Prevention of Future Deaths reports · 2022

Kenneth Goodwin

Regulation 28 report to prevent future deaths, reference 2022-0318, written 14 Oct 2022. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report14 Oct 2022
Reference2022-0318
DeceasedKenneth Goodwin
CoronerLauren Costello
Coroner areaManchester South
CategoryHospital Death (Clinical Procedures and medical management) related deaths
Organisation namedStockport NHS Foundation Trust
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: 

1.  Chief Executive, Stockport NHS Foundation Trust 

1 

CORONER 

I am Lauren Costello, Assistant Coroner, for the Coroner Area of 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 14th June 2022 I commenced an investigation into the death of Kenneth 
Goodwin then aged 86 years. The investigation concluded at the end of the 
inquest on 9th October 2022. At the end of the Inquest, I recorded a narrative 
conclusion that Mr Goodwin died as a result of an acute subdural haematoma 
following a fall. 

  The medical cause of death being  

  1a    Traumatic Subdural Haematoma 

   II     Cholecystitis 

1 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 4 

CIRCUMSTANCES OF THE DEATH 

Kenneth Goodwin was admitted to hospital on 1st June 2022 with severe abdominal pain 
and was treated for sepsis from gall stones and cholecystitis. The infection for which he 
was admitted was gradually improving during his admission following conservative 
treatment.  

Mr Goodwin’s family confirmed to the hospital that he was a falls risk. 

On 3rd June 2022 he had a fall in hospital and banged his head, likely on his hospital bed. 
The fall occurred after being transferred from one ward to another during the night. He was 
transferred at 21:09 and the fall occurred at 01:40 before a falls risk assessment had been 
completed on the new ward. After transfer he displayed signs of confusion and wished to 
get out of bed to use the bathroom despite being catheterized.  The Inquest heard that it 
was unclear if the bed rails were used. 

As a result of the fall, he developed an acute subdural haematoma. This was treated 
conservatively but despite treatment he deteriorated and died on 9th June 2022 whilst still 
at Stepping Hill Hospital. 

Stepping Hill Hospital have taken steps to reduce nighttime transfers for patients 
experiencing confusion or who are at risk of falls. 

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 MATTER OF CONCERN is as follows. – 

(1)  The Inquest heard that the transfer process between wards for patients at risk of 
falls does not require a specific written confirmation that a handover in relation to 
that risk has taken place. 

(2)  The falls risk assessment on the new ward was not completed for just over 4.5 
hours.  The Inquest heard that the target time for this assessment is within 6 
hours, a length of time which is of concern for patients transferred at night, 
displaying signs of confusion, and already identified as a fall risk. 

(3)  The Inquest heard that the use of signs on beds to visually identify falls risk to the 

staff is not consistently used. 

6 

ACTION SHOULD BE TAKEN 

In my opinion action should be taken to prevent future deaths and I believe you and 
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 6th December 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. 

2 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 8 

COPIES and PUBLICATION 

I have sent a copy of my report to the Chief Coroner and to the following Interested 
Persons: 

 of Hempsons, solicitors to the Trust 

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. 

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 

DATE     

                 SIGNED BY CORONER   

14th October 2022                 

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 Stockport NHS Foundation Trust (PDF)
Stockport 
NHS Foundation Trust 

Oak House 
Stepping Hill Hospit91 
Poplar Grove 
Stockport
SK2 7JE 

Private and  confidential 
By email. 

Ms Lauren Costello 
Assistant Coroner 
Coroner's Court 
Mount Tabor 
Mottram Street 
Stockport 
SK13PA 

5 December 2022 

Dear Ms Costello 

Re:  Kenneth  GOODWIN (Deceased) 

I am  writing  to  you  further to  the  inquest of the  late  Kenneth  Goodwin,  which  concluded  on  9  October 2022 
and the concerns you  have raised  relating to the care provided to  Mr Goodwin by this Trustin June 2022. 

I  am  grateful  to  you  for  highlighting  these  concerns  and  for  providing  me  with  an  opportunity  to  respond.  I 
  Matron  for  Surgery, 
asked 
, 
,  Matron  for  Patient  Experience  and  Quality  Improvement  and 
Governance and Quality Manager for the Division of Surgery to investigate on  my  behalf.  They have reviewed 
the matters of concern which arose during the inquest and these are: 

,  Deputy  Director  of Quality  Governance, 

The Inquest heard that the transfer process between wards for patients at risk of falls  does not require 
a specific written confirmation that a handover in  relation to that risk has taken place. 

· 

· 

We can  confirm that the Trust does have i.n  place a formal  hand over document that,  amongst other important 
information,  highlights  whether  or  not  a  patient  is  at  risk  of falls.  This  information  is  completed  and  handed 
over for all  patients who are transferred from  one  area to  another.  In  Mr Goodwin's case,  it has come to  light 
that  staff on  ward  D6  used  a  hand  over document that was  not  formally  authorised  for  use  and  this  did  not 
contain  the  patients falls  risk status.  This  therefore  meant that although  standard  process would  ensure  that 
the handover of risk of falls would be communicated  upon  patient transfer,  that this did  not happen  in  th.e  case 
of Mr Goodwin,  and for that we apologise. 

Action  - The  Trust's  formal  patient handover document was  re-launched  across  the  Trust on  15  November 
2022,  via  the  Trust's  'Risky  Business'  weekly  bulletin  and  also  via  targeted  e-mails  from  the · divisions 
governance  teams.  Alongside  this  all  unauthorised  handover documents  have  been  removed  from  use.  The 
use of the  h.andover document will  be  audited  by  the  senior nursing  team  during  their ward  audit programme 
to  ensure that the  correct handover document is  reliat>ly  utilised.  The  patient handover document will  also  be 
a focus of a senior nurse walkround led by  the Chief Nurse to  highlight the importance .of communication  upon· 
transfer of all appropriate risks. 

· 

The  falls  risk  assessment on  the  new ward  was  not completed  for just over 4.5  hours.  The  Inquest 
· heard that the target time  for this  assessment is  within  6  hours,  a length  of time which  is  of concern 

for patients transferred at night, displaying signs of confusion, and already identified as  a fall  risk. 

The Trust can  confirm that there is a six hour standard for risk assessments to  be  completed following transfer 
of a patient to  a ward.  This window allows the receiving  team to admit the patient into their care,  undertake all 

 
 
 
 
 
 appropriate care for the  patient,  and  document any  necessary risk assessments.  This timeframe is  in  line with 
other NHS  acute  providers  and  recognises  the  time  required  to  complete  accurate  medical  documentation 
whilst caring, for the patient. 

_We  do  however recognise that alongside this process that there must be  a reliable  process to  identify  risks  to 
patients on  handover,  such  as the  risk of falls.  Alongside the admission process documents referenced  above, 
the  transfer process  includes transfer of the  patient's  medical  records  and  formal  patient  handover document 
to  provide  the  receiving  ward  with  all  necessary  details  relating  to  patient  risk  factors.  The  formal  handover 
document is  imperative for patients regardless of time  of transfer and where the patient is transferred to within 
hospital to  ensure that there is  a standardised and  reliable  method of immediate communication  regarding  key 
patient  information.  We  again  apologise  that  in  the  case  of  Mr  Goodwin  that  the  correct  formal  handover 
document was not used. 

The  Inquest  heard  that  the  use  of  signs  on  beds  to  visually  identify  falls  risk  to  the  staff  is  not 
consistently used. 

The  Trust  uses  a  maple  leaf sign  to  identify  patients  at  risk  of falls.  In  the  case  of Mr  Goodwin  we  have 
identified  that  an  agency  nurse  was  not  aware  of the  need  for  the  use  of the  maple  leaf  sign.  The  Trust 
recognises that all temporary staff must be  made familiar with Trust policy and  practice for each  area in which 
they work. 

Action  - The  requirement  for  the  use  of  the  maple  leaf  sign,  identifying  patients  at  risk  of  falls,  was  re­
launched across the Trust on  15  November 2022,  via the Trust's 'Risky Business' weekly bulletin and  also via 
targeted  e-mails from  the  divisions governance teams.  The  requirement for the  use  of the  maple  leaf sign will 
also  be  added  on  all  agency  staff induction  check  lists  to  ensure  that  their  use  is  explained  to  staff who  are 
new to the organisation.  Completion of the checklists is already induded within the audit pmgramme. 

Once again  I would  like to  thank you  for giving  me  the  opportunity to  respond  to your concerns  and  trust that 
my  response  has  been  helpful to you.  If there are -any  areas where  I could  provide further clarification,  please 
do not hesitate to get in  touch. 

Yours sincerely, 

Chief Executive 

2

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