Prevention of Future Deaths reports · 2013

Walter Gordon Powley

Regulation 28 report to prevent future deaths, reference 2013-0251, written 4 Oct 2013. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report4 Oct 2013
Reference2013-0251
DeceasedWalter Gordon Powley
CoronerDonald Coutts-Wood
Coroner areaLeicester City & South Leicestershire
CategoryCare Home Health related deaths
Sourcejudiciary.uk record · original PDF
Responses published3

The report

Text extracted from the PDF text layer. Reproduced verbatim, including the scan's own layout.

REGULATION 28:  REPORT TO PREVENT FUTURE DEATHS (1) 

NOTE: This form is to be used after an inquest. 

REGULATION 28 REPORT TO PREVENT FUTURE DEATHS 

THIS REPORT IS BEING SENT TO: 

1.  The Chief Executive (Mr David Behan), Care Quality Commission, Citygate, 

Gallowgate, Newcastle upon Tyne, NE1 4PA 

2.  The Registered Nursing Home Association (Chief Executive – Frank 

Ursell), John Hewitt House, Tunnel Lane, Off Lifford Lane, Kings Norton, 
Birmingham. B30 3JN 

3.  The Health and Safety Executive, Head of Health and Social Care Services 

Unit 
Buildings, Ty Glas, Llanishen, Cardiff, CF14 5SH 

Public Services – Sector Phase 1, Government 

1 

CORONER 

I am Donald Coutts-Wood,assistant coroner, for the coroner area of Leicester City and 
South Leicestershire 

2 

CORONER’S LEGAL POWERS 

I 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. 

3 

INVESTIGATION and INQUEST 

On 25th May 2012 I commenced an investigation into the death of Walter Gordon 
Powley. The investigation concluded at the end of the inquest on 4th October 2013. The 
conclusion of the inquest was  
“The cause of death was Acute Renal Failure due to Rhabdomyolisis and Metabolic 
Acidosis due to burns to legs.  This followed Mr Powley being admitted to the Care 
Home and he fell against pipes.  The jury considered that contributing to his death were: 
A lack of covering pipework, inadequate ongoing risk assessments, failure to adhere to 
procedures on giving and recording of medication. 
. 

4 

CIRCUMSTANCES OF THE DEATH 

Mr Powley died after he fell against radiator pipes underneath a radiator in his room at 
Western Park View Care and Nursing Home, Hinckley Road, Leicester. He fell on the 8th 
May 2012 having been admitted for emergency respite care on the 4th May 2012.   

When he fell Mr Powley’s legs were not covered.  He sustained one deep burn to his 
right leg and numerous superficial burns to both legs.  These burns were the causes of 
the complications that led to his death 8 days later in hospital. 

5 

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

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 1.Neither the pipes that he fell against nor the valves that connected those pipes to the 
radiator, were covered.  HSE published guidance indicated that the maximum 
temperature of such pipes should be 43 degrees centigrade.  Readings taken from 
uncovered pipes both in Mr Powley’s room and other rooms in the Home indicated that 
the temperatures ranged between 60 degrees centigrade and more than 70 degrees 
centigrade. Evidence was given at the Inquest that a number of other residential homes 
in this area did not have pipes and valves covered.  It may well be therefore that this 
applies throughout the country.   

2.It was therefore also apparent that there had not been a risk assessment of the 
physical circumstances in that room, and whether it was therefore safe for a particular 
resident. 

3.Western Park View had been inspected by the Care Quality Commission and the 
Local Authority on a regular basis.  Evidence indicated that these matters referred to had 
not been recognized by those bodies. 

6 

ACTION SHOULD BE TAKEN 

In my opinion action should be taken to prevent future deaths and I believe your 
organisation have the power to take such action. 

7 

YOUR RESPONSE 

You are under a duty to respond to this report within 56 days of the date of this report, 
namely by 29th November 2013. I, 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. 

8 

COPIES and PUBLICATION 

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

1.Western Park View Care Home;  
2.the family of Mr Powley  

I 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, the coroner, at the time of your 
response, about the release or the publication of your response by the Chief Coroner. 

9 

4th October 2013                                 Signed …………………………………………….. 

2

Responses

3 responses 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 Care Quality Commission (PDF)
CareQuality

Commission Care Quality Commission
Finsbury Tower

Mr Donald Coutts-Wood 103-105 Bunhill Row
Coroner London
The Coroner's Court, EC1Y 8TG
Town Hall, Telephone: 03000 616161
Town Hall Square, Fax: 020 7448 9311
Leicester www.cqc.org.uk
LE1 9BG

29 October 2013
Dear Mr Coutts-Wood,

Thank you for your report into the death of Walter Gordon Powley. The
circumstances in which this gentleman died were indeed sad.

As you will be aware our inspectors regulate against the legislation laid down for us
by the Government which is the Health and Social Care Act 2008 and subsequent
regulations. In assisting providers to understand the legal requirements we
produce guidance about compliance, which sets out what we would expect
providers to take into consideration. In this instance this issue would fall under
Regulation 15 or Outcome 10 which says:

Safety and suitability of premises

15.—(1) The registered person must ensure that service users and others having
access to premises where a regulated activity is carried on are protected against
the risks associated with unsafe or unsuitable premises, by means of—

(a) suitable design and layout;

(b) appropriate measures in relation to the security of the premises; and

(c) adequate maintenance and, where applicable, the proper—

(i) operation of the premises, and

(ii) use of any surrounding grounds, which are owned or occupied by the service
provider in connection with the carrying on of the regulated activity.

(2) In paragraph (1), the term “premises where a regulated activity is carried on”

does not include a service user's own home.

Our guidance states that the provider should also meet the requirements of the
Health and Safety at Work Act 1974 and other relevant legislation. We work
closely with the Health and Safety Executive (HSE) in Leicestershire with
inspectors reporting any issues that they note on their inspections in nursing
homes. Whilst the Commission's (CQC) compliance inspectors do look at the
premises they would not necessarily have a comprehensive knowledge of the
Health and Safety Act. There are a number of outcomes and regulations which
can be assessed and it is rare that compliance inspectors look at them all. The
inspector chooses the outcomes to assess based on the service type, the needs
and vulnerability of the people using the service and any prior knowledge we hold
about the service. Therefore we may not look at the pipe work unless there had
been a complaint or unless it stood out to them that the area was dangerous. Our
inspectors do check that radiators are covered but will often only sample a
selection of people's rooms.

Chairman: David Prior Chief Executive: David Behan CBE
Registered office: Finsbury Tower, 103-105 Bunhill Row, London EC1Y 8TG

Our local compliance inspector did inspect the location in May 2012 and reviewed
seven outcomes or regulations. Unfortunately they did not inspect against
Regulation 15, Outcome 10. We are currently reviewing the way in which we
inspect in adult social care and are piloting a new methodology very soon. Instead
of the current outcomes we will assess against five domains and ask five
questions:

e ls this service safe? Certainly in this circumstance the service was not safe.
e Is this service effective?

e Is this service caring?

e ls this service responsive to people's needs?

e Is this service well-led?

The provider has the ultimate responsibility for ensuring that they know and monitor
any unsafe conditions in the service and take the correct action.

| welcome the timeliness of your report and will share its findings within my
organisation; there are definitely lessons to be learnt from this very sad situation,
which includes exploring the ways in which we can work more closely with the HSE
and how we can ensure, within our new methodology, that our inspectors are
checking high-risk areas such as this.

If you would like to know more about the imminent changes in CQC, please do not
j Head of Regional Compliance in Central West,
or visit our website www.cac.org.uk.

Yours sincerely,
K

David Behan
Chief Executive
Response from Health Safety Executive (PDF)
Awdurdod Gweithredol Health and Safety
lechyd a Diogelwch Executive

Cyfarwyddiaeth Gweithrediadau Operational Strategy Division

Maes

Donald Coutts-Wood - Coroner's Office Public Services Sector Public Services Sector

A ” A i Adeiladau'r Llywodraeth G it Buildings (Phase 1
Leicester City and South Leicestershire ty Glas m oateien we
The Coroner's Court archer an

. Caerdydd CF14 5SH
Town Hall, cia SH
Eston Square, Ffon: 029 20263003 Tel: 029 20263003
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Reference HSCSU/MH/Rule 43 Iiipidwers hae a0y a nin hemos

— —
—

Date 21 November 2013

Dear Sir

INQUEST INTO THE DEATH OF WALTER GORDON POWLEY — 25™ MAY 2012 -
4" OCTOBER 2013 - BURNS FROM CONTACT WITH HOT PIPES

Your Regulation 28 letter dated 4" October 2013 has been passed on to me for reply
as | lead for HSE'’s Health and Social Care Services Unit on the topic of social care. |
was sorry to learn about the death of Walter Powley.

You reported matters of concern to HSE under Schedule 5 of the Coroners and
Justice Act 2009 and regulations 28 and 29 of the Coroners (Investigations)
Regulations 2013.

You requested consideration be given to the following:

1 — Neither the pipes or the valves in the bedroom were covered and readings taken

at the Home indicated that temperatures ranged from 60 Degrees Celsius to over 70

Degrees Celsius. Evidence given suggests that pipes and valves may not be covered
in other Homes in the area.

2 — There was no risk assessment of the physical circumstances of the room and
whether it was safe for the resident.

3 — The Home had been inspected by CQC and the LA and the matters referred to
had not been recognised.

HSE has guidance on the risks from hot water and surfaces on its Health and Social
Care web pages (http://www.hse.gov.uk/healthservices/scalding-burning.htm),
including Information Sheet 6. Further information can also be found in HSE booklet
‘Health and safety in care homes’ (HSG220) which is available on the website and is
currently being reviewed and updated. It is hoped that the revised version will be
available in early Spring 2014.

| totally understand your concerns but see CQC as the lead regulator and inspection
body in England for health and social care providers and we believe they are better
placed to proactively lead on service user safety issues. | note that you have also
written to CQC.

HSE has also just launched a GB Social Care Partners Forum (SCPF) which brings
together regulators, care home representatives and other stakeholders. The aim of the
Forum is to raise standards by producing broadly agreed guidance and disseminating
it to the sector. HSE sees this as an appropriate forum to raise your concerns and it is
our intention to raise the issue of assessing the risk from hot surfaces and pipe-work
at the next meeting. It is hoped that the next meeting will be held in February 2014.
One of the task and finish groups that has been established is looking at mapping
standards and exploring how these can best be promulgated as your concerns no
doubt apply to other established standards.

HSE does not routinely inspect health and social care providers but does investigate
serious incidents meeting our selection criteria and inspect where there is evidence of
poor compliance. This may include, for example, where there is evidence of
established standards, such as those concerning prevention of burns, not being
followed. This is also the case for non-nursing residential care which is enforced by
local authorities. | will share this letter with local authority health and safety regulators
via HSE's Local Authority Unit and also arrange for the matter to be discussed at the
next meeting of the national local authority practitioner forum.

How health and social care is regulated across England is currently being reviewed
following the Mid-Staffordshire Inquiry and this may impact on how such concerns are
taken forwards in the future.

| hope this addresses the concerns you have raised but please do not hesitate to
contact me if you wish to discuss the matter further.

Yours faithfully

Senior Policy Advisor
Health and Social Care Services Unit

Cc _Local Authority Unit (LAU)

iN)
Response from Rnha (PDF)
REGISTERED NURSING TELEPHONE: 0121 451 1088

HOME AS SOCIATION urureo toy cuseantee ar prerneeecpaled
JOHN HEWITT HOUSE, TUNNEL LANE, KINGS NORTON, BIRMINGHAM B30 3JN Website: wwrwrna,c0.uk

Mr D Coutts-Wood
Assistant Coroner
Leicester City and South

Town Hall
Leicester
LE1 9BG Me i
SOUTH LEIC! }
CORONERS D0}
20" December 2013,

23 DEC 2013

Re; Regulation 28 Report to prevent future deaths,
RECEIVED

Dear Sir,
| refer to your report of 4" October 2013 concerning a Regulation 28 matter.

The Registered Nursing Home Association is a trade association for owners of
care homes providing nursing care (previously called nursing homes). There is
no obligation placed upon home owners to join the Registered Nursing Home
Association. The powers of the Association are limited to membership matters,
i.e. removing membership where the standards expected of the Association are
not met.

Western View Care and Nursing Home is not a member of the Registered
Nursing Home Association and, as such, there is nothing that | can do, of a
regulatory manner, in relation to Western View Care and Nursing Home.

| see that your report has also been sent to David Behan at CQC and Steve
Scott at HSE, both of whom have regulatory powers which | am sure that they
will now exercise as necessary.

| do, however, recognise the risk which you have identified and | can report that,
as an Association, we regularly advise members of their responsibility under the
Health & Safety at Work Act. We particularly draw their attention to the need to
ensure that the pipes leading to a radiator, as well as the radiator itself, are
suitably covered to prevent the risk of burns in the event of a patient falling
against the radiator.

We will continue to advise members of the need for risk assessments and
actions to ensure that there are safe radiator temperatures, including pipework,
within the home.

or
QUALITY NURSING CARE

in England No. 982095

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