Prevention of Future Deaths reports · 2019

Charles Knapp

Regulation 28 report to prevent future deaths, reference 2019-0212, written 26 Jun 2019. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report26 Jun 2019
Reference2019-0212
DeceasedCharles Knapp
CoronerAnna Crawford
Coroner areaSurrey
CategoryCommunity health care
Sourcejudiciary.uk record · original PDF
Responses publishednone published

The report

Text extracted from the PDF text layer. Reproduced verbatim, including the scan's own layout.

IN THE SURREY CORONER’S COURT 
IN THE MATTER OF: 

__________________________________________________________ 

The Inquest Touching the Death of Mr Charles Knapp 
A Regulation 28 Report – Action to Prevent Future Deaths 
__________________________________________________________ 

1  THIS REPORT IS BEING SENT TO: 

 

, Director and Ray 

, Manager  

Angel Solutions (UK) Limited 
Ground Floor 
Challenge House, 
616 Mitcham Road, Croydon, UK, 
CR0 3AA  
United Kingdom 

2  CORONER 

Miss Anna Crawford, HM Assistant Coroner for Surrey 

3  CORONER’S LEGAL POWERS 

I make this report under paragraph 7(1) of Schedule 5 to The Coroners 
and Justice Act 2009. 

4 

INQUEST 
The inquest into the death of Mr Charles Knapp was opened on 14 March 
2018.  It was resumed on 17 June 2019 and the conclusion was handed 
down on 18 June 2019.    

The medical cause of Mr Knapp’s death was: 

1a. Aspiration pneumonia 
1b. Paraplegia 
1c. Spinal Injury sustained in 2008  

2. Pressure Sores 

1 

 
 
 
 
 
 
 
 
 
 
 The inquest concluded with a narrative conclusion, which is set out 
below.  

5  CIRCUMSTANCES OF THE DEATH 

In  2008  Mr  Knapp  suffered  a  spinal  cord  injury,  the  cause  of  which  is 
unknown,  which  left  him  paraplegic.  Mr  Knapp  was  at  high  risk  of 
developing  pressure  sores  due  to  his  immobility  and  incontinence  and 
required assistance with all aspects of daily care. He lived alone at his home 
address and was in receipt of a package of care which was funded by Surrey 
County  Council  and  provided  by  Angel  Solutions  UK  Limited.  On  1 
December 2017 Mr Knapp was found to have two necrotic pressure sores, 
which had developed primarily as a result of sitting in his wheelchair and 
contributed  to  by  an  omission  on  the  part  of  his  carers  to  maintain  his 
personal hygiene and to regularly reposition him. They also omitted to seek 
medical attention for the pressure sores. On 12 December 2017 Mr Knapp 
was admitted to East Surrey Hospital as a place of safety due to concerns 
about the care he was receiving at home. On 24 February 2018, whilst at the 
hospital, he developed Aspiration Pneumonia to which he succumbed later 
that day.  The pressure sores caused him pain and  led to him eating and 
drinking in a non-upright position, which contributed to the development 
of the Aspiration Pneumonia. 

2 

 
 6  CORONER’S CONCERNS 

The Coroner’s concerns are as follows: 

(i) 

Angel Solutions (UK) Ltd omitted to maintain Mr Knapp’s 
personal hygiene or regularly reposition him, and thereafter 
omitted to seek medical attention for the pressure sores.  These 
omissions contributed to the development of the pressure sores 
and to Mr Knapp’s death.  

(ii)  Angel Solutions (UK) Ltd did not always provide Mr Knapp 

with two carers, despite his care plan requiring two carers to be 
present in order to move him and otherwise effectively care for 
him.  

(iii)  Angel Solutions (UK) Ltd failed to provide the court with a full 

set of Mr Knapp’s records, and as such the court did not have 
the opportunity to review the records for the key period prior to 
the development of the pressure sores.   

(iv)  Angel Solutions (UK) Ltd failed to supply the court with the full 
name and contact details of the main carer who was responsible 
for Mr Knapp’s care and as such the court did not have the 
benefit of hearing from her.  Further, her surname had been 
redacted from the records which were left at Mr Knapp’s house.  

The MATTER OF CONCERN is: 

The Coroner understands that although Angel Solutions (UK) has now 
been rated as inadequate following an inspection carried out by the Care 
Quality Commission in March 2019, it continues to provide care to 
approximately 8 individuals. The Coroner is concerned that there is a risk 
that the company will provide inadequate care to those individuals and 
keep inadequate patient records in respect of them, which gives rise to the 
risk of future deaths.  

7  ACTION SHOULD BE TAKEN 

In my opinion action should be taken to prevent future deaths and I 
believe that the people listed in paragraph one above have the power to 
take such action.  

3 

 
 
 
  
 8  YOUR RESPONSE 

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

Your response must contain details of action taken or proposed to be 
taken, setting out the timetable for such action. Otherwise you must 
explain why no action is proposed. 

9  COPIES 

I have sent a copy of this report to the following: 

1.  Chief Coroner  
2.  Mr Knapp’s family 
3.  First Community Health and Care  
4.  Surrey County Council  
5.  Care Quality Commission  

10  Signed: 

Anna Crawford 

H.M Assistant Coroner for Surrey 
Dated this 26th day of June 2019 

4

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