Prevention of Future Deaths reports · 2017

Roger Tombs

Regulation 28 report to prevent future deaths, reference 2017-0027, written 13 Feb 2017. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report13 Feb 2017
Reference2017-0027
DeceasedRoger Tombs
CoronerEmma Brown
Coroner areaBirmingham and Solihull
CategoryCare Home Health related deaths
Sourcejudiciary.uk record · original PDF
Responses published2

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

THIS REPORT IS BEING SENT TO: Sunrise Senior Living, Solihull Falls Team, Care Quality Commission

CORONER

| am Emma Brown Area Coroner for Birmingham and Solihull

CORONER’S LEGAL POWERS

1 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.

INVESTIGATION and INQUEST

On 25/05/2016 | commenced an investigation into the death of Roger Harold Tombs. The investigation
concluded at the end of an inquest on 9th February 2017. The conclusion of the inquest was:

“Mr Tombs died as a result of an accidental fall. His needs had not been adequately re-assessed following
a deterioration in his condition, which contributed to his death.”

In addition the jury made findings on the central issues of the case which were;
1. Was there any error or omission in the level of care provided to Mr Tombs that caused or contributed

‘| to his death? YES

2.Was there any error or omission in the sensor mat system that caused or contributed? NO.
CIRCUMSTANCES OF THE DEATH

On the 4th May 2016 at 03:30, Roger Harold Tombs died at Queen Elizabeth Hospital, after admission
following a fall at Sunrise Care Home in Knowle on the 3 May 2016. Roger was subject to a Deprivation
of Liberty Safeguarding Order, due to his learning disabilities. He was at high risk of falls and had had an
increase in falls leading up to his death.

Following a post mortem, the medical cause of death was determined to be:
1a BRONCHOPNEUMONIA

1b SEVERE TRAUMATIC BRAIN INJURY

2 DEMENTIA (DIFFUSE LEWY BODY TYPE)

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. {n the circumstances it is my statutory
duty to report to you.

The MATTERS OF CONCERN are as follows. —

1. The evidence was that fall sensor mats had been placed either side of Mr. Tombs’ bed on top of
crash mats. At the time of his fall on the 3° May 2016 the sensor mats did not sound an alert

2. The instructions for use of the sensor mats state they should be placed on a hard floor.

3. The investigating police officer from the public protection unit gave evidence that she was
concerned that the crash mats below the sensor mats would reduce the effectiveness of the
sensor mats and this could possibly be the reason the mat didn’t sound (there were other
possible explanations).

4, The evidence was that Sunrise of Knowle is still placing sensor mats on top of crash mats.

5. No expert opinion has been sought on this practice but the evidence of the investigating police
officer was that the managing director of the local distributors of the mats told her this was an

unsafe practice in his view.

6. [tis my opinion that there is a risk that the effectiveness of the sensor mats is being reduced by
placing them on crash mats and if this is the case they may not sound when vulnerable residents
are mobilising exposing them to a risk of falls, injury and potentially death.

ACTION SHOULD BE TAKEN

In my opinion action should be taken to prevent future deaths and | believe you 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
Monday 10" April 2017. 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.

COPIES and PUBLICATION

| have sent a copy of my report to the Chief Coroner and to the following Interested Persons: the family
of Mr. Tombs and West Midlands Police.

1am 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.

13/02/2017

‘Area Coroner Birmingham and Solihull

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 Sunrise Senior Living (PDF)
Emma Brown 

Area Coroner 

Birmingham & Solihull Areas 

50 Newton Street 

Birmingham 

B4 6NE 

28 February 2017 

Dear Ms Brown 

Roger Harold Tombs (Deceased)  

I refer to the Regulation 28 Report to Prevent Future Deaths arising out of the Inquest into 

Roger  Tombs  dated  13  February  2017  (“PFD  Report”)  addressed  to  Sunrise  Senior  Living 

(“SSL”). 

As you are aware SSL is one of the providers registered with the Care Quality Commission in 

respect  of  Sunrise  of  Knowle  (“Home”).    SSL  became  registered  with  the  CQC  in  October 

2016 and manages the Home on behalf of Sunrise Operations of Knowle Limited (“SOK”), the 

other  registered  provider.   SSL  was  also  managing  the  Home  at the  time  of  Roger  Tombs’ 

death on behalf of SOK. 

It is expected that SSL will be leaving the Home and will be deregistered by CQC on 1 March 

2017, with another provider coming in to manage the Home and who will be registered with 

CQC.  SOK remains registered with the CQC. 

With the imminent departure of my Client from the Home, I would be grateful if you were 

able to provide guidance on how you would like my Client to respond to the PFD Report.  My 

Client has written to CQC and Solihull MBC Falls Team inviting them to engage in a dialogue 

 
 
 
 
 
 
 
 
 
 
 
 on the matters raised in the PFD Report to help SSL inform its Response (copies of the letters 

are attached). 

My Client will be able to inform you of the steps it took immediately following the Inquest to 

address the matters of concern raised by you in respect of the placing of sensor mats on top 

of crash mats at the Home, but it will not be in a position to describe any measures that may 

be implemented at the Home post 1 March 2017. 

My Client would welcome your views on the above and I look forward to hearing from you. 

Yours sincerely 

Director, Solicitor
Response from Respondent Not Named (PDF)
Emma Brown  
Area Coroner  
Birmingham & Solihull Areas  
50 Newton Street  
Birmingham  
B4 6NE  

By Email only: c/o paul.hodson@birmingham.gov.uk  

20 April 2017  

Dear Ms Brown  

Roger Harold Tombs (Deceased)  

I refer to the Regulation 28 Report to Prevent Future Deaths arising out of the Inquest into Roger 
Tombs dated 13 February 2017 (“PFD Report”) addressed to Solihull Falls Team (SFD).  

Firstly, I wish to thank you for the extended time period to respond to this report.  

The Falls Team was not directly involved in, or present, at the inquest and therefore did not have the 
opportunity to represent themselves or explain any actions taken in respect of falls prevention 
training that was provided to the Sunrise Care Home. All conversations related to the case were with 
the police officer, Sarah Vaughan, and were conducted via telephone following the conclusion of the 
inquest. Nursing staff working within the Falls Team were contacted by Ms Vaughan to discuss the 
advice given by the team to Sunrise Care Home in relation to the correct use of sensor mats.  

The Nurse Lead informed Ms Vaughan that neither she nor any other member of the team had been 
directly involved with the Mr Tombs’ care, and that the advice that had been provided to Sunrise 
was standard guidance on the appropriate use of crash mats and sensors. It was confirmed to Ms 
Vaughan that the standard guidance and training would not have advocated the use of the sensor 
mats being place on top of crash mats. It can be only be assumed that Sunrise Care Home have 
misinterpreted the advice provided by the Fall Team which is supplemented by the recommendation 
that each resident would also need a holistic risk assessment to ensure measures could be put in 
place to meet each individual’s need.  

As we are concerned to hear that Sunrise Care Home are still using the sensor mats incorrectly, and 
as a direct result of the issuing of the PFD Report, I have reviewed practice within the team in  

 
 
 
 
 
 
 
 
 
 
 
 
 relation to the issue of advice and training of this nature and find that it is both consistent and 
accurate. 

Furthermore, to support the dissemination of this across the care home sector, a guidance 
document has been developed outlining good practice in the use of sensor mats and is enclosed for 
your reference. This was sent on 4 April 2017 to Theresa Scragg - Acting Strategic Commissioner for 
Older People, Solihull Metropolitan Borough Council (SMBC), for circulation throughout all care 
homes in the borough.  

It is my understanding that Ms Scragg intends to add to this guidance and supplement this with 
further information related to assistive technology available through SMBC but I have not yet seen 
this additional material. 

Please do not hesitate to contact me if you require further information 

Yours sincerely  

Sam Foster 
Chief Nurse

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