Prevention of Future Deaths reports · 2018

Jane Parker

Regulation 28 report to prevent future deaths, reference 2018-0243, written 25 Jul 2018. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report25 Jul 2018
Reference2018-0243
DeceasedJane Parker
CoronerAlison Mutch
Coroner areaManchester South
CategoryCare Home Health related deaths
Sourcejudiciary.uk record · original PDF
Responses publishednone published

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: Care Quality Commission (CQC),
Minister of State for Care
CORONER

| am Alison Mutch, Senior Coroner, for the Coroner area of South
Manchester

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

INVESTIGATION and INQUEST

On 25" August 2016 | commenced an investigation into the death of Jane
Olive Parker. The investigation concluded on the 28" June 2018 and the
conclusion was one of Short Narrative - Died from the recognised
complications of aspiration of food contributed to by neglect.

The medical cause of death was 1a) Asphyxiation; 1b) Aspiration of Food
Stuff; 1c) Vascular Dementia

Jane Olive Parker had dementia and a history of choking episodes.
Following a choking incident in September 2015, it was indicated by the
General Practitioner and the Speech and Language Team (SALT) that
she be placed on a stage 3 diet. The Care Home records indicated she
was on a stage 4 diet. On 12" July 2016, Jane Olive Parker moved from
Millbrook Care Home to Fir Trees Care Home. The existing care plan
was used and Jane Olive Parker continued to be recorded as requiring a
stage 4 diet. Further difficulties with swallow were not escalated by the
care home to the SALT team as a result it was not picked up that she
should be on a stage 3 diet and she was not further assessed.

On 24" August 2016 Jane Olive Parker was given a non-stage 4 meal
which she ate unobserved in her room. Approximately 40 minutes after
she was given her meal she was found unresponsive in her room. The
pathologist at post-mortem found large pieces of un-chewed food stuffs in
the larynx with smaller food particles extending throughout the trachea

and into the main bronchus.

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. —
The inquest heard that:

1. There was poor understanding by the care home assistants of
what was meant by the types of modified diets that could be
recommended by the SALT teams. Following Mrs Parker’s death
both the Local Authority in question and the Care Home provider
had taken steps to improve knowledge within their care homes but
it was unclear if there were national programmes to ensure that
care assistants understood modified diets and the importance of
adherence to them;

. Within the care home the system for preparing the correct diets
types was such that food would come up to be served and would
then need to be put into the correct format by the care staff. There
was no regular system of the kitchen sorting and marking food to
be served for individual residents with specific dietary
requirements such as Mrs Parker. Following Mrs Parker's death
both the Local Authority in question and the Care Home provider
had taken steps to improve systems within their care homes but it
was unclear if there was national work in place to ensure care
homes and their kitchens ensured clearly marked food was
provided for residents with modified diets;

. In Mrs Parker's case the Inquest heard that there were
opportunities to escalate her case back to SALT after choking
episodes. However there was limited understanding within the care
home assistants of the need to report and escalate choking
episodes to ensure that the SALT team provided expert input and
reduced risk. Following Mrs Parker's death both the Local
Authority in question and the Care Home provider had taken steps
to improve systems within their care homes but it was unclear if
there was national work to ensure that there were appropriate
systems in place to ensure that there were appropriate escalations
to SALT.

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 19" September 2018. 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 vane son of the deceased, who
may find it useful or of interest

| 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.

Alison Mutch OBE

HM Senior Coroner
25.07.2018

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