Prevention of Future Deaths reports · 2021

Joan Rutter

Regulation 28 report to prevent future deaths, reference 2021-0066, written 8 Mar 2021. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report8 Mar 2021
Reference2021-0066
DeceasedJoan Rutter
CoronerAlan Wilson
Coroner areaBlackpool and Fylde
CategoryCare Home Health related deaths
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.

REGULATION 28 REPORT TO PREVENT FUTURE DEATHS 

THIS REPORT IS BEING SENT TO:   

, 

Proprietor, 
Riverside Rest Home 
17 West Beach, 
Lytham St Annes, 
Lancashire, 
FY8 5QH 

1 

CORONER 

I am Alan Anthony Wilson Senior Coroner for Blackpool & Fylde 

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. 
http://www.legislation.gov.uk/ukpga/2009/25/schedule/5/paragraph/7 
http://www.legislation.gov.uk/uksi/2013/1629/part/7/made 

3 

INVESTIGATION and INQUEST 

The death of Joan Elizabeth Rutter on 23rd October 2020 was reported to me and I opened an 
investigation, which concluded by way of an inquest held on 2nd March 2021. 

I determined that the medical cause of Joan’s death was: 
1 a Fracture of cervical vertebral column 
1 b Fall 
1 c  
2 Chronic kidney disease, urinary tract infection and ischaemic bowel  

In box 3 of the Record of Inquest I recorded as follows:  

Joan Rutter was at high risk of suffering a fall. At shortly after 7 am on 23 October 2020, Joan 
was found by a member of the staff at the rest home where she resided and was unresponsive 
on the floor next to her bed. A Paramedic was called and he confirmed that Joan was 
deceased.  Joan had suffered an unwitnessed fall to the floor between her bed and bedside 
table. Staff were unaware that Joan had sought to leave her bed. This was in part because at 
that time the falls mat positioned by the side of her bed in order to alert staff when she moved 
was unplugged. A subsequent post mortem examination revealed Joan had received a fracture 
to the spine as a result of the fall the effects of which proved fatal. At the time of her fall, Joan’s 
physiological reserve was already weakened by her kidney disease, a urinary tract infection and 
a developing ischaemic bowel.  

The conclusion of the Coroner was that Joan Rutter died due to Accidental death 

4 

CIRCUMSTANCES OF THE DEATH 

 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 Joan Rutter, aged 94 years, was at high risk of falling. Care staff were to check upon her every 
two hours. She had a falls mat positioned by the side of her bed. Staff were aware that her levels 
of  confusion  had  worsened  during  the  time  she  had  resided  at  the  rest  home.  There  were 
personal alarms available to Joan, but the court head that Joan’s confusion was such she would 
not  have  appreciated  that  these  alarms  were  available  for  her  to  utlilise  should  she  require 
assistance. Staff knew that Joan had a tendency to wander during the night. 

During the inquest, evidence was received that during the night two members of care staff had 
been responsible for checking on the welfare of up to approximately 24 residents.  Staff were 
expected to check on Joan at 5am that morning. Having considered the available evidence, the 
court was unable to conclude that this 5am check did take place. It was shortly after 7 am when 
a third member of staff arrived to commence her shift, and when she entered Joan’s room to 
check on her welfare, she found Joan unresponsive. 

The court found that there would have been periods overnight when Joan may have required the 
assistance of staff but that this may not have been available when she needed it and this placed 
her at risk. There would have been times when staff members were in other parts of the building 
checking  on  other  residents,  and  they  would  have  been  unaware  that  Joan  may  have  been 
seeking to leave her bed / bedroom.  

Staff would not have been alerted had Joan stepped onto the pressure mat by the side of her 
bed because as was revealed in court the mat was not plugged in at the relevant time and was 
therefore ineffective. From the available evidence, it could not be established how the mat came 
to be unplugged. Had it been operative when Joan left her bed, staff may have been alerted to 
her movements, but this would have been dependent upon the proximity of the two care staff 
and where  they were  in  the  building at that  time?  In the  view of the  court, at various  times 
overnight those Carers would have been unaware Joan had moved from her bed or otherwise 
required assistance.  

When Joan did fall, the court heard that her death would have been instantaneous.  

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 could occur unless action is taken. In the 
circumstances, it is my statutory duty to report to you.  

The MATTERS OF CONCERN are as follows. – 
Record keeping. 
The standard of the records provided by the rest home were poor. There was a paucity of entries 
made during the night shift. For example, entries to reflect Joan had been found wandering in 
the rest home having left her own room were unrecorded.  
A member of the day staff taking over the care of residents would have found it very difficult to 
review  the  records  and  have  an  accurate  understanding  of  how  the  residents  had  presented 
overnight,  thereby  placing  such  day  staff  in  a  difficult  position  taking  over  the  care  of  often 
elderly, vulnerable residents but potentially unaware of recent important events. Although the 
court  received  some  evidence  that  changes  have  been  made  since  Joan’s  death,  the  court 
remains of the view that the standard of record keeping continues to pose a risk to residents and 
future deaths may occur.  

The delivery of care during the night shift. 
Joan was an elderly, vulnerable resident. She was known to be confused, and unlikely to utilize 
personal alarms, and had a tendency to leave her room. She may have left her room at times 

 
 
 
 
 
 
 
 
 
 
 when staff were not available to respond to her movement because they were elsewhere in the 
building. The court is concerned that the night shift operated in a way that meant that staff could 
be  unaware  residents  needed  their  assistance.  Again,  although  the  court  heard  that  some 
changes have been made, the court remained of the view that the way care is delivered overnight 
to residents such as Joan poses a risk to their welfare and future deaths may occur.  

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.  

7 

YOUR RESPONSE 

You are under a duty to respond to this report within 56 days of the date of this report, namely 
by 5th May 2021. 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: 

 – Daughter of Mrs. Joan Rutter 

The Care Quality Commission 
Head of the Quality, Contracts and Safeguarding Adults Service, Lancashire County Council 

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 

08/03/2021 

Signature_ 
Alan Anthony Wilson Senior Coroner Blackpool & Fylde

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