Prevention of Future Deaths reports · 2017

Kathleen Smith

Regulation 28 report to prevent future deaths, reference 2017-0397, written 14 Nov 2017. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report14 Nov 2017
Reference2017-0397
DeceasedKathleen Smith
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: J nterim Chief Executive, Borough Care,
Head Office, 9 Acorn Business Park, Heaton Land, Stockport SK4 1AS.

CORONER

lam 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

On 13" June 2017, Chris Murray, Assistant Coroner for Manchester South, Opened an
inquest into the death of Kathleen Smith who was aged 80 when she died at her care home
on 4"" June 2017. The investigation concluded at the end of the inquest which | heard on
20" October 2017.

The conclusion of the inquest was that Mrs Smith died as a result of a stroke whilst being in
the advanced stages of dementia. Whilst this is a natural cause of death, the inquest
concluded her death was contributed to by a hip fracture sustained on 12th April 2017 at
her care home when she fell to the floor having been pushed by another resident. At the
end of the inquest, | recorded a Narrative Conclusion to this effect.

CIRCUMASTANCES OF THE DEATH

Mrs Smith first moved to Lisburne Court Care Home in Stockport in May 2016, as a result of
needing increasing support due to Alzheimer’s dementia.

On 12" April 2017 whilst in the dining area, Mrs Smith was pushed to the floor by another
resident, resulting in a right neck of femur fracture.

Mrs Smith was taken to Stepping Hill Hospital, where on 15" April 2017 she underwent a
right hip hemi-arthroplasty. In the aftermath of the surgery, Mrs Smith was diagnosed as
having delirium and progression of Alzheimer’s disease. Her diet remained poor and her
fluid intake limited.

Despite some limited signs of improvement whilst in hospital, following a meeting with Mrs
Smith’s family, a decision was made to discharge her back to Lisburne Court for palliation.

Mrs Smith returned to Lisburne Court on 5" May 2017. She sadly died on 37 June 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.

In the course of the inquest | heard evidence that, whilst the management team at Lisburne
Court had notified Greater Manchester Police and Stockport Metropolitan Borough Council
of the incident in which Mrs Smith sustained injury on 12" April 2017, neither the family nor
Borough Care’s corporate risk function had been notified of the circumstances which led to
Mrs Smith’s hip fracture. This latter point raises a particular concern as to Borough Care’s
ability to undertake any meaningful investigation into the circumstances of Mrs Smith’s
injury, with a view to deriving learning for the benefit of other residents.

The inquest also heard evidence that Lisburne Court’s process for internal incident reporting
and escalation largely fell to an individual manager who has since left Borough Care’s
employment. It was a matter of concern that notwithstanding this fact, no audit or similar
review exercise as to incidents or issues at Lisburne Court had been undertaken since the
departure of the individual manager in question, despite the evidence of the Interim Head
of Care that some resident documentation and computer files has allegedly gone missing.

YOUR RESPONSE

You are under a duty to respond to this report within 56 days of the date of this report,
namely by 9" January 2018. 1, 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. (Daughter of the deceased);
2. (Daughter of the deceased).

| have also sent it to Stockport Metropolitan Borough Council, and the Care Quality
Commission who may find it of interest.

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.

14/11/2017

Signature gem
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 Borough Care (PDF)
Borough

Christopher Morris
Coroner's Court

1 Mount Tabor Street
Stockport

SK1 3AG

Head Office:

9 Acorn Business Park -

Heaton Lane - Stockport -

SK4 1AS

Telephone: 0161 475 0140

Fax: 0161 475 0144

Web: www.boroughcare.org.uk

Date: 28.11.2017

Regulation 28 Report to Prevent Future Deaths
Re: Kathleen Smith
Dear Mr Morris

Thank you for your correspondence of 14 November regarding the Death of
Kathleen Smith.

Following the Inquest, | have taken on board your comments regarding head office
not being aware of incidents that happen in the individual care homes within Borough
Care Ltd.

Borough Care Ltd do expect our Managers to keep us informed of events that
happen in the home. However, on this occasion the manager did not inform the
Head of Care regarding the fall that Mrs Smith had or the injury that was incurred.
This should have happened as a matter of procedure.

| have therefor devised a form that managers must complete on a weekly basis to
inform Head of Care of any significant incidents that happen in the home. These
incidents are discussed weekly at our Care & Quality meetings and any follow up is
actioned by the Area Support for that Home. This form was introduced to all
Managers on the 26" October at our monthly Managers meeting and was actioned
by the Managers from the following Monday.

Our Quality Manager and Area support team will also ensure that any incidents are
discussed on their audit meetings with the Home Manager.

It is unfortunate that the Manager of Lisburne Court at that time did not follow
procedure and as discussed in Court the Manager left the service, however if she
hadn't left the service her capability to manager was under scrutiny and action would
have been taken.

| have enclosed two copies of the form completed weekly by the Manager/Deputy
Manager.

wus

& —% INVESTORS
Xf IN PEOPLE

Yours Sincerely

Interim Head of Care

oy INVESTORS
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4. IN PEOPLE

—

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