A carer was stabbed in the neck after her bosses left her alone with a dangerous patient at an Aigburth care home.
Mary King was wounded by a resident at Fulwood Care Ltd on Ampthill Road while visiting to discuss moving them to another service.
Ms King worked for Options for Supported Living, an agency which supports people with mental health issues.
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Liverpool Crown Court heard Ms King, who was not trained to deal with such residents, was left alone in the kitchen with the resident against instructions left in a care plan, which described clear examples of violence and aggression.
The plan stated that no less than two carers should be left with the resident at any time.
While they were alone, the resident crossed the kitchen and plunged a blade into the right side of Ms King's neck.
A statement from the Health and Safety Executive (HSE), which prosecuted the case, said: "While the employee made a physical recovery, she has suffered post-traumatic stress disorder (PTSD) and long-term psychological trauma and is still receiving counselling."
The incident, which occurred on November 2, 2014, led to a years long investigation which ended in court this month with Fulwood Care Ltd, Options for Supported Living and the agency's manager Marie Binns being convicted of breaching health and safety legislation.
HSE investigators found that care plans and risk assessments were in place from Liverpool Council, the NHS and Fulwood Care Limited, all of which indicated the high risk the individual posed to themselves and others.
However neither Fulwood Care Limited or Options for Supported Living took account of these documents prior to the visits by Options for Supported Living.
It was also found that dedicated training and a full risk assessment and care plan for that individual were not undertaken by Options for Supported Living in order to identify the triggers for violence and aggression, and how the risk could be managed.
The investigation found that the need for 2:1 supervision, triggers (things not to say or do) should have been identified and copies of the documents given to Options employees prior to their visits.
Arrangements with regard to communication and supervision by the two care agencies should also have been undertaken and adequate supervision during visits provided by both Options and Fulwood Care.
Options for Supported Living Ltd of St Nicholas House, Old Church Yard, Liverpool, pleaded guilty to breaching Section 2 (1) of the Health and Safety at Work etc. Act 1974 and was fined £31,000 and ordered to pay £10,000 towards costs.
Fulwood Care Ltd of Ampthill Road, Aigburth, Liverpool pleaded guilty to breaching Section 3 (1) of the Health and Safety at Work etc. Act 1974 and was fined £14,000 and ordered to pay £10,000 towards costs.
Marie Binns of Queens Drive, West Derby, Liverpool accepted a formal caution with regard to breaching Section 2(1) of the Health and Safety at Work etc. Act 1974.
HSE inspector, Rose Leese-Weller, said after the hearing: “This was a tragic and wholly avoidable incident. Those in control of work have a responsibility to devise safe methods of working and to provide the necessary information, instruction and training to their workers.
“If a suitable safe system of work had been in place prior to the incident, the individual in care may not have reacted the way they did, and life changing injuries sustained and trauma experienced by the Options employee could have been prevented.”
