Prevention of Future Deaths reports · 2022

Diane Austin-Martin

Regulation 28 report to prevent future deaths, reference 2022-0286, written 14 Sep 2022. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report14 Sep 2022
Reference2022-0286
DeceasedDiane Austin-Martin
CoronerAlison Mutch
Coroner areaManchester South
CategoryOther 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:  Secretary of State for Health and 
Social Care 

1  CORONER 

I am Alison Mutch, Senior Coroner, for the Coroner Area of Greater 
Manchester South 

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 23rd  March 2021 I commenced an investigation into the death of 
Diane Austin-Martin. The investigation concluded on the 29th  July 2022 
and the conclusion was one of Narrative: Died from natural causes 
contributed to by neglect.  The medical cause of death was 1a) 
General debility from multiple sclerosis exacerbated by urinary tract 
infection, pressure ulcerations and low body mass index 

4  CIRCUMSTANCES OF THE DEATH 

Diane Margaret Austin-Martin was a vulnerable adult with significant 
health issues including multiple sclerosis. She had significant care needs. 
She moved to Stockport. The Social Services team in Northern Ireland 
who had been working with her did not notify Stockport Metropolitan 
Borough Council of the move or seek to make robust enquiries to ensure 
the private care in Stockport would be appropriate. She was therefore not 
visible to Stockport Social Services. A claim was made and accepted by 
the Department for Work and Pensions for care support for her. Regular 
payments commenced. There was no evidence of any quality assurance 
in relation to the care provided. She was seen once by the GP. An 
attempt to refer to secondary care was unsuccessful and she was never 
seen or assessed by Multiple Sclerosis Services. Her carers were the 
people she lived with. The level of care was wholly inadequate to meet 
her needs. On 22nd March 2021 when police attended the address she 
was found to have multiple pressure ulcers and be severely underweight. 
She was found in filthy, squalid living conditions. 

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 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.  The inquest heard evidence that there was no clear mechanism to 
ensure that Social Services were aware of her move despite her 
vulnerability having being identified whilst she resided in Northern 
Ireland. As a consequence Social Services were unsighted as to 
her being resident in Stockport; 

2.  DWP were aware of her presence and payments were made 

recognising her needs but there was no mechanism to ensure that 
the care provided was of an appropriate quality; 

3.  The inquest heard that where a private care arrangement exists as 
in this case there is no mechanism to ensure that the care is of a 
sufficient and appropriate quality in contrast to a resident of a care 
home; 

4.  After her initial claim for payment and her initial GP visit she 

dropped out of sight of agencies until she was found. 

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 9th  November 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 namely 
may find it useful or of interest. 

 on behalf of the Family, who 

I am also under a duty to send the Chief Coroner a copy of your 
response. 

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 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 

Alison Mutch 
HM Senior Coroner 

14.09.22 

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 Department of Health and Social Care (PDF)
From Helen Whately 
Minister of State for Social Care 

39 Victoria Street 
London 
SW1H 0EU 

Alison Mutch 
Senior Coroner for the Coroner Area of  
Greater Manchester South 
Coroner’s Court 
1 Mount Tabor Street 
Stockport 
SK1 3AG 

12 June 2024 

Dear Ms Mutch, 

Thank  you  for  your  letter  of  14  September  2022  to  the  then  Secretary  of  State  for 
Health and Social Care at the time Thérèse Coffey, about the death of Diane Austin-
Martin. I am replying as Minister with responsibility for social care.   

Firstly,  I  would  like  to say  how saddened I was  to  read of  the  circumstances  of  Ms 
Austin-Martin’s death, and I offer my sincere condolences to her family. I am grateful 
to you for bringing these matters to my attention.  

Your first concern referred to the lack of a mechanism to ensure that Social Services 
were  aware  of  her  move  despite  her  vulnerability  having  been  identified  whilst  she 
resided  in  Northern  Ireland.  Having  made  enquiries  to  the  Department  of  Health 
Northern  Ireland  (NI),  we  can  advise  that  there  are  general  duties  about  making 
necessary  services  available  under  the  HPSS  (NI)  Order  1972  and  the  Chronically 
Sick  and  Disabled  Persons  (NI)  Act  1978.  There  is  also  the  NI  policy  ‘Adult 
Safeguarding: Prevention and Protection in Partnership: 2015’. Paragraph 14.2 of this 
policy references information sharing for safeguarding purposes. 

The use of these pieces of legislation would depend on an individual assessment of 
need.  NI  officials  have  advised  that  it  would  be  good  practice  to  offer  support  and 
guidance to someone moving and make referrals in accordance with an assessment 
of need at this point. 

In  relation  to  the  second  and  third  concerns  you  raised,  adult  safeguarding  is 
particularly relevant. Given that it is good practice for a local authority’s Safeguarding 
Adults Board (SAB) to work with coroners, you may wish to write to the local SAB for 
further  information  about  this  case,  including  whether  the  SAB  has  considered  a 
Safeguarding Adults Review (SAR).  

1 

 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 Adult safeguarding is relevant because local authorities have a duty, under the Care 
Act 2014, to make enquiries when they suspect that an adult with care and support 
needs is a) at risk of abuse or neglect and b) unable to protect themselves as a result 
of  those  needs.    You  were  concerned  that  there  is  no  mechanism  to  ensure  that 
domiciliary care is of a sufficient and appropriate quality, in contrast to regulation of 
care  homes.  While  it  is  correct  that  CQC  does  not  inspect  unregulated  home  care 
settings, local authority adult safeguarding duties do provide a mechanism by which 
to investigate private home care arrangements if the quality of care puts the cared-for 
person at risk of harm.  

According to the care and support statutory guidance, safeguarding adults with care 
and  support  needs  is  everyone’s  business  and  multi-agency  working  is  vital.  Local 
authorities  must  co-operate  with  such  other  agencies  or  bodies  as  it  considers 
appropriate in the exercise of its adult safeguarding functions, including primary and 
secondary healthcare services. This is described in section 6(7) of the Care Act 20141, 
and those partners must also co-operate with the local authority in the exercise of their 
functions relevant to care and support including those to protect adults.  This means 
that, if a local authority conducts a safeguarding enquiry and finds that action must be 
taken to protect the adult in question, local partners must cooperate and lead on that 
action when required. 

In addition, the Care Act 2014 requires each local authority to set up a Safeguarding 
Adults  Board  (SAB).  SABs  are  required  to  carry  out  a  Safeguarding  Adult  Review 
(SAR)  of  a  case  involving  an  adult  in  its  area  with  needs  for  care  and  support  in 
circumstances where an adult has died, and the SAB knows or suspects the death 
resulted from abuse or neglect (whether or not they knew this at the time of death). 

Your  fourth  and  final  concern  noted  that  Ms  Austin  Martin  dropped  out  of  sight  of 
agencies. NHS England has noted that there are robust processes in place across the 
Stockport GP population around the management of newly registered patients.  The 
expectation is that following registration, an initial appointment will be offered to the 
patient  which  would  include  an  assessment  of  medical  needs,  the  prescribing  of 
medications,  and  a  plan  agreed  for how care  will  be  managed  moving  forward and 
when any regular medications will be reviewed.   The GP Practice where this patient 
was  registered,  have  confirmed  that  Ms  Austin-Martin  was  seen  at  a  face-to-face 
consultation  on  6th  November 2019  shortly  after  registering  on  30th  October.    She 
was  identified  to  have  Multiple  Sclerosis  (MS)  and  asthma  requiring  ongoing 
management with medications, that were duly prescribed and a follow up with local 
MS service (a referral was created to this effect) had been arranged.  She was advised 
to book in for an asthma review with the practice nurse alongside being offered (but 
declined)  a  seasonal  influenza  vaccination.    As  far  as  the  practice  were  aware, 
appropriate follow up and referral had been initiated following her initial consultation 
to address her long-term conditions and medication requirements. 

NHS England has confirmed that this is within the level of expectation of when a new 
patient  registers  with  a  GP  in  Stockport  and  on  this  occasion  all  appropriate  steps 
appear  to  have  been  taken  to  complete  her  initial  registration  assessment  and  to 

1 https://www.legislation.gov.uk/ukpga/2014/23/section/6/enacted  

 
 
 
 
 
 address her long-term conditions and medication requirements with appropriate follow 
up planned. 

NHS England have advised they are seeking further clarity on why the annual reviews 
for Multiple Sclerosis did not take place. 

I hope this response is helpful. Thank you for bringing these concerns to my attention. 

Yours sincerely,  

HELEN WHATELY

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