Misconduct case nurse continuing to practise

Cerela Javillonar removed the woman's nightdress and left her draped in a towel and duvet cover after she suffered a vomiting attack, a misconduct panel heard.

She is also thought to have left the woman on her back, putting her at risk of choking if she vomited again.

Javillonar was dismissed from Drummond Grange care home in Lasswade, Midlothian, after the incident but is still allowed to work as a nurse.

The Nursing and Midwifery Council (NMC) in London heard that visiting relatives discovered the woman, identified only as Resident A, thrashing around in her room at the home's Buccleuch unit. The towel, which had been used to cover the top half of her body, had slipped off, leaving her in an "undignified state".

Resident A suffered from cerebral palsy and limb spasms, had a history of pneumonia and was fed through a tube. On March 22, 2008, she had been sitting in a wheelchair when she started slipping and vomiting, and was moved back to her room, where Javillonar removed her nightdress.

The panel heard that the nurse had then left her lying on her back and at risk of choking for up to 30 minutes while she wrote up notes in the duty room. She claimed the woman had left been on her side and said she had not dressed her because she believed she would vomit again.

The majority of charges against Javillonar were proved, though she was cleared of failing to follow the orders of a senior nurse and of failing to obtain and administer antibiotics promptly to Resident A.

Panel chair Paul Pharaoh said: "We are quite satisfied that she did fail to provide appropriate care, both by leaving the resident in an undignified state and failing to ensure she maintained an appropriate position on the bed."

A spokeswoman for Barchester Healthcare, which operates the home, said: "At Drummond Grange the health and wellbeing of our residents is always our utmost priority. As soon as we uncovered the issues we notified the police and have been working closely with them and the local authorities to assist with their investigation. Following the investigation Cerela was dismissed in November 2008.

"Drummond Grange respects the privacy of residents and staff and is therefore unable to comment further."

The panel also found that Javillonar failed to complete a series of care plans for Resident A, who had been admitted on March 18, in relation to breathing, moving and nutrition.

Mr Pharaoh said she was not Resident A's assigned nurse, but all staff have a "collective responsibility" to draw up the plans.

She was given an 18-month conditions of practice order, during which she will be required to work under supervision. She will have to take assertiveness training within the next six months, must keep a diary about patient dignity, safe practice, communication and documentation of care, tell any new employers of the order and inform the NMC of any disciplinary proceedings against her.

Mr Pharaoh said the case was too serious to take no action or impose a caution but added: "While there may have been a lack of care, there was no malice in the actions."

Margo wants care courses

Lothians MSP Margo MacDonald is calling for care home staff to be required to have a certificate of competence before they can get a job.

She said there was currently no minimum qualification or level of experience laid down for working with old people. She claimed minimum requirements would help put the sector on a stronger footing.

She said: "Anyone who works in a care home should have a certificate of competence to work with elderly people.

Ms MacDonald said she was not suggesting a requirement for a certificate of competence would mean no more troubling cases, such as the Elsie Inglis nursing home, shut down after the death of one of the residents sparked a police investigation, but added: "It would not have done any harm."

Ms MacDonald, who is due to meet Health Secretary Nicola Sturgeon to discuss the issue, said: "I'm sure the colleges could put on an appropriate course."