Prevention of Future Deaths reports · 2017

Geoffrey Spencer

Regulation 28 report to prevent future deaths, reference 2017-0281, written 6 Oct 2017. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report6 Oct 2017
Reference2017-0281
DeceasedGeoffrey Spencer
CoronerChris Morris
Coroner areaManchester South
CategoryHospital Death (Clinical Procedures and medical management) 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

THIS REPORT IS BEING SENT TO:  (Vatron / Registered Manager, The
Lakes Care Centre, Lakes Road, Dukinfield, Tameside, SK16 4TX

CORONER

tam Chris Morris, Area Coroner for Manchester South.

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.

http://www. legislation.gov.uk/ukpga/2009/25/schedule/5/paragraph/7

http://www. legislation.gov.uk/uksi/2013/1629/part/7/made

INVESTIGATION and INQUEST

Following the opening of an investigation on 31% May 2017, on 6" June 2017, Andrew
Bridgeman, Assistant Coroner for Manchester South, opened an inquest into the death of
Geoffrey Spencer who died on 28" May 2017 aged 90 at Tameside General Hospital,
Ashton-under-Lyne. The investigation concluded at the end of the inquest which | heard on
5" October 2017.

The conclusion of the inquest was that Mr Spencer died from a respiratory arrest secondary
to aspiration pneumonia. Whilst multiple serious medical problems placed Mr Spencer at
risk of aspiration pneumonia, his death was contributed to by injuries sustained in an
unwitnessed fall at his care home. At the end of the inquest, | recorded a narrative
conclusion to this effect.

CIRCUMASTANCES OF THE DEATH

Mr Spencer first became a resident at The Lakes Care Centre in 2015 as a result of the
progression of vascular dementia. Although initially Mr Spencer was relatively mobile, in
November of that year he had a stroke which diminished his mobility and impaired his
ability to swallow safely.

On occasion, Mr Spencer became agitated, and input was sought from the Mental Health
team and the General Practitioner to try and mitigate this.

On 24" May 2017, Mr Spencer was particularly agitated, having had a restless night. At
around lunchtime, he was thought to be seated in the lounge area of the Coniston Unit at

The Lakes Care Centre, which at all times was meant to be under supervision of an
attendant member of staff.

At around the time some residents were being helped to the dining room for lunch, Mr
Spencer was observed to be on the floor, some distance away from his chair. The evidence
at inquest did not disclose how Mr Spencer had come to be on the floor, and particularly
whether or not this had occurred whilst the lounge was unintended.

Later that day, Mr Spencer was noted to be in pain. An ambulance was called, and Mr
Spencer was taken to Tameside General Hospital where a fractured neck of femur was
diagnosed.

Although Mr Spencer was initially placed on the trauma operating list on 25" May 2017, he
was not considered fit for surgery. Mr Spencer developed symptoms of respiratory
problems later that day, and treatment for aspiration pneumonia was commenced on 26"
May 2017. Very sadly, Mr Spencer’s condition deteriorated further, and he died in hospital
on 28" May 2017.

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.

Notwithstanding the serious injury sustained by Mr Spencer, and the residual possibility that
this was sustained in circumstances where the lounge area was unattended by a member of
staff, it is a matter of concern that no formal investigation has been undertaken in relation
to this incident by The Lakes.

Whilst evidence emerged in the course of the inquest of improvements to the Care Centre's
Falls Policy and more formal reporting and analysis of falls at The Lakes, it is a matter of
concern that the absence of a formal investigation has reduced the potential for learning to
be derived from this incident with a view to improving the safety of other residents.

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 1 December 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:

1) a Daughter of the Deceased);
2) (Son of the Deceased).

| have also sent it to the Care Quality Commission who may find it useful or of interest.
lam 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.

6" October 2017

Signature

Chris Morris HM Area Coroner Manchester South

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 The Lakes Care Centre (PDF)
29 NOV 2017
Ac os

he ahes

Care Centre

Chris Morris
HM Area Coroner
Coroners Court
1 Mount Tabor Street.
Stockport, SK1 3AG
28% November 2017

Dear Mr. Morris,

This is my response to the Section 28 report raised by you following the inquest of the late Mr.
Geoffrey Spencer.

You raised concern during the course of the inquest that no formal investigation had been
undertaken in relation to this incident, by The Lakes. I responded at the time by informing you
that we had recently redeveloped our falls policy, post falls assessment and carried outa
monthly analysis of all falls at The Lakes. The concerns you raised led me to reflect on our
current practice and review what we could do better. This started with a complete investigation
into what had actually happened on the day of the incident;

e Timeline of events
e Staff and designation on duty?
e Who was doing what and where?

Once I had done this, it was evident that all of the above were relevant factors in the incident. |
will do my best to try and explain this to you;

It was lunch time period, the unit is a 25 bedded Dementia Care unit, at that time the occupancy
level was 23 residents (2 empty bedrooms), of those 23 residents, 2 residents stayed in their
own rooms, which left 21 residents in the communal lounge area.

All staff were on duty, our staffing levels are 4 care staff plus 1 activities coordinator throughout
the day and 3 staff at night, as this is not a Nursing unit, there are no Nurses employed.

The residents of this unit suffer varying degrees of Dementia, not challenging behaviour to the
extent of requiring a nursing unit, but certainly disorientation which can lead to agitation and
CONFUSION...

Blackeliffe Ltd., The Lakes, off Boyds Walk, Dukinfield, Cheshire SK16 4T™X

Cus nts avacivties Telepbone: 0161-330 2444 + Fax: 0161-339 0087
Website: unwwdakescare.couk + E-mail info@lakescare.co.uk

oe Tass Directors: J. Meredith, B Meredith, L. Meredith
R.N.H.A,

suet lunch time, 2 members of staff support residents into the dining room, whilst 1 member
of staff remains in the lounge area, and 1 staff member stays in the dining room to monitor
incoming residents. Because of the very nature of the condition, this process can in itself
become quite hectic as mobile residents will start to walk towards the dining room then turn
around and go in the opposite direction, with staff trying to manage the safety and maintain a
calm atmosphere at all times. In these conditions it is quite feesable that a resident could slip
onto the floor from a chair, without being seen by care staff present, as they may be looking and
dealing with other residents in the room.

By standing back and looking at this, it was clear to me that changes need to be made to
optimise and make best use of the resources we have by changing work patterns. In this current
climate it is not viable to increase staffing levels whilst the true cost of care is not being
acknowledged, therefore I need to look at better ways of working to reduce risk and increase
safety. This is what we have done;

*See attached; Corrective Action Plan*

Yours Sincerely

Registered Manager

Related reports

Other reports by Chris Morris

See all →

More reports categorised “Hospital Death (Clinical Procedures and medical management) related deaths”

See all →

Track Hospital Death (Clinical Procedures and medical management) related deaths

See every Prevention of Future Deaths report matching Hospital Death (Clinical Procedures and medical management) 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.