Prevention of Future Deaths reports · 2013

Joan Mary Jones

Regulation 28 report to prevent future deaths, reference 2013-0234, written 20 Sep 2013. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report20 Sep 2013
Reference2013-0234
DeceasedJoan Mary Jones
CoronerCatherine Mason
Coroner areaLeicester City and South Leicestershire
CategoryCare Home Health related deaths
Sourcejudiciary.uk record · original PDF
Responses published1

The report

Text recovered by OCR from a scanned PDF. OCR is imperfect: check anything you rely on against the source PDF. Reproduced verbatim, including the scan's own layout.

REGULATION 28 REPORT TO PREVENT FUTURE DEATHS
THIS REPORT IS BEING SENT TO:

4. The Manager, The Manor Residential & Nursing Care Home, 78-80
Lutterworth Road, Aylestone, Leicester, LE2 8PG

CORONER

| am Catherine Mason senior coroner, for the coroner area of Leicester City and South
Leicestershire

CORONER'S LEGAL POWERS

| make this report under paragraph 7, Schedule 5, of the Coroners and Justice Act 2009
and regulations 28 and 29 of the Coroners (Investigations) Regulations 2013.

INVESTIGATION and INQUEST

On 9" October 2012 | commenced an investigation into the death of Joan Mary Jones.
The investigation concluded at the end of the inquest on 18" September 2013. The
conclusion of the inquest was that the cause of death was Bilateral bronchopneumonia
due to locally advanced adenocarcinoma of the large bowel and Alzheimer’s dementia.
A narrative, conclusion was recorded as follows:

On the 23° September 2012 Mrs Jones became unwell and was seen by an out of
hours doctor who diagnosed a viral infection. No further concerns were raised until the
30” September 2012 when she became unresponsive following an episode of aspiration
the previous day. Again an out of hours practitioner attended. Mrs Jones thereafter
continued to deteriorate and she died on the 1" October 2012 at The Manor and
Residential Home, Leicester. Medical opinion is that when Mrs Jones initial illness had
not showed signs of improvement after 2 to 3 days her General Practitioner should have
been notified and it is likely that antibiotics would have been prescribed. This did not
happen. As a result there was a missed opportunity to treat. However, medical
evidence is that it is unclear whether the outcome would have been different.

CIRCUMSTANCES OF THE DEATH

Mrs Jones was a resident at The Manor and Residential Home, Leicester and was
known to have Alzheimer’s dementia. An out of hours doctor saw her on the 23°
September 2012 because the professionals caring for her were concerned about her
being unwell. The doctor found her to have a runny nose and a slight cough. All vital
signs were within normal range and a viral upper respiratory tract infection was
diagnosed. Medication was not considered necessary and advice was given to
encourage fluids and report any deterioration or further concerns.

Mrs Jones continued to be cared for at the Home. On the 30” September those caring
for Mrs Jones sought assistance from an out of hours advanced nurse practitioner.
When he attended he observed that Mrs Jones had cold like symptoms and again
considered them to be viral in nature. He noted a low blood pressure but was not
concerned with it of itself. However, evidence revealed that he was not told of the
doctor's visit the week before nor of the vital signs recorded at that stage. In addition, he
was not infirmed of the aspiration. He said if he had he thought it was likely that he
would have made arrangements for Mrs Jones to be admitted to hospital rather than
instruct that she should remain at the Home.

A Doctor from the practice that Mrs Jones was registered at, said that she would not
necessarily have admitted Mrs Jones to hospital had she been faced with the same
situation, but gave evidence that when Mrs Jones had not showed signs of improvement
after 2 to 3 days following the medical attendance on the 23 September 2012, she
would have expected the Home to have contacted the practice and a doctor would have

visited. Furthermore, she stated that in her professional opinion, with the knowledge of
Mrs Jones’ dementia and the care home setting, antibiotics would have been prescribed.
However, she was not able to say whether on a balance of probabilities the outcome
would have been different. However, she was clear in saying that there was a missed
opportunity to treat and communicate with Mrs Jones' family and discuss an advanced
care plan.

CORONER'S CONCERNS

During the course of the inquest the evidence revealed matters giving rise to concern. In
my opinion there is a risk that future deaths will occur unless action is taken. In the
circumstances it is my statutory duty to report to you.

The MATTERS OF CONCERN are as follows. —

(1) The staff did not escalate Mrs Jones’ care when they should have done

(2) The staff did not communicate all that was known to them and therefore attending
health care professionals were unable to make fully informed decisions

(3) Due to the lack of communication, an appropriate package of care was not put in
place for Mrs Jones

(4) These omissions (failure to escalate and the lack of communication with other
attending health care professionals) together or alone, could in future circumstances
cause or contribute to death.

ACTION SHOULD BE TAKEN

In my opinion action should be taken to prevent future deaths and | believe you have the
power to take such action.

YOUR RESPONSE

You are under a duty to respond to this report within 56 days of the date of this report,
namely by the 15” November 2013. |, the coroner, may extend the period.

Your response must contain details of action taken or proposed to be taken, setting out
the timetable for action. Otherwise you must explain why no action is proposed.

COPIES and PUBLICATION

| have sent a copy of my report to the Chief Coroner and to the following Interested
Persons:

| am also under a duty to send the Chief Coroner a copy of your response.

The Chief Coroner may publish either or both in a complete or redacted or summary
form. He may send a copy of this report to any person who he believes may find it useful
or of interest. You may make representations to me, at the time of your
response, about the release or the publicati your response by the Chief Coroner.

20" September 2013

Responses

1 response published against this report on judiciary.uk. A response is a body's written reply to the coroner's concerns; publication is at the discretion of the Chief Coroner's office, so an absent response does not mean nobody replied.

Response from The Manor (PDF)
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11th November 2013 

Dear Coroner, 

Ref Mrs Joan Mary Jones 

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October 2012 Mrs Jones passed away at the Manor Care Home in Leicester.  After the death 

On  1
of Mrs Jones an inquest was held on  18th  September 2013. The verdict was a narrative one, with 
directive for the home's manager to take further action to ensure clear lines of communication after 
and out of hours GP visit. Also the home was to contact the family to meet up and answer any 
outstanding questions they had. 

On  19th  September 2013 a memo was sent to all the unit leads to ensure that following any input from 
GP's and out of hours nurses, doctors the family must be contacted, that the communication sheet 
must be completed following any discussions, involvement with any health care professionals. That 
these communications sheets must be shared with any health care professionals and completed after 
each visit by health care professionals. These visits must be communicated to the family. 

It was also agreed that the home's manager would meet up with the family to discuss any 
unanswered questions. 

We have written to 
recorded deliver to ensure receipt of the letter. 

 on 20

th 

September 2013 and 6

November2013, second time 

th 

Since we have not had any response from 
consultant, BKR Care Consultancy (BKRCC), to write and offer to arrange a meeting to discuss any 
questions with the family.  BKRCC will be writing to 
 by 18 Nov 2013. This will be sent 
recorded delivery. 

  we have asked our  independent care 

Cc: 

78-80 Lutterworth Road  ,Aylestone, Leicester, LE2 8PG 
Tel:  0116 2990225/229,Fax: 0116 2990257, E-mail themanorcarehome@hotmail.com 

 
 
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06/11/2013  10:15 
AYlestone 
1 Earl  Russell  Street 
Ai 1es tone 
Leicester 
Leicestershire 
LE2  8LH 

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Oate  of  Issue:  06/11/2013  10:15 
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 20t h  September 2013 

Dear 

, 

RE:  Late  Mrs Jones 

I  write further to the coroner's inquest that was held  on  the  18t h  September 2013.  I  was 
ade aware at the inquest that you  had some concerns about the care that your mother 
Late  Mrs. Jones received  from the home, and would like to arrange a meeting so that we 
can  discuss these and  an  internal investigation can  commence. 

Please contact me on  the numbers below or my mobile
appointment can  be arranged at your convenience to discuss these concerns. 

 so that an 

I  will  look forward  to hearing from you  soon. 

Manager 

78-80 Lutterworth Road ,Aylestone, Leicester, LE2 BPG 
Tel:  0116 2990225/229,Fax: 0116 2990257, E-mail themanorcarehome@hotmail.com

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