Prevention of Future Deaths reports · 2016

Lee Grimes

Regulation 28 report to prevent future deaths, reference 2016 – 0268, written 26 Jul 2016. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report26 Jul 2016
Reference2016 – 0268
DeceasedLee Grimes
CoronerRachael Griffin
Coroner areaManchester (West)
CategoryCommunity health care and emergency services related deaths
Sourcejudiciary.uk record · original PDF
Responses published2

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.  Mr  Jeremy  Alston,  Chief  Executive  of  Next  Stage,  Comtech  House,  28 

Manchester Road, Westhoughton, Bolton, BL5 3QJ 

2.  Mr  Simon  Barber,  Chief  Executive  of  5  Boroughs  Partnership  NHS 
Foundation Trust, Hollins Park House, Hollins Lane, Winwick, Warrington

1  CORONER 

I  am  Rachael  Clare  Griffin,  Assistant  Coroner,  for  the  Coroner  Area  of 
Manchester West 

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  the  23rd  March  2016  I  commenced  an  investigation  into  the  death  of  Lee 
Francis Grimes, born on the 12th September 1975. 

The investigation concluded at the end of the Inquest on the 13th July 2016. 

The Medical Cause of Death was: 

1a Acute Left Ventricular Failure 
1b Cocaine Induced Cardiac Ischaemia 

The conclusion of the Inquest was Drug Related Death. 

4  CIRCUMSTANCES OF THE DEATH 

On the 21st March 2016 the deceased, who was known to misuse Cocaine, was 
found  in  a  collapsed  and  unresponsive  condition  in  the  bedroom  at  his  home 
address at 8 Avondale Street, Standish, Wigan. 

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.  During the inquest evidence was heard that: 

1

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 i.  Mr Grimes suffered with schizophrenia and was under the care of 
the Mental Health Services. Since 2004 he had been supported in 
the  community  by  support  workers  from  Next  Stage  which  is  a 
home health care service. They provided assistance to Mr Grimes 
on  a  daily  basis,  Monday  to  Friday.  They  would  attend  at  his 
home address to  assist  him with basic activities and monitor his 
mental  health.  If  there  was  a  deterioration  in  his  mental  health 
they  would  contact  the  appropriate  service  to  ensure  Mr  Grimes 
was assessed and provided with treatment as required. 

ii.  On  Thursday  17th  March  2016  a  support  worker  attended  upon 
Mr  Grimes  and  noted  that  he  was  not  himself.  At  that  time,  he 
disclosed  to  her  that  he  had  taken  an  excessive  dose  of  his 
prescribed medication. A note was made of this disclosure but no 
action was taken following that information being provided to the 
support worker. 

iii. 

iv. 

v. 

The  following  day,  Friday  18th  March,  another  support  worker, 
  attended  upon  Mr  Grimes  at  about  10am,  when  he 
again disclosed that he had taken an overdose of his Procyclidine 
medication, explaining he had taken 12 tablets. At that time, 

  called  Wigan  Recovery  North,  the  Community  Mental 
Health  Team  which  is  governed  by  5  Borough  Partnerships  NHS 
Foundation  Trust,  to  speak  to  a  Community  Psychiatric  Nurse 
(CPN), to report that Mr Grimes had taken excessive medication. 
 requesting 
A message was left on an answerphone by 
a call back and explaining that Mr Grimes had taken an overdose 
of medication. No return call was made to 
nor was any 
further call made to Wigan Recovery North by employees at Next 
Stage  to  follow  up  the  initial  message  left.  Mr  Grimes  did  not 
have  any  contact  with  anyone  after  Friday  18th  March  and  was 
found dead at his home address on Monday 21st March. 

Evidence  was  given  that  if  a  service  user  discloses  they  have 
taken an overdose of medication to a support worker from Next 
Stage,  that  support  worker  should  then  speak  to  a  CPN  from 
Wigan  Recovery  North,  if  the  disclosure  is  made  during  their 
operating  hours  of  9am  to  5pm  Monday  to  Friday.  If  the 
disclosure is made out of office hours, Next Stage have an out of 
hours system where action is taken by the person contacted out 
of  hours  to  further  investigate  or  manage  the  service  user’s 
wellbeing. 

Evidence was given by 
 that there is training that Next 
Stage offer in respect of how to deal with a report of an overdose 
by  a  service  user,  and  other  situations  that  may  arise  when 
providing support to a service user, but that he had not had any 
training in 3 years as his workload did not allow him to undertake 
  confirmed  that  he  felt  he,  and  the  other 
training. 
employees from Next Stage, would benefit from further training, 
which could prevent a future death.  

2

 
 
 
 
 
 
 
 2.  I have concerns with regard to the following: 

i. 

ii. 

That no action was taken by an employee of Next Stage following 
Mr Grimes’ disclosure of an overdose of medication on Thursday 
the  17th  March.  I  have  further  concern  that  when  action  was 
taken  on  the  Friday  18th  March,  a  message  was  left  for  the 
Community  Mental  Health  Team  which  was  not  followed  up  by 
Next Stage, or answered and actioned by the Community Mental 
Health  Team.  Although  Mr  Grimes’  death  was  not  as  a  result  of 
an overdose, he did not receive any assessment, or treatment, in 
respect  of  the  overdose  he  disclosed.  In  view  of  the  fact  that 
there  was  no  contact  from  the  Next  Stage  or  the  Community 
Mental  Health  team  over  the  weekend,  he  was  vulnerable  to 
taking a further overdose of medication. 

I have concerns that if this situation occurs in the future, another 
person  could  die.  In  view  of  that  I  would  ask  that  the  current 
policies  and  procedures  in  place  at  Next  Stage  to  deal  with  the 
disclosure  of  an  overdose  of  medication  by  a  service  user,  are 
reviewed,  and  cascaded  down  to  all  employees.  I  would  also 
request that a review is carried out by 5 Boroughs Partnership of 
the policies and procedures in place regarding  the processing of 
referrals  to  Wigan  Recovery  North  given  the  fact  that  the 
message  left  by 
  on  the  Friday  morning  was  never 
acted upon, as if this were to happen again in the future I believe 
there could be a further death. 

6  ACTION SHOULD BE TAKEN 

In  my  opinion  urgent  action  should  be  taken  to  prevent  future  deaths  and  I 
believe you and/or 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, 20th September 2016. 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) 

, Mr Grimes’ mother on behalf of the family 

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

3

 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
 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  Dated 

Signed 

26th July 2016                          

Rachael C Griffin 

4

Responses

2 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 5 Borough Partnership NHS Trust (PDF)
5 Boroughs Partnership INHS|

NHS Foundation Trust
Our Ref: Chief Executives Office
Hollins Park Hospital
Your Ref: Winwick
Warrington
Cheshire
WA2 8WA
21 September 2016 Tel: 01925 664001
Fax: 01925 664052
PRIVATE AND CONFIDENTIAL Email:
Mrs R C Griffin

HM Assistant Coroner
Great Manchester (West)
HM Coroners Court
Paderborn House

Civic Centre

Howell Croft North
Bolton

BL1 1JW

Dear Mrs Griffin
Re: Lee Francis Grimes — deceased

Thank you for your letter of 26 July 2016 regarding your findings at the inquest into
the death of Lee Francis Grimes on 13 July 2016 and the directions given under the
Regulations 28 and 29 of the Coroners (Investigations) Regulations 2013.

In response to your request to review the policies and procedures in place regarding
the processing of referrals to Wigan Recovery North, | can confirm that a review of
these procedures has been undertaken > = Matron for Quality, in
conjunction with the respective team manager

This review took the form of examining how messages are received into the team,
identifying the person who is responsible for responding to referrals by phone call
and how these are recorded.

The review found that referrals by phone cail to Wigan Recovery North are received
by the team secretary who is responsible to then transfer the call to a Duty Officer.
The Duty Officer is a registered mental health nurse who will deal with the referral
ensuring appropriate subsequent action is taken. A Support Time and Recovery
(STR) worker is also available to support this process and will always liaise with the
registered mental health nurse to discuss appropriate actions.

Chief Executive: Mr. Simon J. Barber vt Me,
ER YA)
Trust Headquarters, Hollins Park House, Hollins Lane, Winwick, Warrington, WA2 8WA. . Ws

Mini Com Number 01925 664094 Asap

If the call is of an urgent nature and both Duty Officer and STR worker are engaged
with other clients, the team secretary will immediately transfer the cail to an available
registered mental health nurse in order that the matter can be dealt with effectively.
However if the caller deems their message as of a less urgent nature, this is logged
into the communication message book, which is checked by the Duty Officer
regularly throughout the shift.

This procedure is well established within the team and ae .:.: satisfied
that all staff members were able to describe this in detail and demonstrate
awareness of the correct procedure and their subsequent responsibilities in this
regard.

We note from the evidence presented at the hearing that an answerphone message
was left for the team on the morning of Friday 18 March 2016 at approximately 10
am, however it has not been possible to determine where the message was left.

Wigan Recovery North does not utilise an answerphone service before 5pm. An
answerphone is only utilised and available outside of normal office working hours, i.e.
on weekday evenings after 5pm and at weekends. All messages left during these
times are reviewed and addressed at the start of the next working day. The Trust
has considered the possibility that the worker in this case may have used an
incorrect number for the team.

In exercising learning from this review, we have ensured that the team’s correct
contact details, including the telephone number, has been re-circulated to all our
partner agencies and that the lessons learned from this inquest are shared.

This learning has also been discussed within The Trust’s Quality and Safety Meeting
with the Wigan Borough and the team manager has shared your findings from the
inquest with the team directly involved in the care of Mr Grimes.

| hope you will find the above information useful in providing assurance that all
referrals received by phone into Wigan Recovery North are appropriately dealt with.
If | can be of any further assistance or you require further information about the steps
the Trust has undertaken, please do not hesitate to contact me.

Yours sincerely

Chief Nurse, Executive Director of Clinical Operational Services

Chief Executive: Mr. Simon J. Barber st htoe,
PAYA)
Trust Headquarters, Hollins Park House, Hollins Lane, Winwick, Warrington, WA2 8WA WY:

Mini Com Number 01925 664094 Cros
Response from Next Stage (PDF)
MEMBER OF THE

a
-UKHCA-

UNITED KINGDOM
HOME CARE ASSOCIATION
LIMITED
INCORPORATING HOME CARE
AND HOME NURSING SERVICES

Ms R Griffin

HM Coroner’s Court
Paderborn House
Howell Croft North
Bolton

BLIIQY

Date 8" August 2016

Dear Ms Griffin

Ne 2

NEXT p-
STAGE

“A Way Forward”

28 Manchester Road
Westhoughton
Lancashire

BL5 3Q)

RECEIVED Tel: 01942 818569
Fax: 01942 810520

11 AUG 2016 Web: next-stageltd.org.uk

LEE FRANCIS GRIMES - DECEASED.

Iam responding to your letter dated 26" July 2016 and can confirm the following actions have taken place.

e The communications policy has been revised and details easy to follow procedures when effectively communicating a
concern about our clients. (policy included)

e All staff is trained in this policy and other key policies at their initial induction to the company.

e We have a carousel of regular training for all staff. This policy will be added to this and all staff will have continued
access to the training provided.

e Staffs have always had clear direction about reporting and recording concerns about clients. The member of staff who
did not report the concerns on the 17" March 2016 has been dealt with by the company’s disciplinary procedures.

Please do not hesitate in contacting me if you require any further information.

Kind Regards

eM, 7
Sores OY INVESTORS CareQuality MINDFUL ‘
=i We 4,2 IN PEOPLE Qa EMPLOYER Vora x

AsagO

Company Registration No. 5022820

RECEIVED
11 AUG 2016

Subject: Section: Page No. 1 of 2
Effectively communicating

An incident or concern about Issue Date: Last review Date:
Service User Jan 2005 1* August 2016

Policy No: OP0126 Policy Scope: Approv A
All Services
Service Manager

This policy should be read in conjunction with our Adult Safeguarding policy No OP0010
and Data Protection policy No. OP0043.

Staff will witness and be privilege to incidents and information regarding our clients on a
daily basis. Most interaction and information will be positive and have a positive impact on
the individual’s life. Positive changes and achievements need to be recorded and shared
where appropriate. Positive outcomes can, with approval be shared with significant others,
placing authority and relevant professionals, this course of action should be encouraged.

When staff witness or receive information that could be detrimental to the client we need to
inform the relevant professional bodies who can advise and assist with helping the client.

Information or incidents that need to be reported include:
e Any safeguarding concern
e Deterioration in health
e Drug and alcohol use
¢ Unusual behaviours
¢ Criminal activity
e Hospitalisation
e Missing

This list is not exhaustive; if in any doubt report your concerns immediately to your line
manager.

It is the responsibility of each member of staff to ensure they have all the relevant
professional contact details for their clients including out of hours numbers.

PROCEDURE:

In the event of a member of staff receiving information they are concerned about or
witnessing an incident they are to immediately report it by phone to the relevant professionals
involved such as the clients CPN, Social worker, Duty team, you need to make a record of the
following:

Name of person spoken to
Title of this person
Contact Number

Date and time
Conversation held

The same information needs to be given to the Registered Manager or in their absence the
‘Senior Service manager by either phone or email.

In the event that there is no one available to speak to within the local authority staff are to
continue to phone and email their concerns until they have spoken to the relevant person and
received instructions from the relevant person within the local authority. This instruction
applies to all members of staff within the company.

At the first opportunity the staff members gets they are to fill out a detailed incident sheet and
hands it to their line manager. When recording information staff are to ensure they record
only factual information and include dates, times and names of any individual spoken to.

The reporting member of staff will be the main point of contact, when further about the
reported incident is received they are to inform their line manager immediately.

If a member of staff knows they are going to be absent during an ongoing investigation they
are to ensure that their line manager is fully aware and briefed.

A simple rule to follow is: if in any doubt report it to the relevant professional body and or
your line manager and always follow up with a detailed incident report.

Related reports

Other reports by Rachael Griffin

See all →

More reports categorised “Community health care and emergency services related deaths”

See all →

Track Community health care and emergency services related deaths

See every Prevention of Future Deaths report matching Community health care and emergency services related deaths, and how often a new one appears.

What would an alert for this have sent me? Search the full text

Free to try — the preview shows the real matches and how many arrived in the last 12 months. Your first email alert is free.

These reports are published by the Chief Coroner's office at judiciary.uk and are © Crown copyright. The text here is reproduced from the published PDF so it can be searched. If something on this page is wrong, or you are a person named in it and want it reviewed, email drcjar@gmail.com and we will act promptly.