Nurse accused of putting care home residents at risk by falsifying records and failing to update care plans

A care home nurse put patients at risk by falsifying records and failing to add vital information to care plans, a professional conduct panel has heard.

The Nursing and Midwifery Council (NMC) described the actions of Jennifer Ann Stevenson as a “successive string of failings” at the opening of the hearing on Monday.

She faces six charges relating to alleged misconduct between 2017 and 2019, when she was employed at Lady Forester Community Nursing Home in Much Wenlock, run by English Care.

Ms Stevenson did not attend the virtual hearing and the panel was told she did not intend to renew her NMC registration due to retirement.

Stuart Dingle, presenting the case on behalf of the NMC, told the hearing that issues was first identified in August 2018 when the Care Quality Commission (CQC) inspected the home and reviewed several of Ms Stevenson’s care plans.

As a result of concerns raised by the inspectors, the home implemented an electronic care plan system, which went live in February 2019, and Ms Stevenson was given additional training.

However by June 2019, concerns were raised that several of Ms Stevenson’s care plan reviews were being repeatedly delayed.

An audit was carried out which found “significant omissions and errors” in her care plans, Mr Dingle said.

Keith Baggaley, deputy manager at the home, gave evidence to the panel and said that prior to the electronic system going live managers had identified numerous cases in which Ms Stevenson had not updated care plans – including one which had remained unaltered for 18 months.

The new system revealed she was rushing through care plan reviews without making changes. Mr Baggaley said each review should have taken at least 25 minutes, but Ms Stevenson’s reviews were being completed far more quickly with one updated in under a minute.

The audit identified three care plans which were a particular cause for concern.

The first related a resident with diabetes, identified during the hearing as Resident A, who almost ran out of insulin after Ms Stevenson failed to order any, and had pressure sores which Ms Stevenson had failed to record in his care plan.

Mr Baggaley said Resident A “could have gone into a coma and could have died” had he run out of insulin, but another nurse had been able to get an urgent prescription.

In the second case, a resident with dementia, named as Resident B, was displaying behavioural changes which indicated they were “in a great deal of pain”, but Ms Stevenson did not record this.

A third resident, Resident C, who also had dementia, was supposed to be weighed regularly due to significant weight loss.

The audit identified Ms Stevenson had entered the exact same weight for three consecutive weeks.

The resident was weighed and was found to be more than 1kg less than the weight Ms Stevenson had recorded for the previous day, which Baggaley said was not possible.

There was also a failure by Ms Stevenson to involve the family of Resident C in reviewing the care plan “for a considerable amount of time”, Mr Baggaley said.

Mr Baggaley told the panel that when Ms Stevenson was asked about the findings of the audit she “tried to lay blame on everybody but herself” and “came up with numerous excuses”.

Summing up the NMC’s case, Mr Dingle said: “There was a history from this registrant of improper and insufficient care planning.”

He said this began prior to 2018, including the incident in which a care plan remaining unchanged for 18 months.

Mr Dingle continued: “You then have the CQC review which flags up the inadequacies in this registrant’s care planning, which prompted significant change in the care home and intense training with the registrant.

“Despite that intense training and support which remained available to her, we see repeated failings from this registrant to keep care plans properly updated, causing potentially serious harm to residents and preventing managers and staff from identifying residents’ needs and ensuring processes were put in place to protect residents.”

Mr Dingle said Ms Stevenson’s failings caused “unnecessary pain and suffering” for Resident B and included the “serious matter” of knowingly falsifying Resident C’s weight records.

Mr Dingle described Mr Baggaley as a “very credible and consistent witness”.

He invited the panel to find the charges proved, describing Ms Stevenson’s actions as a “successive series of failings”.

The panel will reconvene on Tuesday to deliver its findings.