A Devon, UK, care home has been fined £180,000 after two wheelchair users drowned when a specially designed vessel capsized.
A third person suffered serious harm after she was found face down in the water.
Burdon Grange Care Home pleaded guilty during a hearing at Exeter Magistrates Court to failing to provide safe care and treatment fo three people, resulting in avoidable harm to them.
The accident happened on June 8 2022 when the open boat they were on board capsised on Roadford Lake, Devon, England.
Alison Tilsley, 63, Alex Wood, 43, and Kate Dart who was in her 50s, were part of a group of six residents and carers from Burdon Grange care home who had hired a Wheelyboat designed for wheelchair users from the lake’s activity centre for a trip on the lake.
No way to escape
While on the trip, the Wheelyboat took on water and capsized.
The court heard that the victims were strapped into wheelchairs and sank to the bottom of the lake when they were thrown into the water during the capsize with no way to escape.
A staff member who could not swim became trapped under the boat for around 15 minutes.
The court heard that the provider, manager and staff all failed to assess the risks of the boat trip and did not take reasonable, practical steps to manage the risks for the highly vulnerable people in their care.
In addition, staff also failed to plan for what would happen if service users entered the water.
Not maintained
“When people are supported to take part in activities, they have the right to expect providers will properly assess and manage the risks to keep them safe. Tragically, this did not happen for Alison Tilsley, Alex Wood and Kate Dart at Roadford Lake,” said Catherine Campbell, CQC’s deputy director operations in Devon.
“The failure of the provider, management and staff to identify and address clear dangers was unacceptable and placed highly vulnerable people at serious risk of harm.”
A Marine Accident Investigation Branch (MAIB) report found that the boat had not been properly maintained which allowed the water to leak in and destabilise it.
Boating tragedy
The report made several recommendations including that Burdon Grange care home should review its risk assessments for activities provided by organisations outside of the care home environment and identify any hazards.
There are also recommendations for South West Lakes, a wheelyboat operator, and the Wheelyboat Trust, which provided the boat.
The care home was also ordered to pay a £190 victim surcharge and £20,000 costs.
Burdon Grange said in a statement after the case: “We recognise the pain and distress this boating tragedy has caused the families, relatives and friends of Alex and Ali whose losses are still profoundly felt by our community.
“Our priority now is to move forward and consistently deliver the high-quality care and support our residents and their families rightfully expect.”
