Prevention of Future Deaths reports · 2017

Kenneth Cottam

Regulation 28 report to prevent future deaths, reference 2017-0360, written 7 Dec 2017. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report7 Dec 2017
Reference2017-0360
DeceasedKenneth Cottam
CoronerAnna Crawford
Coroner areaDerby and Derbyshire
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

REGULATION 28 REPORT TO PREVENT FUTURE DEATHS

THIS REPORT IS BEING SENT TO:

Managing Director

Coxbench Hall Residential Home
Alfreton Road

Derby

DE21 5BB

1 | CORONER

1am Anna Crawford, Assistant Coroner for the area of Derby and Derbyshire

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 19 April 2016 an inquest was opened into the death of Kenneth Cottam. The inquest
concluded on 7 November 2017. The medical cause of death was recorded as:
ta.Acute Subdural Haematoma with Mass Effect.

The inquest concluded with a narrative conclusion,

4 | CIRCUMSTANCES OF THE DEATH

Mr Cottam was an 89 year old gentleman and a resident at Coxbench Hall Residential
Home. His mobility was limited and he used a zimmer frame and wheelchair at times,
He had not had a fall since 2012 but was nervous about falling.

From the morning of 4 April 2016 onwards staff recorded that Mr Cottam appeared
confused. On 6 April 2016 he was observed to have a bruise on his right hip and
stomach and he reported that on the night of 3/4 April 2016 he had fallen on to his bed.
On 8 April 2016 Mr Cottam sustained an unwitnessed fall in his bedroom. He reported
that he had lost his balance whilst standing up from his chair. He was checked over by
a member of staff who did not observe any injuries and did not have any concerns.

On 9 April 2016 a family member became concerned that Mr Cottam’s speech was
slurred and staff called an ambulance. Mr Cottam was taken to the Royal Derby
Hospital where he was diagnosed with a subdural bleed with mass effect. He was
managed conservatively. However, his condition deteriorated and he died at the
hospital on 13 April 2016.

Having heard evidence, the court was unable to establish whether Mr Cottam had
sustained his head injury as a result of the reported fall on 3/4 April 2016 or the
subsequent fall on 8 April 2016.

The court heard evidence that a falls risk assessment was not carried out in relation to
Mr Cottam, either on his arrival at Coxbench Hall Care Home on 1 March 2016, or after
he reported having fallen on 3/4 April 2016.

The court also heard that no consideration was given to a potential link between the
confusion that Mr Cottam had been experiencing since 4 April 2016 and the fall that he

reported sustaining on the night of 3/4 April 2016. As a result, the GP, who saw Mr
Cottam on 8 April 2016 in relation to his ongoing confusion, was not informed about the
reported fall or bruising.

CORONER’S CONCERNS

Having heard evidence from the management team at Coxbench Hall Care Home, the
court was not reassured that there are clear and robust policies and procedures in place
in relation to falls prevention and falls management, or that those policies and
procedures are widely and consistently understood by staff.

The MATTERS OF CONCERN are as follows, —

(1) The court was not reassured that there are clear and robust policies and
procedures in place in relation to falls risk assessment and management.

(2) The court was not reassured that staff had a sufficient understanding of the falls
policies and procedures in place to enable them implement them consistently
and appropriately.

ACTION SHOULD BE TAKEN

In my opinion action should be taken to prevent future deaths and | believe your
organisation has the power to take such action.

YOUR RESPONSE

You are under a duty to respond to this report within 56 days of its date. I, the Coroner,
may extend the period on request,

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:

1

2. Care Quality Commission
3. The Chief Coroner

| 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.

ANNA CRAWFORD
7 DECEMBER 2017

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 Coxbench Hall Residentail Home (PDF)
Coxbench Hall Residential Home

Alfreton Road, Coxbench, Derby DE21 5BB

Telephone: (01332) 880200 Fax: (01332) 881199
E-Mail: office@coxbench-hall.co.uk

Web site: www.coxbench-hall.co.uk ee

Ms. A. Crawford, Assistant Coroner, Delivered by hand
Coroner’s Court,

St. Katherine’s House,

St. Mary’s Wharf,

Mansfield Road,

Derby. DE13TQ

30" January 2018

Dear Ms. Crawford,

Kenneth Granville Cottam deceased — Reg. 28 Report

We are writing in response to the Matters of Concern which are as follows, and to reassure
the Coroner’s Court that we, as a matter of course, do all that we can for our Residents in the
subject of falling.

(1) The Court was not reassured that there are clear and robust policies and procedures in
place in relation to falls risk assessment and management.

(2) The Court was not reassured that staff had a sufficient understanding of the falls
policies and procedures in place to enable them to implement them consistently and
appropriately.

You have in your possession some documentation that I delivered to your office the day after
the Inquest, i.e. on 8"" November 2017, being documents that we had had with us at the
Inquest but which were not brought to your attention at the time. That documentation
included the items listed on the attached ‘Taking to Inquest re Mr. Cottam — 07/11/20177!.
We now enclose the following:

Falls Policies”.

All staff sign a ‘Policy Checklist’ form once when they join the Company to prove that they

have been shown the Policies and where they are kept, and then sign again annually, and they
are encouraged to re-read the Policies and Procedures as often as possible.

Continued overleaf ...

* List of documents taken to Coroner’s Office on 07/11/2017
? Falls Policy and Accident Reporting Policy

Enjoy your retirement years in elegant

surroundings with the support of top quality, family style care. er
xz

Registered No. 1746888

When there is an accident or incident, the staff who is ‘first on the scene’ completes an
accident report form. This gets sent to the Office Manager, who checks that the General
Manager has seen it — indicated by the General Manager’s signature on the form (obviously if
she hasn’t, the form is sent to her). The Office Manager checks whether it is a matter that
needs further investigation, or whether the matter has been dealt with and the Resident is all
right so that the form can be filed. The General Manager also does this, but also ensures that
the fall, if it was a fall, is noted on the Falls Audit form? and all other procedures have been
attended to; i.e. the following procedures which are carried out by Carers and Senior Carers:

She will check the Daily Care Report entries by the care staff.
She will check that a Body Map has been done. Body Mapping Policy attached’,

She will check that there is a Falls Diary and Incident Analysis form’ in the Resident’s
Support Plan (perhaps this is a first incident and there wasn’t one previously).

Staff know that for each fall, the following forms must be completed, so the General Manager
will also check that these have been done: Falls Risk Assessment Tool®; Falls Risk
Assessment Screening Tool’; Falls Checklist — Environmental Factors’,

Following Policy, a ‘Risk Assessment for when there is a high risk of falls’ form? is
commenced on the occasion of a second fall. There are two versions of this risk assessment
as some Residents prefer that their falls mat is plugged in only at night for example, so the
alternative risk assessment is then used.

We hope that the above answers the Regulation 28. We should be very grateful if you would
please let us know if it does not.

su =

For and on behalf of Coxbench Hall Ltd.

3 Falls Audit form — [blank example]

* Body Mapping Policy

° Falls Diary and Incident Analysis form

° Falls Risk Assessment Tool

7 Falls Risk Assessment Screening Tool

* Falls Checklist — Environmental Factors

° Risk Assessment for when there is a high risk of falls x2

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