Prevention of Future Deaths reports · 2016

Lillian Hursell

Regulation 28 report to prevent future deaths, reference 2016-0129, written 1 Apr 2016. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report1 Apr 2016
Reference2016-0129
DeceasedLillian Hursell
CoronerPatricia Harding
Coroner areaMid Kent and Medway
CategoryCare Home Health 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:  REPORT TO PREVENT FUTURE DEATHS (1) 

. 

REGULATION 28 REPORT TO PREVENT FUTURE DEATHS 

THIS REPORT IS BEING SENT TO: 

1.  Ranc Care Homes Ltd 

1 

CORONER 

I am Patricia Harding, senior coroner for the coroner area of Mid Kent & Medway 

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 15th July 2015 I commenced an investigation into the death of Lilian Hursell,  94 
years. The investigation concluded at the end of the inquest on 29th March 2016. The 
conclusion of the inquest was that Lilian Hursell died as the result of an accident 

4 

CIRCUMSTANCES OF THE DEATH 

Lilian Hursell died on 6th July 2015 at Pembury Hospital from pneumonia contracted as a 
result of immobility contributed to by unstable fractured cervical vertebra occasioned as 
a result of a fall from bed on 30th June 2015 at Maidstone Care Centre when cotrails had 
been lowered in order to provide personal care and the provider of that care was not 
positioned at the bedside so as to prevent the fall occurring 

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)  The mechanism to hold the cotsides (bedrails) in a vertical position comprise a 

retaining button in a sliding vertical rail which engages with a corresponding hole 
in a static rail. Whilst this mechanism operates safely when the mechanism is 
properly engaged which is established by an audible click, staff at the care 
home had experienced occasions when the cotsides retaining button had not 
been fully engaged when the cotside had been raised to prevent a resident 
falling from the bed rendering the cotside unstable and at risk of lowering 
inadvertently. 

(2)  Nursing and healthcare staff moved a patient onto her back and placed a pillow 
under her head when the patient had suffered a significant uncontrolled fall onto 

1 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 her face and the extent of her injuries had not been assessed. It was known at 
the time that this happened that she had suffered a head trauma as she had a 
bleeding injury to her forehead, she had however additionally suffered a 
subdural haematoma and had fractures to her cervical vertebra 

6 

ACTION SHOULD BE TAKEN 

In my opinion action should be taken to prevent future deaths and I believe your 
organisation has 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 1st June 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 
Ambulance Service. I have also sent it to Care Quality Commission who may find it 
useful or of interest. 

nurse, South East Coast 

 daughter, 

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 

1st April 2016                                         [SIGNED BY CORONER] 

2

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 Respondent Not Named (PDF)
Ranc Care Homes Limited
King George Place
762 Eastern Avenue
Newbury Park
Ilford, Essex
IG2 7HU

Tel: 020 8554 5600
Fax: 020 8554 5944
www.ranccare.co.uk

Patricia Harding
Senior Coroner
Mid Kent and Medway

6th May 2016

Dear Madam,

Response to Regulation 28: Report to prevent future deaths (1)

I am writing in response to the Regulation 28: Report to prevent future deaths (1) to set out the actions taken in 
response and additionally proposed to be taken following the death of Lillian Hursall.

The Matters of Concern are:

1. The mechanism to hold the cotsides (bedrails) in a vertical position comprise a retaining bolt in a sliding 

vertical rail which engages with a corresponding hole in a static rail. Whilst the mechanism operates safely 
when the mechanism is properly engaged which is established by an audible click, staff at the care home had 
experienced occasions when the cotsides retaining button had not been fully engaged when the cotside had 
been raised to prevent a resident falling from bed rendering the cotside unstable and at risk of lowering 
inadvertently.

2. Nursing and healthcare staff moved a patient onto her back and placed a pillow under her head when the 

patient had suffered a significant uncontrolled fall onto her face and the extent of her injuries had not been 
assessed. It was known at the time that this happened that she had suffered a head trauma as she had a 
bleeding injury to her forehead, she had additionally suffered a subdural haematoma and had fractures to 
her cervical vertebra.

Having considered the findings of the coroner we have taken the following actions immediately:











A programme of re-training in first aid has been commenced and will be completed by the 1st June 2016. The 
training is delivered via City and Guilds accredited learning and via a competency based workbook for all the 
care staff, this is monitored for compliance by the Head of Quality and Compliance.
A programme of moving and handling re-training has been commenced and will be completed by the 1st
June 2016, this is carried out in the blended approach of e-learning and via competency based workbooks 
for all staff delivering care.
A programme of health and safety retraining has been commenced and will be completed by the 1st June 
2016. This is been done via City and Guilds accredited training and competency based workbooks which are 
independently invigilated.
A thorough system of bedrail audits has been introduced to ensure all bedrails lock with an audible click into 
the safety bracket. This entails an audit via the maintenance operative to check for safety and security which 
is then rechecked by the home manager.
Staff have been re-educated in bed rail use in order to ensure the locking mechanism is properly engaged.
This was done via a process of direct supervisions.

 



Staff have received health and safety briefings in daily meetings to reiterate the potential dangers of not 
ensuring bed rails are locked in position. This is recorded via staff meeting minutes and direct supervisions.
All staff have been advised that following a fall  no person should be moved until a full assessment by a 
suitably trained person has been carried out.

Should the coroner require additional information in respect of the actions taken or planned please do not hesitate 
to get in touch with me.

Yours Sincerely

Chief Operating Officer
For and on behalf of Ranc Care Homes Limited

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