A recent judgment involving a support worker injured by a service user highlights the importance of behaviour-specific risk assessments, effective training, clear communication, and appropriate staffing arrangements in residential care settings. The case provides a clear illustration of the heightened obligations placed on employers in residential care environments where service users present known risks of violence.
The claimant, a support worker in a residential care setting, was injured during her night-time duties. After settling one tenant to bed, she entered the communal area where another tenant – who required two-to-one support – approached her while seated on a gym ball. This tenant frequently sought hand-holding, and the claimant initially engaged in this familiar interaction.
The tenant then pulled her towards him with unexpected force, continued bouncing, extended his arms as if seeking a conciliatory hug, placed his hands behind her head and bit her cheek. Colleagues were initially unaware of the incident. One of the tenant’s designated support workers attempted release techniques but was unable to assist.
Risk assessments and employer liability are critical in such cases. The claimant alleged that the employer failed to carry out an adequate behaviour-specific risk assessment addressing the tenant’s biting behaviour, and did not provide clear, specific training on how to avoid or manage bites. She also argued that the employer failed to warn her that the tenant was “cycling”, a recognised escalation pattern, and that staff did not intervene appropriately when she entered the communal area despite the tenant’s requirement for two-to-one support.
Employer Liability Explored
Two authorities are relevant to incidents involving service-user violence: Wisniewski (a minor) v Central Manchester Health Authority [1998] EWCA Civ 596 and City of Wakefield MDC v Slater [2005] EWHC 3528 (QB). Both emphasise foreseeability of harm and the heightened duty of care required where an employer knows of a specific behavioural risk.
Employers owe a duty to take reasonable care for the safety of their employees. In settings involving individuals with challenging or violent behaviour, this duty requires a suitable and sufficient risk assessment addressing the specific behaviours known to pose a risk. Where a particular risk, such as biting, is foreseeable, the employer must adopt a higher degree of care and ensure that training, guidance, and staffing arrangements reflect the seriousness of that risk.
The obligation extends to communicating developing risks promptly and ensuring that staff understand the behaviours that may indicate an escalating risk of harm. This requires effective communication and clear protocols for managing and responding to incidents of violence. They must prioritise behaviour-specific risk assessments, effective training, and clear communication to reduce the risk of incidents.
Guidance for Care Providers
The judgment offers valuable guidance on what “reasonable care” requires in practice when managing service users with challenging behaviour. For practitioners advising care providers, it highlights the importance of behaviour-specific risk assessments, effective training, clear communication, and appropriate staffing arrangements in residential care settings.
In residential care, the ability to manage and respond to violent behaviour is critical to ensuring the safety of both staff and service users. By prioritising behaviour-specific risk assessments, effective training, and clear communication, employers can reduce the risk of incidents and provide a safer environment for everyone involved.
Ultimately, the employer’s failure to provide adequate training and support contributed to the claimant’s injuries, highlighting the need for employers to take their obligations seriously and provide a safe working environment for their employees.
Heightened Duty of Care
The employer’s heightened duty of care is a critical aspect of residential care settings.
