Prevention of Future Deaths reports · 2018

Mavis Reeves

Regulation 28 report to prevent future deaths, reference 2018-0035, written 6 Feb 2018. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report6 Feb 2018
Reference2018-0035
DeceasedMavis Reeves
CoronerIan Pears
Coroner areaBedfordshire and Luton
CategoryOther related deaths
Organisation namedEast of England Ambulance Service NHS Trust
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.

for Bedfordshire & Luton

REGULATION 28 REPORT TO PREVENT FUTURE DEATHS

THIS REPORT !S BEING SENT TO:

First Port Retirement Property Services Limited '
Marlborough House

Wigmore Lane

Luton

LU2 9EX

CORONER

lam lan Pears, Acting Senior Coroner for Bedfordshire & Luton

t y

(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.

| http:/Avww. legislation.gov.uk/ukpga/2009/25/schedule/5/paragraph/7 |
hito:/Awww.legislation.gov.uk/uksi/2013/1629/part/7/made

i.

3 | INVESTIGATION and INQUEST
On 5 July 2017 | commenced an Investigation into the death of MAVIS JEANNE |
REEVES, 83 years old. The Investigation concluded at the end of the Inquest on
31 January 2018. The Conclusion of the Inquest was ‘natural causes’.

| 4 | CIRCUMSTANCES OF THE DEATH
On the 18 July 2017 at 08:52 hours the deceased pulled her Careline cord in her)
flat saying she had a dry mouth and was struggling to breathe. The Paramedics

i arrived in the car park at 08:55 hours but due to an automated entry system, and
obtaining a key to her flat, there was a delay in their reaching the deceased. The
Paramedics were with the deceased at 09:18 hours and performed CPR until

| 10:12 hours.
L i _.
5

| CORONER’S CONCERNS

During the course of the Inquest the evidence revealed matters giving rise to \

Senior Coroner, The Court House, Woburn Street, AMPTHILL. Bedfordshire, MK45 21IX
Tel 0300-300-6559 { Fax 0300-300-8267

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 foliows. —

(1) At the Inquest it was revealed that there are 4 ways a non-resident can

enter the building:

(a) By entering the room number on the keypad

(b) By using a code

(c) By pressing 2 buttons, namely “clear” and then “call”

(d) By being allowed in by a resident that was passing through the
entrance

The deceased did not answer the call; the code was not available to the
paramedic, who had arrived before it was forwarded to his car's
computer. In any event that which arrived was probably not the correct
code.

The “call” button is supposed to connect to the Emergency Call Centre,
but will not connect if the Careline has been pulled. In this case, the fact
that the deceased was still talking to the Careline Operator meant that
option (c) above was not available to the paramedic. This is because the
system in place is an analogue system and there is only one line going
from the building to Careline.

Evidence was heard that only 3% of Careline calls result in 999 being
called. The remaining 97% are non-urgent calls, accidental calls and
calls by residents who are lonely.

This means that access using option (c) could be deprived by anyone
else in the building using the system.

Further it means that once one resident is using the system that no other
resident can call the Careline, even if there is an emergency.

The scenario of a resident calling the Careline in an emergency and
staying on the line is understandable and cannot be that unusual.

It appears that a digital system wouid avoid these problems.

It is understood that for a digital system to be installed the residents must
agree to fund it, and that would then form part of the service charge.

My concern is twofold. First, do the residents know of the limitation within
the Careline System currently installed? Secondly, in the absence of an
upgrade to digital, plans need to be put in place so that the emergency
services can gain access without undue delay.

Senior Coroner, The Court House, Woburn Street, AMPTHILL, Bedfordshire, MK45 2HX.
Tel 0300-300-6559 | Fax 0300-300-8267

(2) The Inquest heard that the analogue system takes 90 seconds to
connect. The reason for this is because it is also sending data relating to
the caller to the Careline Operator’s Terminal. A digital system would
reduce that to 4 seconds.

My concern again is whether the residents know this. In cases where |
promptness is important 90 seconds can be the difference between life
and death.

(3) The key safe contains numerous keys including the master key. The
paramedic had difficulties identifying which was the master key. j

It is important that the keys be clearly labelled to avoid delay in the

emergency services gaining access.

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 13 April 2018. |, 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: QJ (niece of the deceased), East of England
Ambulance Service NHS Trust and to Appello Limited.

it appears to me that your residents need to be involved in deciding
whether to incur the cost of an upgrade. | have attached a redacted copy
of this Regulation 28 Report and | give permission, should you feel it
appropriate, to send the redacted copy to your residents either in person
or to each residence to be placed on a central noticeboard. i

Senior Coroner, The Court House, Woburn Street, AMPTHILL, Bedfordshire, MK45 2HX
Tel 0300-300-6559 | Fax 0300-300-8267

| | 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.

Dated 06 February 2018

_ IAN PEARS
Acting Senior Coroner
Bedfordshire & Luton

Senior Coroner, The Court House, Woburn Street, AMPTHILL, Bedfordshire, MK45 2HX
Tel 0300-300-6559 | Fax 0300-300-8267

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 Firstport Retirement (PDF)
IN THE BEDFORSHIRE AND LUTON CORONER’S COURT 

IN THE MATTER OF: 

The Inquest Touching the Death of Mavis Jeanne Reeves 
Response to Ian Pears’ Regulation 28 Report (Action to Prevent Future Deaths) 
From FirstPort Retirement Property Services Limited 

1. 

1.1 

1.2 

2. 

2.1 

2.2 

INTRODUCTION 

This  document  sets  out  the  response  of  FirstPort  Retirement  Property  Services  Limited 
(“FirstPort”)  to  paragraph  5  of  Ian  Pears’  Regulation  28  report  dated  6  February  2018  (the 
“Report”). For the ease of reference the Coroners matters of concern detailed at paragraph 5 of 
the Report are set out below: 

 5(1) At the Inquest it was revealed that there are 4 ways a non-resident can enter the building: 

(a) By entering the room number on the keypad 

(b) By using a code 

(c) By pressing 2 buttons, namely “clear” and then “call” 

(d) By being allowed in by a resident that was passing through the entrance 

First, do residents know of the limitation with the Careline System currently installed?  

Secondly, in the absence of an upgrade to digital, plans need to be put in place so that the 
emergency services can gain access without undue delay. 

5(2) The Inquest heard that the analogue system takes 90 seconds to connect. The reason for this is 
because it is also sending data relating to the caller to the Careline Operator’s Terminal. A digital 
system would reduce that to 4 seconds.   

My concern again is whether the residents know this. In cases where promptness is important 90 
seconds can be the difference between life and death.  

5(3) the key safe contains numerous keys including the master key. The paramedic had difficulties 
identifying which was the master key. 

It is important that the keys be clearly labelled to avoid delay in the emergency services gaining 
access. 

The above matters of concern are dealt with individually at paragraphs 2 to 4. 

PARAGRAPH 5(1) 

We will address your two concerns raised within this paragraph in turn.  

However,  prior  to  addressing  your  concerns  we  would  like  to  provide  some  background 
information regarding the system in place.  

UK-611129600.1 

 
 
 
 
 
 2.2.1 

The LD3 analogue system currently in place was installed in September 2014 at a cost 
of  £24,958.00.  The  system  is  an  industry-accepted  grade  and  recognised  as  fit  for 
purpose.  Others  within 
in  newly 
industry  regularly 
constructed/refurbished residential facilities similar to the premises in question.  

the  system 

install 

the 

2.2.2  When  the  upgrade  was  completed  in  2014,  all  residents  were  informed  of  how  the 
system works and the various entry methods. The entry system is also discussed with 
new residents on their new resident induction. 

2.3 

First, do the residents know if the limitation within the Careline System currently installed.  

2.3.1 

To ensure that the residents are fully aware of how the current Careline System works 
we  held  a  residents  meeting  on  4  April  2018.  The  findings  contained  within  the 
Prevention  of  Future  Deaths  report  were  discussed  with  the  residents  as  well  as  the 
possibility of a new digital entry system. The contents of the meeting was followed up 
in writing, the letter was provided to the residents on 10 April 2018. Within the letter 
the residents were advised that a further meeting would take place on 2 May 2018 should 
they wish to ask any further questions or raise any concerns regarding the entry system. 

2.3.2 

The residents discussed the option of changing the system to a digital system however 
they have confirmed that they are happy with the current system and do not wish to 
change from the current system. 

2.4 

Secondly,  in  the  absence  of  an  upgrade  to  digital,  plans  need  to  be  put  in  place  so  that  the 
emergency services can gain access without undue delay. 

2.4.1 

2.4.2 

As set out within the Report, there are four ways for the emergency services to gain 
access to the premises as a non-resident. Whilst the system in place at the time of the 
incident  is  recognised  as  an  acceptable  and  fit  for  purpose  system,  it  is  recognised 
however that on the day in question the code provided was not correct. 

The error was due to the Appello Careline Operator not being aware of the correct code 
required for the particular type of Tunstall installed. This was formally raised with the 
Monitoring Services Director at Appello Careline and a joint review, with ourselves, 
was undertaken to ensure that all of their systems contained the correct numbers/codes 
for all of the developments that we manage and for which they provide this service. We 
have  ensured  that  the  correct  codes  are  now  contained  on  their  system  and  that  all 
operators at Appello Careline will see the correct codes when they connect to a specific 
development.  

2.4.3 

Further, as set out in paragraph 4.1 the master key is now individually stored to ensure 
ease of access for any emergency services.  

2.4.4  Whilst the system in place is of the required standard, we are committed to ensuring the 
safety  of  the  residents  and  as  such,  we  have  looked  into  whether  any  further  safety 
measures could be put in place to ensure that the emergency services can have access to 
the premises without delay.  

(a) 

Firstly, we looked into installing Safelink at the premises, which is a system 
for enabling access to the building for carers visiting a residential premises 
and  a  further  service  offered  by  Appello  Carline.  They  have  confirmed 
however  that  this  is  a  rotating  code,  which  they  issue  and  which  changes 
regularly and therefore it would not allow emergency services to access the 
building without first registering for a code. The system was not designed for 

UK-611129600.1 

2 

 this  type  of  interaction;  it  was  concluded  therefore  that  installing  Safelink 
would not add a further method of entry for the emergency services. 

(b) 

Secondly, we looked into installing an emergency telephone line at the entry 
gate. Appello Careline has confirmed however that the number provided at the 
front gate is an emergency number that connects direct to them and is treated 
with the same priority and urgency as a fire call at the residence. Again, this 
would not therefore add a further method of entry for the emergency services.    

3. 

3.1 

4. 

4.1 

PARAGRAPH 5(2) 

We set out our response in respect to communicating the potential limitations with the analogue 
system, as outlined by the Coroner, in paragraph 2.2 above.   

PARAGRAPH 5(3) 

At the time of the incident all keys were clearly labelled and stored in the key safe at the main 
entrance. The safe has a speech module and pull cord as is industry standard. However, we note 
the Coroners concern that despite this control measure the paramedic had difficulty locating the 
master key and as an additional control measure we have therefore separated this key from the 
bunch of keys and it is stored separately and prominently within the key safe.  

UK-611129600.1 

3

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