Prevention of Future Deaths reports · 2013

Stanley Dobson

Regulation 28 report to prevent future deaths, reference 2013-0303, written 7 Nov 2013. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report7 Nov 2013
Reference2013-0303
DeceasedStanley Dobson
CoronerMartin Fleming
Coroner areaSurrey
CategoryCommunity health care and emergency services related deaths
Organisation namedMid Staffordshire NHS Foundation Trust
Sourcejudiciary.uk record · original PDF
Responses published1

The report

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

IN THE SURREY CORONER’S COURT
IN THE MATTER OF:
__________________________________________________________
The Inquests Touching the Death of Stanley Charles Dodson
A Regulation Report – Action to Prevent Future Deaths
__________________________________________________________
THIS REPORT IS BEING SENT TO:
Harmoni
1 CORONER
Martin Fleming ADC Surrey
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 20 of the Coroners
(Investigations) Regulations 2013
3 INVESTIGATION and INQUEST
On 9/10/12 I opened an inquest into the death of Stanley Charles Dodson
who, at the date of his deaths was aged 84 years. The inquest was
resumed and concluded on 7th November 2013.
I found that the cause of death to be: ‐
1(a) Left Ventricular Failure
1(b) Hypertensive Heart Disease
I concluded with a narrative verdict.
4 CIRCUMSTANCES OF THE DEATH
On 1/10/12, Stanley Charles Dodson was found to have died at his home
address at 2 Wallis Mews, Guildford Road, Leatherhead, Surrey. Prior to
his death he had been prescribed warfarin for a thrombus and
methotrexate for his Dermatomyositis, which were withdrawn by his
doctor, given his failing short‐term memory and confusion. Mr Dodson
had a Mole Valley Community Alarm fitted and at approximately 10pm
30/9/12 he telephoned the operative to ask for a doctor to provide him
with medication. The operative then contacted Harmoni to request the
attendance of an on call doctor. The doctor responded by telephoning Mr
Dodson 3 times but without response and he left a message on his answer
phone to ask Mr Dodson to contact him or emergency services if
RT3762 1
necessary. Mr Dodson was found to have died the next day.
5 CORONER’S CONCERNS
During the course of the inquest the evidence revealed a matter that gave
rise to concern and which, in my opinion, there is a risk that future deaths
could occur by reason thereof unless action is taken.
The MATTER OF CONCERN is as follows. –
 Although the Doctor made several attempts to directly contact Mr
Dodson and left a telephone message for him, these difficulties
were not reported back to the operative to enable consideration of
further action to contact him.
I would be grateful if you could re consider the appropriateness of
extending your existing protocols to requirement that locum doctors
should inform the operatives in the event of the non response of patients.
6 ACTION SHOULD BE TAKEN
In my opinion action should be taken to prevent future deaths and I
believe that Harmoni have the power to take such action.
7 YOUR RESPONSE
You are under a duty to respond to this report within 56 days of its date; I
may extend that period on request.
Your response must contain details of action taken or proposed to be
taken, setting out the timetable for such action. Otherwise you must
explain why no action is proposed.
8 COPIES
I have sent a copy of this report to:
Mole Valley District Council
Chief Coroner
Coroners Society
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9 DATED this 23/7/13
RT3762 3

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 Department of Health (PDF)
"From the Rt Hon Jeremy Hunt MP
Secretary of State for Health

Department
of H ealth Richmond House
79 Whitehall
POC 1_794073 London
SWIA 2NS
Michael D Oakley Tel: 020 7210 3000
HM Coroner Mb-sofs@dh. gsi. gov.uk
North Yorkshire East
Forsyth House
Market Place
Malton
YOI17 7LR 28 AUG 2013

Wes ie, erly |

Thank you for your Rule 43 letter of 6 July 2013 regarding the sad deaths of Stanley
Dobson and Lesley Taylor.

In your letter you asked me to consider reviewing the staff ratios in care homes and
establishing national guidelines or regulations.

You are correct that there are no set ratios of staff to residents in care and nursing
homes. The levels of need of residents can vary a great deal and it would simply not
be practical to devise ratios which would be suitable for all circumstances.
However, all homes are required by law to ensure that sufficient numbers of
properly qualified staff are on duty at all times.

The Care Quality Commission (CQC) is the independent regulator of health and

_ adult social care providers in England. Under the Health and Social Care Act, 2008,
all providers of regulated activities, including NHS, public and independent sector
providers, must register with CQC and meet regulations and standards governing
the safety and quality of services. Regulation 22 of the Health and Social Care Act

2008 (Regulated Activities) Regulations 2010, against which CQC registers and
| regulates providers, states:

“In order to safeguard the health, safety and welfare of service users, the
registered person must take appropriate steps to ensure that, at all times, there
are sufficient numbers of suitably qualified, skilled and experienced persons
employed for the purposes of carrying on the regulated activity.”

CQC is responsible for deciding whether providers are meeting regulatory
requirements. It is an offence for a provider not to comply with the requirements

and under the 2008 Act, CQC has a wide range of enforcement powers it can use if
it finds a provider is not compliant.

On 26 March 2013, the Government published Patients First and Foremost, its
initial response to the Report of the Public Inquiry into Mid Staffordshire NHS
Foundation Trust. The document sets out an initial overarching response on behalf
of the health and care system as a whole.

One of the recommendations was that CQC should introduce new Chief inspectors
of Social Care, Hospitals and Primary Care, as well as a set of new fundamental
standards of safety and quality, which make explicit the basic standard beneath
which care should never fall. CQC published its new three year strategy for 2013 to
2016 and set out how it would introduce the recommendations, as well as setting out
its strategic priorities for driving improvement in the quality of care.
http://www.cqc.org.uk/sites/default/files/media/documents/cqc_strategy_consultatio
n_2013-2016 tagged _0.pdf

On 19 July, Andrea Sutcliffe was appointed to be the first Chief Inspector of Social
Care. The Chief Inspector will:
— Make authoritative judgements about the quality of care and recommend that
action is taken when they identify failing providers
— Spearhead inspections based on risk, not frequency, together with more in-
depth inspections where quality is found to be poor
— Be the public face of CQC to their respective professions or sectors and lead
communicators with the media
— Produce a single rating system covering all providers

The Department and the CQC will develop the fundamental standards of care to
reflect the experiences of service users and carers. CQC is currently consulting on
the new standards, which, when finalised, will be incorporated in to the registration
requirements, alongside other ‘expected standards’ that providers will also need to
meet. The regulation requirements will still include a requirement related to
staffing, which will be similar to the current requirement referred to above. There is
no intention to add specific staffing ratios to the registration requirements.

I hope this response is helpful. Thank you for bringing the circumstances of Stanley
Hope’s and Lesley Taylor’s deaths to my attention.

Ye sae
Ie

JEREMY Aunt

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