Prevention of Future Deaths reports · 2022

Gerald Tuck

Regulation 28 report to prevent future deaths, reference 2022-0254, written 12 Aug 2022. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report12 Aug 2022
Reference2022-0254
DeceasedGerald Tuck
CoronerRachael Griffin
Coroner areaDorset
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 (1) 

NOTE:  This form is to be used after an inquest 

REGULATION  28 REPORT TO PREVENT FUTURE DEATHS 

THIS REPORT IS BEING SENT TO: 

1. 

,  Managing  Director of Tricuro 

1 

CORONER 

I  am  Rachael  Clare  Griffin,  Senior Coroner,  for the  Coroner Area  of Dorset 

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 

15th

On  the 
Gerald  Kenneth  Tuck,  born  on  the  17th  June  1931. 

March  2022  an  investigation  was  commenced  into  the  death  of 

The  investigation  concluded  at the end  of the Inquest on  the  11th  August 2022. 

The  Medical  Cause  of Death  was: 

la Pneumonia 
lb Immobility due to traumatic head  injury 
le 

II  Frailty  Diabetes  Cerebrovascular  disease,  Atrial  Fibrillation,  Dementia, 
Hypertension 

The  conclusion  of the Inquest was "Accident" 

4 

CIRCUMSTANCES OF THE DEATH 

The  deceased,  who  suffered  with  dementia,  became  a  resident  at  Sidney  Gale 
House  Residential  Home,  Bridport in  January 2017.  On  the  25th  December  2021 
he  fell  at the  home  and  was  admitted  to  Dorset County  Hospital,  Dorchester.  A 
CT  scan  did  not  reveal  any  head  injury  and  he  was  subsequently  discharged 
back to the home  on  the  27th  December 2021.  There  is  no  record  of a review  of 
his  falls  risk  assessment  following  his  return.  He  was  found  on  the  floor  in  the 
home  on  the  27th  January  2022  but  was  not  thought  to  have  sustained  any 
injury.  That  day  he  was  prescribed  antibiotics  for  a  suspected  urine  infection. 
There  is  no  record  of a  further  review  of his  falls  risk  assessment.  On  the  28th 
January  2022  he  was  found  on  the floor in  his  bedroom  at the  address  and  had 
bruisinq  and  a  lump  to  his  forehead.  He  was  taken  to  Dorchester  Cou nty 

1 

 Hospital  where  a  CT  brain  scan  revealed  he  had  sustained  2  acute  subdural 
haematomas.  His  condition  deteriorated  and  he  was  discharged  back  to  Sidney 
Gale  House  Residential  Home  on  the  22nd  February  2022  where  he  died  on  the 
2nd  March  2022. 

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.  During  the Inquest evidence  was  heard that: 

i. 

ii. 

Sidney  Gale  House  Residential  Home  is  governed  by  Tricuro 
Limited 

Upon  a  person  becoming  a  resident  at the  home,  a  care  plan  is 
put  in  place  which  requires  a  number  of risk  assessments  to  be 
undertaken.  These  risk  assessments,  and  the  care  plan,  are 
reviewed  monthly.  If there  is  an  incident,  such  as  a  fall,  the 
expectation  is  for  the  care  plan  and  the  risks  to  be  further 
reviewed,  however  there 
is  no  formal  policy,  procedure  or 
guidance  document in  place  covering  this. 

iii.  On  the  25th  December  2021  the  deceased  fell  at the  home  and 
was  taken  to  hospital.  He  was  discharged  on  the  27th  December 
2021.  He  fell  again  on  the  27th  January  2022  and  again  on  the 
28th  January 2022 when  the fatal  injury was  sustained. 

iv. 

The  Registered  Manager  of  Sidney  Gale  House  gave  evidence 
that  his  last  falls  risk  assessment  is  documented  to  have  taken 
place  on  the  16th  December  2021.  There  is  no  evidence  one  was 
completed  after  this  prior  to  the  fatal  fall  on  the  28th  January 
2022.  The  monthly review  was  due  on  the  31st  January  2022  and 
there  was  no  assessment  recorded  after  the  falls  on  the  25th 
December 2021  and  27th  January 2022. 

2. 

I  have concerns with  regard  to the following: 

i. 

There  is  no  written  policy  or  guidance  in  place  at  Sidney  Gale 
the  review  of  care  plans 
House  Residential  Home  around 
following  an  incident at the  home  and  this  could  lead  to  a future 
death  is  necessary  risk assessments  are  not undertaken  following 
an  incident occurring. 

6  ACTION SHOULD BE TAKEN 

In  my  opinion  urqent  action  should  be  taken  to  prevent  future  deaths  and  I 

2 

 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,  7th October 2022.  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: 

(1)  Mr Tuck's family 

I  have  also  sent a copy of my  report to the following  people  who  I  believe  have 
a sufficient interest in the contents of it: 

Care  Quality Commission 

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  Dated 

Signed 

12th  Au  ust 2022 

Rachael  C Griffin

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 Tricuro (PDF)
Official 

To:  Rachael Griffin 

Tricuro 

Tricuro  Head Office  0 
Beech House 
28-30 Wimborne Road 
Poole 
Dorset 
BH15 2BU 

& 
e 

www.tricuro.co.uk 

7th  October 2022 

Dear Rachael, 

I write  in  response  to  your letter relating  to  a person  who  resided  in  one  of our services,  we 
have carefully reviewed this event to ensure that this does not happen again and that we have 
sufficient policy and procedures within Tricuro to inform all staff as to what they need to follow. 

Background  information: 

Mr Gerald Tuck (known as Gerry) 
Sidney Gale House,  Flood Lane,  Bridport,  DT6 3QG 

Gerry was admitted to Sidney Gale House Residential Home on  15th January 2017. 
On  admittance a care plan commenced  and  added  to and  changed over time due to differing 
needs  and  outcomes.  All  care  plans  are  reviewed  on  a  monthly  basis  with  input from  the 
resident,  carers and family.  Waterflow etc 
Gerry required  assistance  with  maintaining  all  aspects  of personal  care  throughout  the  day 
and  night.  Gerry was  able  to  mobilise  independently with  the  use  of a Zimmer frame,  he 
chose to spend  all  his time in  his room  including mealtimes.  At night a sensor mat was used 
to alert staff to Gerry getting out of bed  as frequently throughout the night he would  be sat on 
the edge of his bed.  Gerry had the daily paper delivered.  At times it was hard to converse 
with Gerry due to his loss of hearing and  staff would write things down for him to read. 
Gerry lived with the following  health conditions 
Type 2 Diabetes - Insulin administered daily 
Glaucoma 
Essential hypertension 
Atrial Fibrillation 
Mixed  Dementia 
Sensorineural hearing Loss 
Allergy to Trimethroprim, erythromycin and mepore 
A DNAR was in  place 

The Care  Company Wholly Owned by Dorset Council and  Bournemouth, Christchurch  and  Poole 
Council (BCP) 

Tricuro Limited (09536732)  and Tricuro Support Limited (09536638) 
Beech  House, 28-30 Wimborne Road,  Poole, Dorset,  BH15 2BU 
Registered in England and Wales 

L0027 

 
 
 
 I have broken down our response and actions to each area: 

The 25TH of December 2021  - Gerry fell  in  his room 

The service did follow the falls policy and  call for an  ambulance as  it was an  unwitnessed fall, 
and  he takes warfarin.  Gerry also said  he had  hit his head. 
Post fall observations were taken until the ambulance arrived and admitted Gerry into Hospital. 
When  he  returned  to  the  service  he  returned  with  antibiotics  for  an  infection,  and  the  staff 
updated his medications, and  monitored  his health and wellbeing. 
On review of his notes,  I can see staff frequently checked on Gerry and updated his body map 
to reflect a skin tear from  the fall  that the District Nurse was tending to. 

However, what should have happened is that his care plan and  risk assessments were 
reviewed and  updated following his arrival back into the service. 

On  the  26th 
of  January  2022  Gerry  was  visited  by  the  GP  due  to  him  being  unsettled  in 
behaviour and  more  confused,  the  GP  prescribed  some  antibiotics  and  suggested  a trial  of 
Memantine. 

I can see staff recorded checking on  him  frequently. 

On  the  27TH of  January 2022  Gerry had  an  unwitnessed fall,  they stated  no  injuries,  and  they 
did  commence post falls monitoring to  observe for any deterioration and did  not note any. 

However,  given  that  he  takes  warfarin  the  protocol  should have  been  to  contact  the 
ambulance  service  to  assess,  and  his  care  plans  and  risk  assessments  should  have 
been updated. 

On  the 28th of January 2022 Staff contacted  the  GP as they felt he was more confused than 
normal  and  were  awaiting  antibiotics  to  be  delivered,  they  called  the  GP  to  chase  the 
medications. 

Sadly, he later fell and had clearly injured himself as staff observed some blood on the fall and 
they followed  policy by calling for an ambulance. 

Our Falls  policy does state the need to  use the  post falls assessment tool  and  had  this  have 
been used and followed accordingly following his fall on the 27th ot January 2022 the staff would 
have been  guided that as  he takes warfarin medical assistance should be sought. 

To  mitigate  further  risks  we  have  uploaded  the  post  falls  assessment  tool  to  the 
electronic recording  system that  is  used  to ensure staff do  see,  follow  and  record  on 
this. 

The  falls  policy  has  been  reviewed  and  updated  to  reflect  the  need  of anticoagulant 
recognition and escalation following an fall. 

The  Care  Com pany Wholly Owned by Dorset Council and  Bournemouth, Christchurch and  Poo 
Cou nciI ( BCP) 

Tricuro Limited (09536732)  and Tricuro Support Limited (09536638) 
Beech  House, 28-30 Wimborne Road,  Poole,  Dorset,  BH 15 2BU 
Registered in  England and Wales 

 Our policy also reflects that staff are expected to update the falls risk assessments and mobility 
care  plans after any fall to  ensure that the care,  support and  risks are managed accordingly. 
We  have ensured that all  staff within the service and  the wider company are very clear of the 
policy and that this must be  followed. 

Tricuro  have also  now introduced  a live  accident and  Incident reporting  system,  this  means 
that any falls  or other accidents  or incidents are  directly available  for our quality assurance 
teams to see,  our locality team  and  the registered  managers. 

This  means that we  can  instantly check that the  service  has carried  out all  of the  necessary 
actions in response to events and that the persons support plan and  risk have been actioned. 
We also have created a policy and procedure for any deaths in service which details the need 
to  investigate any unexpected deaths,  this  will  prevent us from  being  unaware at head  office 
of anyone who sadly passes away. 

Death  reports  are  now  reported  internally  to  Head  Office  which  means  we  can  review  all 
reports to ensure that deaths were handled appropriately but also to ensure that the care and 
support prior to this was as  it should  be. 

Services are ensuring that falls are monitored within service level and any root cause analysis 
learnt  or 
is  completed  and  actioned  as  needed,  managers  share  any 
recommendations with  other services. 

lessons 

Furthermore,  we  have falls  focus group which  means we  are able to  keep staff updated and 
reiterate the falls policy process and  importantly how to  reduce the risk of falls . 

Tricuro also now have a monthly safeguarding and accidents/incident report that is  presented 
at Senior leadership meetings for scrutiny and review. 

I hope this  provides  you  with  the  assurances you  need  relating  to  this  event and  to  prevent 
and mitigate any future risks. 

Please do let me know if you  require any additional  information. 

) 

J 

Yours sincerely 

Executive Director of Operations 

The  Care  Com pany Wholly Owned  by Dorset Council and  Bournemouth, Christchurch and  Poo 
Cou nciI ( BCP) 

Tricuro Limited (09536732)  and Tricuro Support Limited (09536638) 
Beech  House, 28-30  Wimborne Road,  Poole,  Dorset, BH1 S 2BU 
Registe red in England and Wales

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