Prevention of Future Deaths reports · 2021

Dorothy Seekings

Regulation 28 report to prevent future deaths, reference 2021-0230, written 7 Jul 2021. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report7 Jul 2021
Reference2021-0230
DeceasedDorothy Seekings
CoronerSean McGovern
Coroner areaWarwickshire
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 

THIS REPORT IS BEING SENT TO: 

 – Owner-Clifton Court Nursing Home (Crosscrown Ltd) 

1. 
2.  Family of Mrs. Dorothy Seekings 
3.  Chief Coroner 
4.  Care Quality Commission 

1 

CORONER 

I am Sean McGovern, senior coroner, for the coroner area of Warwickshire 

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. 
[HYPERLINKS] 

3 

INVESTIGATION and INQUEST 

On 21st September 2019, I commenced an investigation into the death of Dorothy 
Seekings 87 years old. The investigation concluded at the end of the inquest on 
7th July 2021.The conclusion of the inquest was a Narrative Verdict.  

4 

CIRCUMSTANCES OF THE DEATH 

Mrs Seekings was resident at Clifton Court Nursing Home in Rugby. 

She was a frail elderly lady who could neither speak nor walk. She was 
highly vulnerable. 

During the night of 8th August 2019 another resident of the home entered 
her room. 

 It is not clear why he went into her room but he suffered from dementia and 
may have thought he was in his room which was next door. 

A carer entered Mrs Seeking’s room at approximately 4.00am  and 
discovered she was dead. Lying next to her on bed was the other resident 
who was fully clothed. 

A post mortem examination showed she had died of blunt force injuries. 

 On the balance of probabilities those injuries were caused by the other 
resident. 

He was arrested that night but was assessed as being unfit to be detained 
or interviewed. Subsequently he was detained under Mental Health Act. I 
am satisfied that he was suffering from rapidly deteriorating Vascular 
Dementia and on 8th August 2019 could not form the mens rea for any form 
of unlawful killing. 

He died on 5 May 2020.    

Although the events of 8th August 2019 were not reasonably predictable I 
1 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 record that there was ineffective promulgation of the care plan for the other 
resident and occasions of physical violence to care and nursing staff (but 
not to fellow residents) by the other resident  largely around his personal 
care (washing, bathing), which were missed opportunities to trigger a re-
assessment of his overall risk 

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. – 

 did not record incidents 

 had acted aggressively to staff members 

(1) the care plans for 
where 
including an occasion when a staff member was 
kicked in the mouth by 
(2) the failure to raise a safeguarding alert with the local authority regarding the above 
incident. 
(3) The staff did not appear to be aware of the contents of the care plan for 
resident 
ACTION SHOULD BE TAKEN 

. 

 or other 

6 

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, 

2 

 
 
 
 
 
 
 
 namely by 2nd September 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 
 (daughters). I have also sent it to the Care 
Quality Commission who may find it useful or of interest. 

 & 

I am also under a duty to send a copy of your response to the Chief Coroner and all 
interested persons who in my opinion should receive it. 

I may also send a copy of your response to any other person who I believe may find it 
useful or of interest. 

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. 

9 

7th July 2021 

Sean McGovern 

3

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 Crosscrown Ltd (PDF)
RESPONSE TO CORONER’S REQUEST FOR REGULATION 28 REPORT TO PREVENT FUTURE DEATHS 
FOLLOWING THE INQUEST INTO THE DEATH OF DOROTHY SEEKINGS CONCLUDED ON THE 7TH JULY 2021 BY 
A NARRATIVE VERDICT  

MATTERS OF CONCERN  

The matters of concern raised by the Coroner are as follows: 

(i)

The  care  plans  for 

  did  not  record  incidents  where 

  had  acted  aggressively  to  staff

members including an occasion when a staff member was kicked in the mouth by 

.

(ii)

The  failure  to  raise  a  safeguarding  alert  with  the  Local  Authority  regarding  the  above

incident.

(iii)

The  staff  did  not  appear  to  be  aware  of  the  contents  of  the  care  plan  for 

  or  other

residents.

Crosscrown  Limited  owns  a  number  of  Residential  &  Nursing  Care  Homes  in  Warwickshire,  Dorset  and 

Wiltshire and offer a  range of services from residential and nursing care through  to dementia and respite 

care.   

Following the tragic events of the 8th August 2019 the organisation has implemented a number of changes 

which are now in place and which hopefully address the concerns which have been raised.   

The  two  key  changes  are  the  acceleration  of  the  implementation  of  a  digital  care  management  software 

system called CareDocs.  This was being gradually introduced into the Homes run by Crosscrown during the 

Summer of 2019 but the events of August 8th accelerated the implementation of the new system and it is 

now  in  place  in  all  Crosscrown  Homes  including  Clifton  Court  and  has  been  for  some  time.    The  digital 

CareDocs system allows Care Plans to be created that meet the specific requirements of individual service 

users and it allows the creation of a care plan reflective of the needs and preferences of the individual user. 

 The CareDocs system  is stored  on a cloud portal package and mobile devices which are connected to the 

internet allow detailed daily notes to be recorded, care assessments to take place and for all staff to review 

resident information.  Clifton Court have found the system intuitive and easy to use by all staff regardless of 

their  level  of  computer  literacy.    The  evidence  based  features  of  the  system  allow  Clifton  Court  to 

demonstrate a safe, caring and responsive environment and allows compliance to be monitored.  It allows 

for  the  creation  of  a  digital  care  plan, digital  care  assessments,  daily  notes  to be  updated  and  charts  and 

body  maps  to  all  be  recorded  and  in  one  place.    The  staff  can  have  easy  access  to  profiles  and  most 

importantly the digital care document itself through desk top computers, laptops, tablets and even mobile 

phones.  Clifton Court has purchased a number of tablets to be given to each member of staff for their use 

and that is the usual device upon which information is recorded.  It should be stressed that all nurses and 

carers have access to CareDocs.  When a new member of staff joins the organisation  they undergo a two 

week period of training for which time they are supernumerary and thereafter there is a “buddy” scheme 

which  lasts from  between  two  weeks  and  three months depending  on  the requirements of  the  individual 

member of staff. During that time the individual undergoes a detailed period of training into the CareDocs 

system.   

The  introduction  of  the  system  was  dependent  on  upgrading  the  Wi-fi  capability  throughout  the  Homes 

which ensures that the electronic care plan records can be utilised and read and updated throughout Clifton 

Court.   

The second significant change made by Crosscrown Limited was the appointment of a Quality Assurance & 

Compliance  Manager  in  August  2019  which  led  to  the  creation  of  an  Operations  Team  developed 

throughout  2020  and  fully  implemented  by  December  2020.  This  team  is  responsible  for  compliance  and 

governance  across  the  Crosscrown  Homes  including  of  course  Clifton  Court.    The  team  contains  three 

members who are responsible for Quality Assurance and Compliance together with matters of governance, 

human  resources  and  learning  and  development.    The  Operations  Team  are  supported  and  guided  by  an 

 
 
 
 
 independent external consultant called The Care Excellence Partnership. The lead at that organisation is an 

experienced former national lead and inspector of services for the CQC.   

The  Operations  Team  have  overseen  the  implementation  of  the  CareDocs  scheme  and  implemented  a 

number of new processes which deal with issues of training and good practice.   

The  Operations  Team  have  implemented  two  relevant  programs  entitled  “Understanding  Challenging 

Behaviour and Dementia Training” and “Safeguarding Training” and the issue of safeguarding is now a part 

of the induction process at the Crosscrown Homes.   

The Operations Team has implemented an enhanced agenda for the fortnightly staff meetings that are held 

at Clifton Court to include inter alia infection control – Covid, health and safety and accurate and systematic 

recording of behavioral issues.   

Under the new scheme such behaviour is recorded on the CareDocs system which prompts the completion 

of  an  Antecedent  Behaviour  Consequences  form  on  the  CareDocs  system.    The  Care  Home  Manager  at 

Clifton  Court  checks  on  a  daily  basis  for  amongst  other  things  any  ABC  charts  which  may  have  been 

completed by members of staff. Should any safeguarding issues be recorded then the Manager will contact 

Adult Social Services and complete that process.  The Operations Team are copied into all emails in relation 

to any safeguarding issues.  In the last eighteen months Clifton Court has made eight referrals to the Adult 

Social Services Team at Warwickshire County Council all of which were closed down without an action by the 

Council.   The issue of safeguarding is also now part of the Monthly Managers Report and is analysed by the 

Operations Team and evaluated for any patterns or learning issues.   

 
 
 
 
 
 
 
 The  Operations  Team  has  implemented  backing  up  the  issue  of  safeguarding  by  issuing  each  and  every 

member  of  staff  with  a  small  pocket  sized  laminated  safeguarding  document  to  remind  the  staff  of 

safeguarding issues.

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