Prevention of Future Deaths reports · 2020

Donald Elliott

Regulation 28 report to prevent future deaths, reference 2020-0109, written 12 Feb 2020. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report12 Feb 2020
Reference2020-0109
DeceasedDonald Elliott
CoronerPaul Cooper
Coroner areaLincolnshire
CategoryCare Home Health related deaths · Other 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 (1)

NOTE: This from is to be used after an inquest.
REGULATION 28 REPORT TO PREVENT DEATHS

THIS REPORT IS BEING SENT TO:

1 Glenholme Holdingham Grange Care Home

1 CORONER

I am Paul COOPER, HM Assistant Coroner for the area of Lincolnshire

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 05/03/2019 I commenced an investigation into the death of Donald George ELLIOTT aged 88.
The investigation concluded at the end of the inquest on 07 February 2020. The conclusion of the
inquest was:

I a Intracranial Haemorrhage

I b

I c

II Parkinson's Disease, Dementia, Heart Failure.
4 CIRCUMSTANCES OF THE DEATH
The deceased was cared for at Glenholme Holdingham Grange, Whittle Road, Holdingham, Sleaford.
Following at least one fall in the home (that was witnessed) on 31st January 2019 as a result of which
on the balance of probabilities the deceased hit his head on the floor (although this was not
witnessed) .The deceased was taken to hospital where he stayed until 9th February 2019. He was
then discharged back to the home and was nursed in bed until he died on 22nd February 2019.

5 CORONER’S CONCERNS

The MATTERS OF CONCERNS are as follows: (brief summary of matters of concern)
1.
deceased was recorded as falling.

Please confirm the level of staffing present on 24/01/2019 and 31/01/2019 at the time the

2.
Regulation 18 Health and Social Care Act 2008 as to:

Is the Care Home able to evidence and demonstrate on both dates they complied with

a)

Deploying enough suitably qualified competent and experienced staff and,

b)
appraisals that are necessary for them to carry out their role and responsibilities.

That those staff received the support, training, professional development, supervision and

This report is raised due to the contradictory evidence filed in the Inquest for and on behalf of

3.
Glenholme Holdingham Grange Care Home and to ascertain why the coronial service was only
notified the day before the Inquest why 2 witnesses formerly engaged by the Care Home failed to
attend the inquest under summons. An explanation of which is required as to what efforts and
resources were deployed to locate them by a manager/director.

 6 ACTION SHOULD BE TAKEN
In my opinion action should be taken to prevent future deaths and I believe you (and/or your
organisation) have the power to take such action.

7 YOUR RESPONSE

You are under a duty to respond to this report within 56 days of the date of this report,
namely by 08 April 2020.

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 :

……………………………………………………………………………………………………………………
……………………………………………………………………………………………………………………

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

Paul COOPER
HM Assistant Coroner for
Lincolnshire
Dated: 12 February 2020

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 Holdingham Grange Nursing Home (PDF)
2  11  1 

r:~"O 

.  LvL 

HOLDINGHAM GRANGE 

INVESTIGATION REPORT RE  The  late Donald  Elliott (DE)  17.08.30 

BACKGROUND 

Mr  Elliott was  admitted  to  Holdingham  Grange,  from  another care  home, in  August  2018  in 
order to  be nearer to his wife ; who lives in Sleaford . DE was at a high risk of falling ; which was 
highlighted  in  the  risk  assessment  and  an  appropriate  care  plan  was  developed . He  walked 
with  a  frame  but  frequently  tripped  over  his  feet  and  his  frame.  He  used  a  wheelchair  for 
distances. He had a sensor mat next to his bed to alert staff when he was up, which  he agreed 
to.  Other than that staff observed him  as was normal  in  the course of the day. He was  able to 
use his call  bell  and , although forgetful , he did ring  most of the time . 

He  was  never  funded  for  or  deemed  that  he  required  1-1  observation.  He  was  funded  for 
nursing care.  He was visited by his wife  most days. He came up for meals into the dining areas 
and  socialised with  others. He  had  capacity to  make decisions  about where  he wanted  to  go 
and  what  he  wanted  to  do .  He  was  sometimes  confused  to  time  and  place  but  was  easily 
reassured  and  re  orientated . 

He  lived  on  the  Nursing  unit  initially, as  th is was the  only unit that was  open.  He  moved  onto 
the dementia unit when  it  opened  on  7th  January 2019. At that time the  staff ratio was  2 staff 
to  4 residents in  the day and  1 carer and  nurse floating  at night, (3  residents were  residential 
and  1 was nursing). 

CONCERN 

Coroner raised  some questions which  required  a response  by April  8th  2020  : 

Staffing  levels on  both  days,  when Mr Elliott to  confirm we  had  sufficient suitably trained  staff 

Why 2 staff called to  attend the inquest did  not attend 

If staff received  support, supervisions and appraisals to  enable them to carry out their roles 
and  responsibilities . 

INVESTIGATION METHODOLOGY 

Interviews with staff present during  incident 

•  Care  records 
• 
•  Rotas 
•  Allocation  sheets 
•  Resident occupancy sheets 
•  Accident reports 

FINDINGS 

24.01 .19 

There were two staff on  duty during the day and  one carer and a 'floating ' nurse at night. 
There were four residents on  the unit. 

 31.01 .19 

There was a registered  nurse and  an  agency carer on  the unit when he fell.  Staff to resident 
ratio was 2-4 at the time of the fall.  The fall  was witnessed by the carer who did not see him 
hit his  head.  He was checked  over by the  nurse who was giving medication at the time. 

The investigation has demonstrated that there were sufficient, suitably qualified , staff on  duty 
on  24.01 .19 and 31 .01 .19 to meet the needs of the  residents occupying the  home at the time. 

Agency staff on  duty at the time had received appropriate training through their agency; which 
was  evidenced  within  the  contract  with  them . The  same  agency  staff attended  the  home  to 
maintain continuity . 

24.01 .10: 

Staffing levels during the day included ; the Registered nurse manager, a registered nurse and 
4 care staff and  an  activities person in  the day and  one registered  nurse and two care staff at 
night.  The  total  number  of  residents  in  the  home  on  the  24.01 .19  were  27.  Eight  of which 
required  nursing care and the remaining  required social  and  personal care. 

31 .01.19: 

Staffing  levels  on  this  day  were  I registered  nurse  manager,  2  nurses  and  9  carers  and  an 
activities  person , one carer being  on  induction day, and  the  second  nurse was supernumery 
for care planning a ratio of  1-3, and  1 nurse and 2 carers  at  night,  a ratio of 1-8  28 residents 
were in  the home in  total 8 requiring  nursing care and  the remaining social and personal  care 

DE  had  not been  assessed as  requiring  1-1  care therefore usual observations and checks 
were undertaken. 

Staff complete  training  before  commencing  employment.  During  the  probation  period  a  full 
induction  is  completed  and  supervision  is  provided.  Staff  with  prior  care  experience  are 
employed where possible. 

No summons was received  by the manager or any other staff to attend the  inquest.  Please 
accept our apologies as  none of the staff would  knowingly not attend . . 

Actions: 

We have reviewed  all  our falls  risk assessments we work in  partnership with  OTs to  discuss 
suitable equipment and this  is  ongoing and falls training  is  available for all  staff. 

Registered  Manger 

27 .03.2020

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