Prevention of Future Deaths reports · 2017

Frederick Chisnall

Regulation 28 report to prevent future deaths, reference 2017-0017, written 30 Jan 2017. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report30 Jan 2017
Reference2017-0017
DeceasedFrederick Chisnall
CoronerJanet Napier
Coroner areaCheshire
CategoryCare Home Health related deaths
Sourcejudiciary.uk record · original PDF
Responses published1

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.

REGULATION 28: REPORT TO PREVENT FUTURE DEATHS (1)

REGULATION 28 REPORT TO PREVENT FUTURE DEATHS
THIS REPORT IS BEING SENT TO:

1. St Helens Clinical Commissioning Group
2. Halton Clinical Commissioning Group

1 | CORONER

lam Janet Elizabeth Napier, assistant coroner, for the coroner area of Cheshire

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 7 April 2016 an investigation was commenced into the death of Frederick Chisnall
aged 79 of Forshaw Unit, St Mary's Nursing Home, Penny Lane, Warrington. The
investigation concluded at the end of the inquest on 19 December 2016. The conclusion
of the inquest was that the deceased died due to a myocardial infarction.

4 | CIRCUMSTANCES OF THE DEATH

The deceased was subject to a Deprivation of Liberty Order at the time and was being
given one to one nursing care, which | was told was commissioned by yourselves, from
the two Agencies “Reflex” and “Challenge Recruitment". | believe an Adult Safeguarding
investigation was carried out following the death and was not finalised by the date of the
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.

The MATTERS OF CONCERN are as follows.

During the inquest concerns were raised about the actions of the Agency staff regarding
producing proper documentation, and being aware of how to monitor changes in clinical
condition and obtaining medical or nursing help urgently when appropriate.

Although in this case this did not cause any serious sequelae, | wonder if you could
assess the adequacy of the training given to the staff you commission, to ensure this
does not happen in the future.

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.

YOUR RESPONSE

You are under a duty to respond to this report within 56 days of the date of this report,
namely by 26 March 2017. |, 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.

COPIES and PUBLICATION

| have sent a copy of my report to the Chief Coroner and to the following Interested
Persons namely the family of the deceased and the Care Quality Commission.

| 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 senda 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.

Dated: 30 January 2017 Sines:

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 St Helens Clinical Commissioning Group (PDF)
St Helens Clinical Commissioning Group

St Helens Chamber
Salisbury Street
Off Chalon Way

St Helens
WA10 1FY

30"" March 2017

Dr J E Napier
Assistant Coroner
West Annexe
Town Hall
Sankey Street
Warrington

WA1 1UH

Dear Dr Napier

Re: Frederick Chisnall (Deceased)
Further to your response letter to Professor Sarah O’Brien, dated 07/02/17, |

can provide the following update in relation to the safeguarding investigation
and assurance actions taken to mitigate any future risks:

Safeguarding Investigation

The safeguarding investigation was led by Warrington Local Authority as St
Marys where Mr Chisnall resided was within the borough of Warrington this is
in line with national guidance and procedures.

St Helens Local Authority Safeguarding Unit was apprised of the investigation
and the outcomes. The safeguarding case was closed on 23/01/17.

There we no actions identified for St Helens through the safeguarding
investigation.

The safeguarding investigation was partially substantiated it was concluded
that there was no evidence of neglect and that Mr Chisnall's death was not
caused by a failure of those employed to deliver his care.

However concerns did exist in relation to staff record keeping in respect of the
agency staff and responsiveness to the changes in clinical condition of Mr
Chisnall in respect of a nurse employed by St Mary's.

and NS)

St Helens
Council Chamber

Working in partnership with

Action Taken as part of the Safeguarding investigation:

e Challenge Recruitment- no action taken as no findings

e Reflex Agency- further training provided to the staff by the agency

* St Mary’s Nursing home- disciplinary action was taken in respect of the
nurse by St Mary's.

St Mary’s Nursing Home gave assurance that they would no longer use Reflex
Agency for non-registered staff.

The Team Manager for St Helens Contracts and Quality Monitoring service
also liaised directly with the agencies involved for assurance of actions taken
following the conclusion of the safeguarding investigation.

Since the incident, St Mary's CQC inspection determined that they were good
overall. They had quality audits in place and Warrington Borough Council's
care quality monitoring team had found no issues with the service.

All nurses complete audits of records on a monthly basis which is further
quality assured by the home manager.

Assurance

Further to the above | would like to offer assurance that robust contractual and
quality monitoring processes are in place in respect of all placements funded
by St Helens CCG and St Helens Local Authority.

All service users will be assessed to determine the level of need and the type
of placement required and wherever possible this will be provided within
borough.

Before admission a placement vetting process is undertaken which for out of
borough placements will include liaison with the host authority. The service
user will receive an annual review and there is a contractual expectation that
the residential/ nursing home will review care needs on an on-going basis and
advise if there is any significant change in the needs of an individual.

In addition for out of borough placements the Local Authority Quality
Monitoring Team will undertake regular desk top reviews where they will
speak directly with the host authority, the care/nursing home, the service user
or representative and check any CQC reports.

In respect of the use of agency staff the agency contract is with the
care/nursing home. There is a clear expectation that agency staff will be
provided with the relevant training, and supervision from the agency and that
they work to the care/nursing homes policies and procedures as part of its
CQC registration.

| hope this answers your additional queries,

Yours sincerely

Working in partnership with

St. lens StHelens
Counci! Chamber

Chief Nurse

a «i: Nurse — NHS Halton CCG

and

StHelens StHelens
Council Chamber

Working in partnership with

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