Failure to follow care plans
• Unauthorised use of seclusion
• Medication errors
• Failure to document or investigate bruising

A River House spokesperson said: "We have worked closely with Alicia's family since her admission in 2018 and addressed all concerns raised with us.

"The service has been inspected several times by the Regulation and Quality Improvement Authority (RQIA) since then, with inspections recognising the quality of care and support provided.

"River House has been working tirelessly with the family and the Trust for the last 14 months to find a suitable alternative placement to better meet Alicia's needs, which we hope will happen later this year".

Based on those complaints the Belfast Health and Social Care Trust reported the allegations of abuse to the Department of Health in 2021, which triggered a serious adverse incident (SAI) review.

An SAI is any event or circumstance that led or could have led to unintended or unexpected harm, loss, or damage.

That review took almost four years to complete, however Alicia's mother and other families were not engaged with, or asked for their feedback.

While Catherine had been assured she would have the opportunity to contribute to the review, this did not happen.

The families then took a judicial review on the Belfast Trust's investigation and days before it was to be heard the trust conceded that it was unlawful.

The High Court subsequently quashed the SAI review and report in full.

The trust has now committed to carry out a fresh investigation through a new and independent panel.

According to Phoenix Law, which represented Catherine, the process should have been completed within 12 weeks but instead took four years.

In a statement, Belfast Trust said it had invited families from River House to meetings and had offered a direct apology.

Victoria Haddock, a solicitor at Phoenix Law, said it was deeply concerning that legal action was required to secure a lawful review into serious incidents involving vulnerable adults, particularly given the heightened scrutiny around safeguarding in the wake of the Muckamore Abbey Hospital Inquiry.

"The outcome achieved is significant as the previous case law limited the ability of families and patients to challenge the legality of SAI reviews through the courts," she said.

"This case signals a shift by demonstrating that SAI reviews are not beyond legal scrutiny and can be successfully challenged.

"This case sends a clear message that families cannot be shut out from investigations into the care of their loved ones."

In a statement, Belfast Trust said it acknowledged the process had been lengthy and that it had appointed a family engagement lead.

It said it had been working with River House since 2021 to improve facilities and safeguarding as part of a comprehensive action plan.

It added that it continued to work with the Fox family over their concerns.

The investigations at Muckamore have led to 19 staff being dismissed, nine have received final warnings, 11 received formal warnings, one verbal warning has been issued.

37 members of staff have left their jobs, 52 cases are still awaiting legal process and 65 members of staff are known to the Nursing and Midwifery Council.