Prevention of Future Deaths reports · 2019

Margaret Melia

Regulation 28 report to prevent future deaths, reference 2019-0320, written 18 Apr 2019. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report18 Apr 2019
Reference2019-0320
DeceasedMargaret Melia
CoronerZafar Siddique
Coroner areaBlack Country
CategoryCare Home Health related deaths
Sourcejudiciary.uk record · original PDF
Responses published1

The report

Text extracted from the PDF text layer. 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: 

1.  Chief Executive, HC-One, Southgate House, Archer Street, Darlington, DL3 

6AH c/o Dovetail Court Care Home 

2.  Managing Director, Lakeview Care Home 

3.  Care Quality Commission are copied in for their reference only. 

1 

CORONER 

I am Zafar Siddique, Senior Coroner, for the coroner area of the Black Country. 

2 

CORONER’S LEGAL POWERS 

I 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. 

3 

INVESTIGATION and INQUEST 

On  the  16  November  2018,  I  commenced  an  investigation  into  the  death  of  Mrs 
Margaret Melia. The investigation concluded at the end of the inquest on 1 April 2019. 
The conclusion of the inquest was a short form conclusion of natural causes. 

The cause of death was:   

1a     Advanced Dementia 
 b 
 c 
II   

Old Age, Malnourished, Ischaemic Heart Disease 

4 

CIRCUMSTANCES OF THE DEATH 

i)  Mrs  Melia  was  admitted  to  Dovetail  Court  Care  Home  on  the  9  October 
2018  from  Lakeview  Care  Home.    She  had  a  medical  history  including 
arthritis,  Alzheimer’s,  chronic  obstructive  pulmonary  disease  and  required 
substantial care for her daily living activities.  

ii)  As part of the pre-assessment, on the 29 September 2018, Mrs Melia was 
assessed by a manager from Dovedale Court. The nurse on duty (Lakeview  
Care Home) advised the assessor that she would be requesting the GP to 
visit  her  in  2  days  (01.10.18)  to  prescribe  subcutaneous  fluids  due  to  Mrs 
Melia’s  oral  intake  was  poor  and  it  would  be  required  if  her  fluid  intake 
dropped below 500ml daily. 

iii)  The  relevant  equipment  required  to  administer  subcutaneous  fluids  wasn’t 
available at Dovetail Care Home and no subcutaneous fluids were given. 

iv)  Mrs Melia’s condition started to decline rapidly from around the 22 October 

1 

[IL1: PROTECT] 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 and her food and fluid intake dropped.  

v) 

 She  was  admitted  to  Sandwell Hospital  and  treated  for  dehydration  and  a 
lower  respiratory  tract  infection  with  antibiotics.    Sadly,  her  condition 
continued to decline and she was placed on end of life palliative care.  She 
passed away on the 7 November 2018.  

5 

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.  Evidence  emerged  during  the  inquest  that  there  was  an  inadequate  discharge 
and pre-assessment process between Lakeview Care Home and Dovetail Care 
Home over the requirement of subcutaneous fluids.  

6 

ACTION SHOULD BE TAKEN 

In my opinion action should be taken to prevent future deaths and I believe you have the 
power to take such action.  

1.  Both  Care  Homes  may  wish  to  consider  urgently  reviewing  the  protocols  in 
place  during  discharge  and  pre-assessment  of  patients.    In  particular,  the 
requirement  of  any  medication  should  be  set  out  clearly  to  avoid  any 
misunderstanding that could result in harm to a patient. 

7 

YOUR RESPONSE 

You are under a duty to respond to this report within 56 days of the date of this report, 
namely by 13 June 2019. 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. 

8 

COPIES and PUBLICATION 

I  have  sent  a  copy  of  my  report  to  the  Chief  Coroner  and  to  the  following  Interested 
Persons; Family. 

I 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. 

9 

 18  April 2019                                                

Mr Zafar Siddique
Senior Coroner 

2 

[IL1: PROTECT] 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 Black Country Area 

3 

[IL1: PROTECT]

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 Hc One (PDF)
Mr Zafar Siddique 
Senior Coroner 
Coroner’s Court 
Jack Judge House 
Halesowen Street 
Oldbury, B69 2AJ 

13 June 2019 

Dear Mr Siddique, 

I write to inform you of the actions taken at HC-One in response to your Regulation 28 report to 
prevent future deaths, following your investigation into the death of Mrs Melia. 

In response to the matters of concern highlighted, we took the following actions:   

We reviewed our policies and practices as an organisation in relation to our pre-admission 
and admission processes. 

We reviewed the current Admission process checklist. 

The action we have taken as a result: 

On reviewing our practices, we identified that if a delay occurred between the pre-admission 
assessment conducted, there needed to be clearer guidance set out for colleagues within 
our Admission, Transfer and Discharge Procedure (Appendix 1). We have now included 
practice that in the eventuality the pre-assessment was completed more than five days prior 
to admission to the home, further information should be sought from the hospital ward/care 
home/social worker as soon as possible. This will include the update of any medication 
changes or outcome of any recent healthcare professional reviews of the person during this 
period, to avoid any misunderstanding that could result in harm. 

The changes to practice have been cascaded across the organisation via our Homes’ 
Bulletin, which is sent to our homes. 

Our Admission process checklist (Appendix 2), which is available within all our homes to ensure 
all aspects of the organisation’s pre-admission and admission processes are completed, has 
been updated to reflect this improvement in practice.  

HC-One 
T 01325 351100  F 01325 351144 
Correspondence & Registered Office: Southgate House, Archer Street, Darlington, County Durham, DL3 6AH 
Registered in England and Wales: HC-One Limited, registration no. 07712656; Meridian Healthcare Limited, registration no. 01952719;  
HC-One Beamish Limited, registration no. 05217764; HC-One Oval Limited, registration no. 10257888; RV Care Homes Limited, registration no. 07417290. 

 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 
  
 
 
 
 
 
 
 
 I do hope this information is helpful and offers you the reassurance that we, at HC-One, have 
taken the issues raised seriously and have taken appropriate action with the intention of 
improving the care and safety of our Residents. 

Yours sincerely 

Head of Quality and Regulation 

Page 2 of 2

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