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Scald death care home sentenced Scald death care home sentenced
(20 minutes later)
A care home has been fined £100,000 after a disabled woman was scalded in a bath and died from her injuries.A care home has been fined £100,000 after a disabled woman was scalded in a bath and died from her injuries.
Yelena Hasselberg-Langley, who needed 24-hour care, suffered 20% burns when she was put into the bath at Lifeways Community Care Home in Oxford in 2007. Yelena Hasselberg-Langley, who needed 24-hour care, suffered 25% burns when she was put into the bath at Lifeways Community Care Home in Oxford in 2007.
The 18-year-old, who had cerebral palsy and epilepsy, died of multiple organ failure in hospital four days later. An inquest recorded a narrative verdict.The 18-year-old, who had cerebral palsy and epilepsy, died of multiple organ failure in hospital four days later. An inquest recorded a narrative verdict.
Lifeways Community Care admitted health and safety breaches last year.Lifeways Community Care admitted health and safety breaches last year.
The firm was also ordered to pay £45,000 costs.The firm was also ordered to pay £45,000 costs.
'Excruciating agony''Excruciating agony'
The Health and Safety Executive, which prosecuted the company, said the water was "excessively hot" at more than 44C (111.2F).The Health and Safety Executive, which prosecuted the company, said the water was "excessively hot" at more than 44C (111.2F).
Judge Patrick Eccles QC, said: "The case evokes a great deal of pity for her suffering and a sense of outrage that her ensuing scalding injury and death could have been easily avoided.Judge Patrick Eccles QC, said: "The case evokes a great deal of pity for her suffering and a sense of outrage that her ensuing scalding injury and death could have been easily avoided.
"She was blind, paraplegic, epileptic and severely disabled."She was blind, paraplegic, epileptic and severely disabled.
"She had some power of speech but could not clearly communicate her distress when placed in the bath and she would have suffered excruciating agony before being taken to hospital.""She had some power of speech but could not clearly communicate her distress when placed in the bath and she would have suffered excruciating agony before being taken to hospital."
During an inquest at Oxford Coroner's Court into Ms Hasselberg-Langley's death, two carers told how they had not been trained in using the bath and thought its temperature was controlled by a thermostat.During an inquest at Oxford Coroner's Court into Ms Hasselberg-Langley's death, two carers told how they had not been trained in using the bath and thought its temperature was controlled by a thermostat.
The court heard a special valve to prevent scalding was never set
One of the carers, Anna Majchrowska, told the jury she tested the water before Ms Hasselberg-Langley was lowered into it and had been happy it was at the right temperature.One of the carers, Anna Majchrowska, told the jury she tested the water before Ms Hasselberg-Langley was lowered into it and had been happy it was at the right temperature.
Pamela Booker, the other carer, said she had refused to operate the bath. Pamela Booker, the other carer, said she had refused to operate the bath at the home in Owens Way, Cowley.
Instead, Ms Booker said she prepared Ms Hasselberg-Langley for her bath by changing her before placing her into a sling and lowering her into the water.Instead, Ms Booker said she prepared Ms Hasselberg-Langley for her bath by changing her before placing her into a sling and lowering her into the water.
She told the inquest that Ms Hasselberg-Langley went rigid and her skin reddened and she shouted to her colleague to raise the hoist.She told the inquest that Ms Hasselberg-Langley went rigid and her skin reddened and she shouted to her colleague to raise the hoist.
A police inquiry was conducted but the Crown Prosecution Service decided that no criminal charges would be brought.
The Health and Safety Executive, which prosecuted Lifeways, said the investigation revealed that although the bath used was fitted with a special valve to prevent scalding, this valve was never set.
But Judge Eccles acknowledged the HSE inquiry failed to reveal who had fitted or failed to set the bath valve which could have prevented the tragedy.
However, he added: "After seven weeks there was still no bath thermometer for testing the water [at the care home] and none of the staff had been trained to implement Lifeways' written policy for bathing service users."
Judge Eccles said the company policy required bath water to be between 37C and 40C, and staff were advised to physically test the temperature with an elbow or un-gloved hand.