Prevention of Future Deaths reports · 2016

Jack Molyneux

Regulation 28 report to prevent future deaths, reference 2016-0168, written 29 Apr 2016. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report29 Apr 2016
Reference2016-0168
DeceasedJack Molyneux
CoronerVeronica Hamilton-Deeley
Coroner areaBrighton and Hove
CategoryHospital Death (Clinical Procedures and medical management) related deaths
Organisation namedBrighton and Sussex University Hospitals NHS Trust
Sourcejudiciary.uk record · original PDF
Responses publishednone published

The report

Text recovered by OCR from a scanned PDF. OCR is imperfect: check anything you rely on against the source PDF. Reproduced verbatim, including the scan's own layout.

VERONICA HAMILTON-DEELEY, LL.B.
Her Majesty’s Senior Coroner

THE CORONER’S OFFICE
WOODVALE, LEWES ROAD

for the City of Brighton & Hove BRIGHTON
BN2 3QB

Assistant Coroners BS eA, ge Telephone: Brighton

CATHARINE PALMER LL.B (HONS) SELL EL RERION Dl? Fax: Brighton]

KAREN HENDERSON, BSC,BM,MRCPI,FRC. -

GILVA D.J.TISSHAW, BA(LA W)HONS

CORONERS SOCIETY OF ENGLAND AND WALES
ANNEX A
REGULATION 28: REPORT TO PREVENT FUTURE DEATHS (1)

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

THIS REPORT IS BEING SENT TO:

1. Dr Gillian Fairfield, Chief Executive, Brighton Sussex University
Hospitals NHS Trust, Royal Sussex County Hospital, Eastern Road,

Brighton
1 CORONER
| am Veronica HAMILTON-DEELEY, Senior Coroner, for the City of Brighton and
Hove
2 CORONER’S LEGAL POWERS © :

| 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 5" February 2016 | commenced an investigation into the death of Jack
MOLYNEUX. The investigation concluded at the end of the inquest on 22%? April
2016. The conclusion of the inquest was a NARRATIVE CONCLUSION ~ Please
see attached sheet.

4 CIRCUMSTANCES OF THE DEATH

See Record of Inquest

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.

VERONICA HAMILTON-DEELEY, LL.B.
Her Majesty’s Senior Coroner
for the City of Brighton & Hove

THE CORONER’S OFFICE
WOODVALE, LEWES ROAD
BRIGHTON

BN2 3QB

Assistant Coroners

CATHARINE PALMER LL.B (HONS)
KAREN HENDERSON, BSC,BM,MRCPLFRC. -
GILVA D.J.TISSHAW, BA(LAW)HONS

Telephone: Brighton (01273) 292046
Fax: Brighton (01273) 292047

The MATTERS OF CONCERN are as follows. —

Mr Jack MOLYNEUX was awaiting discharge to an appropriate Nursing Home. He
was on a 19 bedded ward for elderly male patients and during that time he was not
suffering from any acute physical illness, but he did however have moderately
advanced mixed alzheimer's and vascular dementia and he needed to be
mobilised, he needed to be appropriately hydrated and have his nutrition
maintained. He needed mouth care, he had dentures but the top plate was lost. He
needed personal hygiene, he needed to have his psychological wellbeing
maintained and he needed stimulation and he also needed to have his medications
given to him appropriately. It was clear that he did not have mental capacity, it was
clear that he could not consider the consequences of his decisions not to accept
care or hydration and nutrition or his medications and yet no consideration was
given of placing him on a Deprivation of Liberty Safeguarding Order. He needed,
but he didn’t receive full care in respect of all the matters mentioned above.

Mobility

He was never helped to mobilise or to maintain the good mobility which he had
when he came into hospital. He was never offered to have his outdoor clothes and
perhaps to be assisted to go down to the hospital shop to buy a newspaper which
was something he used to do every day before he came into hospital. He lost 20%
of his bodyweight in the one calendar month when he was in hospital and
absolutely no note was taken of this and he wasn’t referred to the dieticians until he
had been in hospital for almost that full calendar month.

His mouth was in such an appalling state when he moved to his nursing home that
the nursing home immediately raised a safeguarding alert on the grounds of
neglect. His dentures were lost and his mouth was in such a poor state that the
staff, on Vallance Ward, were unaware that he even had a lower plate in his mouth.

His personal hygiene was such that whilst it was noted he was washed there was
no evidence whatsoever that he was ever offered a bath or shower in the four
weeks of his admission. There was no evidence whatsoever that any form of
stimulation was provided. There was a television by his bed but no evidence that
anybody ever discussed with him whether he might like to watch anything on it.

With regard to his psychological wellbeing this appeared from the evidence before
me to have been completely disregarded. Finally with regard to his medications he
refused all his medications on an inconsistent basis but he did take his Memantine
for pretty well every day of his hospital admission apart from on a couple of
occasions just before he was discharged.

VERONICA HAMILTON-DEELEY, LL.B.
Her Majesty’s Senior Coroner
for the City of Brighton & Hove

THE CORONER’S OFFICE
WOODVALE, LEWES ROAD
BRIGHTON
BN2 3QB
Assistant Coroners Telephone: oviohor
CATHARINE PALMER LL.B (HONS) Fax: Brightor
KAREN HENDERSON, BSC,BM,MRCPI,FRC.-
GILVA D.J.TISSHAW, BA(LA W)HONS

At the Inquest | found that whilst he had been neglected during his admission, the
circumstances did not reach the required standards for a conclusion of neglect
contributing to his death.

| believe this to be one of the most disturbing cases of sub optimal care that | have
come across recently and | am not at all satisfied that this Inquest will result in any
effective action being taken which is why | am concerned to follow up this matter
and to ensure that all those who should know about this situation are informed.

Certainly | found that the above omissions and failings contributed to Mr Molyneux’s
death.

When he arrived at the nursing home he came on the evening of the 25" January
and on the 26" the staff at Partridge House achieved an almost miraculous
transformation. He was dressed, although he needed the help of two members of
staff, he was on his feet and assisted to mobilise to the toilet, he was sitting out in a
bucket chair with other residents and was entertained with a film, his mouth was
cleaned, the GP provided mouth wash and mouth gel which was applied. His
halitosis which had been so strong that it could be smelt outside his room at
Partridge House was resolved, he was smiling and reasonably responsive and was
eating and drinking again and also engaged with his son, waving goodbye to him
when he had visited on the 26" or 27". His death was unexpected. Partridge
House staff had hoped that whilst he would not have been able to go home he
could at least have a reasonable standard of life and be enabled to be content.

Finally, it is of note that an urgent DOLS was put in place on the morning of the 27"
January 2016.

6 ACTION SHOULD BE TAKEN

In my opinion action should be taken to prevent future deaths and | believe you
AND 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 22" July 2016. |, 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.

VERONICA HAMILTON-DEELEY, LL.B.
Her Majesty’s Senior Coroner
for the City of Brighton & Hove

THE CORONER’S OFFICE
WOODVALE, LEWES ROAD
BRIGHTON

BN2 3QB

Assistant Coroners (A e Fe ASN Telephone: Brighton
CATHARINE PALMER LL.B (HONS) ea ELAS a Fax: Brighton
KAREN HENDERSON, BSC,BM,MRCPI,FRC. .

GILVA D.J.TISSHAW, BA(LAW)HONS

8 COPIES and PUBLICATION

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

Secretary of State for Health, Department of Health
Simon Stevens — Chief Executive NHS England
National Patient Safety Agency
Clinical Commissioning Group

- Director of Public Health
, ¥£ Chair of BSUH NHS Trust

~ Director for Clinical Quality and Primary Care

2 TFT
Care Quality Commission
. | Medico-Legal Services

| have also sent it to:-

OHNOARONS

1.
2.
3.

Who may find it useful or of interest.
| 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 Date: 29" April 2016 jy whan SIGNE pe vole

Senior Coroner Brighton andHove

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