Prevention of Future Deaths reports · 2018

Sheila Hadfield

Regulation 28 report to prevent future deaths, reference 2018-0334, written 27 Sep 2018. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report27 Sep 2018
Reference2018-0334
DeceasedSheila Hadfield
CoronerAlison Mutch
Coroner areaManchester South
CategoryHospital Death (Clinical Procedures and medical management) related deaths · Mental 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

/2 | CORONER'S LEGAL POWERS

REGULATION 28 REPORT TO PREVENT FUTURE DEATHS

THIS REPORT IS BEING SENT TO: The Secretary of State for Health |
CORONER

lam Alison Mutch ,Senior Coroner, for the coroner area of South
Manchester

| 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

T INVESTIGATION and INQUEST

On 2°? October 2017, | commenced an investigation into the death of
Sheila Ann Hadfield. The investigation concluded on the 17" September
2018 and the conclusion was one of Narrative: Died from the recognised
complications of a natural cause exacerbated by a period of immobility
following an accidental fall.

The medical cause of death was 1a Sepsis; 1 b Left sided empyema
and purulent pericarditis;1 c Left sided bronchopneumonia

1

Sheila Ann Hadfield had a long standing mental health disorder of
paranoid schizophrenia. She resided at Chester House, a residential care
home. As part of her illness she self-neglected including poor personal
hygiene and refusal of food. She would regularly stay in her room for
significant periods of time and refuse access to care home staff. On 17th
August 2017 it was identified that a best interest meeting would be
beneficial as the home was struggling to cope. There were limited
opportunities for placement elsewhere.

She went to her room on 21st September 2017. She did not come out for
meals on 22nd September and refused access to her room. At about
14.00 on 22nd September 2017 she was found on the floor of her room
by care staff. An ambulance was called and she was transferred to
Stepping Hill Hospital. She was treated for sepsis. On 19th September |
2017 she died at Stepping Hill Hospital from sepsis. |

1

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:

1. The inquest heard that the home that Mrs Hadfield was placed in
struggled to cope with her needs. However, there was a national
shortage of suitable beds for individuals of a similar age to Sheila
Hadfield with her complex mental health needs. The majority of
available care provision was dementia beds which would have
been unsuitable. The inquest was told that this meant that had Mrs.
Hadfield not remained where she was she would have had to go
onto a mental health ward on a voluntary basis or been sectioned
if she had refused.

T 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 22"4 November 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

I
| have sent a copy of my report to the Chief Coroner and to the following

Interested Persons namely Mrs Evans, sister of Sheila Hadfield and

daughter of Shelia Hadfield , 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.

Allison Mutch OBE
HM Senior Coroner

27.09.29018 ov

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 Department of Health Social Care (PDF)
uy From Jackie Doyle-Price MP’

Department Pesta Unies Sacra ol Sie i Neal et

oT riea

Social Care 39 Vlora Stet
SWIH OEU

Your Ref: 8339/CLB 020 7210 4850

PFD-1151095

Ms Alison Patricia Mutch
HM Coroner's Court

1 Mount Tabor Street
Stockport SKI 3AG

‘ (\ November 2018

DRay VA Mukes

Thank you for your correspondence of 27 September to Matt Hancock about the
death of Mrs Sheila Ann Hadfield. I am responding as Minister with portfolio
responsibility for mental health.

My officials have made enquiries with NHS England on the matter of concern in your
report.

From the information provided, it appears that the main issue is about the availability
of appropriately trained and resourced social care services, including care homes with
specialist mental health staff and seamless interfaces with secondary mental health
services specialising in older people’s functional mental health.

NHS England acknowledge that access to mental health expertise within care homes,
whether through referrals, staff training or integrated teams, is not always adequate.

Older people in care homes typically have more complex health and social care needs
than those living in their own homes, yet access to healthcare, and mental health care
in particular, for this group of service users is not always adequate. There is evidence
that care home residents can experience problems accessing NHS primary and
secondary healthcare services, including GPs.

It is important that care homes ensure they have good links with GPs and referral
arrangements in place so that healthcare services can be accessed easily and promptly
as and when needed.

Quality Standard QS50, Mental wellbeing of older people in care homes' published
by the National Institute for Health and Care Excetlence (NICE), recommends that
‘older people in care homes have access to the full range of healthcare services when
they need them’, and that care homes ensure they ‘... work in partnership with
healthcare organisations to implement effective arrangements for access to primary,
secondary, specialist and mental health services for older people in care homes’.

Ata national level, NHS England has taken steps to help improve healthcare in care
homes through the roll out of ‘Enhanced Health in Care Home’ Vanguards? as part of
the Five Year Forward View’s New Models of Care Programme.

Many of the Vanguard sites have included some mental health components in their
care models, with several reporting positive results and learnings that other areas
could benefit from. For example, in sites that have incorporated mental health
expertise into integrated care teams such as the Gateshead Vanguard, team members
have highly valued the contribution of their mental health colleagues in improving
the support delivered to people with complex and ongoing care needs. This has
included support for older people with functional mental health needs such as
depression, anxiety, bipolar disorder and schizophrenia.

Building on the experience of the Vanguard sites, the development of Integrated Care
Systems (ICSs) and Sustainability and Transformation Partnerships (STPs) provides a
valuable opportunity to strengthen collaboration between health and social care
services in a local footprint, and to help improve the provision of mental health care
in care homes. Such arrangements are for local areas to determine, according to the
local need and the make-up of local services.

I hope this response is helpful. Thank you for bringing these concerns to my
attention.

i pe

JACKIE DOYLE-PRICE

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