Prevention of Future Deaths reports · 2015

Anne Horner

Regulation 28 report to prevent future deaths, reference 2015-0047, written 11 Feb 2015. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report11 Feb 2015
Reference2015-0047
DeceasedAnne Horner
CoronerSimon Nelson
Coroner areaManchester North
CategoryHospital Death (Clinical Procedures and medical management) related deaths
Sourcejudiciary.uk record · original PDF
Responses published1

The report

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

REGULATION 28: REPORTTO PREVENT FUTURE DEATHS (1)
REGULATION 28 REPORTTO PREVENT FUTURE DEATHS
THIS REPORT IS BEING SENT TO:
1. Department of Health
2. Bury MBC
3. Care Quality Commission
4. Messrs. Latimer Lee Solicitors on behalfofOak Lodge Care Home
5. Family ofthe deceased
6. Chief Coroner
CORONER
I am Simon Nelson, HM Senior Coronerforthe Coroner area of Manchester North
2 CORONER’S LEGAL POWERS
I make this report under paragraph 7, Schedule 5, ofthe Coroner’s and Justice Act 2009 and Regulations 28
and 29 ofthe Coroners (Investigations) Regulations 2013
3 INVESTIGATION and INQUEST
On the 7th April 2014 I commenced an investigation into the death of Anne Homer for whom the cause of
death had been given as being that of la) Traumatic Acute Subdural Haemorrhage with Renal Cell
Carcinoma with Lung Metastases; Anticoagulation Therapy, whilst not causative of death, being
contributory factors under 2. At an Inquest at the Rochdale Coroners Court Heywood on the 2n2d January
2015, the following conclusion was reached ‘against a background of increasing frailty of health and use of
anti-coagulation therapy Anne Homer died at The Salford Royal Hospital on the 2th5 March 2014 from a
traumatic head injury precipitated initially by inadvertent impact with a toilet door which was being opened
at Oak Lodge Care Home at approximately 05:l5hrs that day but which may have been aggravated by
subsequent trauma following her collapse at approximately 09:40hrs that day whilst at the Care Home’.
4 CIRCUMSTANCES OF DEATH
As above
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
reportto you.
The MATTERS OF CONCERN are as follows:
1. The deceased had been a resident at Oak Lodge Nursing Home for approximately 6 weeks prior to
her death during which time she was able to access and use bathroom facilities that were close to
the bedroom which she occupied.
2. At approximately 02:3ohrs on the 6th March 2014 whilst Mrs Homer was within the toilet cubicle
within the bathroom she sustained a minor head injury when the door to the cubicle struck her
head as it was being opened by a Health Care Assistant who was undertaking room checks.
3. At approximately 05:30hrs on the 2th5 March 2014 Mrs Homer was involved in a virtually identical
incident, again whilst sitting within the toilet cubicle. Sadly later that morning she was found
unresponsive and notwithstanding her transfer to the emergency department at Salford Royal
Hospital, she was diagnosed as having an unsurvivable brain injury.
4. The evidence at Inquest confirmed that the bathroom facility which included the toilet cubicle was
constructed in or about 1988 in compliance with the relevant Planning Permission and Building
Regulations. I accept that the facility had been used on many previous occasions without incident.
The fact however that a resident sustained injury on two separate occasions within a period of 6
weeks gives rise to concern. I anticipate that there are many establishments within England and
Wales where toilet facilities are not dissimilar to those at Oak Lodge Nursing Home. I understand
that separate guidance in relation to disabled toilet design suggests doors that open outwards to
facilitate access if someone falls behind the door. Whilst photographic images produced at Inquest
suggested adequate door clearance for a resident sitting normally on the toilet, that would not be
so for an individual resident who sat / was slumped forward.
6 ACTION SHOULD BE TAKEN
In my opinion action should be taken to consider legislation that would prevent fatalities occurring in
similar circumstances and I believe each ofyou respectively have the powerto 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 8th April
2015. 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 ChiefCoroner and to the following Interested Persons namely:
1. Department of Health
2. Bury MBC
3. Care Quality Commission
4. Messrs. Latimer Lee Solicitors on behalfofOak Lodge Care Home
5. Family ofthe deceased
I am also under a duty to send the ChiefCoroner a copy ofyour response.
The Chief Coroner may publish either or both in a complete or redacted or summary from. He may send a
copy of this report to any person who he believes may find it usefulor 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 ChiefCoroner.
4c)
g Date: 1th1 February 2015 Signed.(J,

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 Care Quality Commission (PDF)
CareQuality
Commission
North Region
Care Quality Commission
Citygate
Gallowgate
4 Newcastle upon Tyne
NE1 4PA
Mr S Nelson
Telephone: 03000 616161
HM Senior Coroner
Fax: 03000 616172
Office of HM Coroner
The Phoenix Centre www.cqc.org.uk
L/Cpl Stephen Shaw MC Way
Heywood
OL1O 1LR
20 March 2015
Our ref:
Re: Anne Homer (deceased) Regulation 28 notice
Dear Mr Nelson
We were very sad to read about the death of Mrs Homer and the circumstances in
which she died. Thank you for your report and the requirement for us to review
what actions should be taken to try to prevent the occurrence or continuation of
such circumstances in the future.
Please treat this letter as the formal response of the Care Quality Commission
(‘CQC’) to your report dated 11 February 2015.
In terms of the actions that we have taken since theevent we have been in
,
dialogue with the provider requesting information relating to the incident. This has
included requiring information from the provider under Section 64 of the Health and
Social Care Act 2008. This information has now been provided. The provider has
confirmed to us in writing that the toilet has been decommissioned and is no longer
in use.
We note your comment relating to toilet doors opening outwards. It seems to us
that it would not be appropriate for the CQC to provide any expert comment in this
area. We respecifully suggest that it would be more appropriate for the Building
Control department of the Bury Metropolitan Borough Council to advise on such
matters. We are mindful on the one hand that a door opening outwards into a
corridor might reduce the risk of a person using the toilet striking their head against
an opened door while increasing accessibility in the event of a fall. On the other
hand, we also recognise that outward-opening doors may pose inherent risks to
passers-by outside a toilet and especially so where a service is frequented by
people who may have a visual impairment or mobility problems. It is the
responsibility of the service provider to manage the risks posed by whichever
mechanism it implements to ensure the welfare and safety of service users.
Registered office: FinsburyTower, 103-105 Bunhill Row, London EC1Y8TG
CareQuality
Commission
In terms of further actions that we have undertaken to address concerns
highlighted in your report, the CQC has also inspected the home on an
unannounced basis. The resultant report is currently in draft format and will shortly
to be sent to the provider for comment and any factual accuracy representations.
We have identified a number of areas the provider needs to address within the
care home although none relate to the concerns raised in your report. If you wish
we will send a copy of the report to you once it has been published.
We hope that this letter adequately sets out the steps that the CQC has taken to
address the concerns identified in your report following the inquest following into
Mrs Homer’s very sad death. If we can be any further assistance please do not
hesitate to contact us.
Yours sincerely
Head of Inspection Adult Social Care (North Central)
Registered office: FinsburyTower, 103-105 Bunhill Row, London EC1Y8TG

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