Prevention of Future Deaths reports · 2023

Terence Burns

Regulation 28 report to prevent future deaths, reference 2023-0243, written 14 Jul 2023. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report14 Jul 2023
Reference2023-0243
DeceasedTerence Burns
CoronerAndrew Cousins
Coroner areaBlackpool & Fylde
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) 

REGULATION 28 REPORT TO PREVENT FUTURE DEATHS 

THIS REPORT IS  BEING  SENT TO:  HIGHGROVE REST HOME, BLACKPOOL 

1 

CORONER

I am Andrew Cousins, Assistant Coroner, for the area of 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. 

3 

INVESTIGATION and INQUEST 

On  10  July  2023,  at  an  inquest  held  at  Blackpool  Town  Hall,  I  returned  a  short  form 
conclusion that Mr Terence Burns died as a result of misadventure. 

I found the cause of death to be: 

1 (a) Choking 

ii  Bronchopneumonia and  brain  infarct 

4 

CIRCUMSTANCES OF THE DEATH 

I returned the following in  box 3 of the  Record of Inquest recorded: 

Mr Terence  Burns was  resident at  the  Highgrove  Rest  Home,  Blackpool.  The care  plan 
that was  put  in  place for Mr Burns  included  that  he  required  a  blended  food  diet.  On  28 
October 2022,  Mr Burns' physical condition deteriorated and an  ambulance was called to 
the Highgrove Rest Home. When Mr Burns was transferred to Blackpool Victoria Hospital, 
to  North  West  Ambulance  Services. 
his  dietary  requirements  were  not  notified 
Consequently, during his course of treatment, the dietary requirements for Mr Burns were 
not  known  by  Blackpool  Victoria  Hospital.  During  the  evening  of 28  October 2022,  Mr 
Burns  was  given  a  sandwich  to  eat  at  Blackpool  Victoria  Hospital.  At  approximately 
22.52hrs on  28 October 2022,  Mr Burns was found  unresponsive  in  the  hospital  cubicle 
with  food  reside  in  his  throat.  Mr  Burns  displayed  no  breathing  effort  and  died  at 
approximately 23.00hrs. 

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 evidence in this case was that Mr Burns had a history of food aspiration, and following 
an assessment by the SALT team,  he was  placed  on  bended diet. 

The  written  care  plan  that  was  in  place  at  Highgrove  Rest  Home  did  not  contain  the 
information  that  Mr  Burns  required  a  blended  diet.  Having  heard  the oral  evidence from 
the two carers who attended the  inquest to  give evidence,  I accepted that Mr Burns was 
being fed  a blended diet in  advance of his attendance at hospital on 28 October 2022. 

I found  that the  monthly reviews  of the  care  plan,  that were carried  out on  4 September 
and 8 October 2022, did not amend the care plan to include the  need for a blended diet, 
and accordingly the written care plan did not accurately define the nutritional needs of Mr 
Burns.  This  missing  information  from  the  care  plan  was  a  concern  for  me  as  the 
documentary evidence relating to the nutritional requirements of Mr Burns was not correct. 

Furthermore,  I  was  concerned  that  the  oral  evidence  that  I  heard  at  the  inquest, 
established that the documents handed over to North West Ambulance Services when Mr 
Burns was taken to  hospital, were  not checked . When  Mr Burns was taken to  hospital,  it 
could  not be  ascertained what information was sent with  Mr Burns to enable the  hospital 
to meet his care needs. 

I found that these matters gave rise to a risk of further death and engaged my duty under 
paragraph  7,  Schedule  5,  of the  Coroners  and  Justice Act 2009 and  regulations  28  and 
29 of the Coroners (Investigations) Regulations 2013. 

6 

ACTION SHOULD BE TAKEN 

In  my opinion action should  be taken to  prevent future deaths and  I 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, 
namely by 8 September 2023.  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: 

The family of Terence Burns 

The 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. 

2 

 9 

Andrew Cousins 

~ ' I f '~  

Assistant Coroner for Blackpool & The Fylde 
Dated: 14 July 2023 

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 Highgrove Rest Home (PDF)
Introduction:

Following the tragic death of TB and the subsequent Coroner's inquest, it was ordered
that we, as the resident's care provider, submit our plan of necessary actions in order to
eliminate the risk of future such occurrence. | therefore set out below our itinerary of
actions taken, those actions which are currently in progress and our proposed future
actions, Although systems and processes were in place for the updating of care plans
and hospital passports, we acknowledge that in this very sad case these were not
followed, because of this a more robust system was implemented. These are as follows:

Actions taken

* Hospital passports are checked by two members of senior staff weekly.

* Care Plans are updated monthly or when any changes to care are required by a
senior member of management.

¢ Implementation of hospital passport checklist

* Northwest Ambulance service to sign hospital checklist to say information has
been passed over.

e Provider contacted Northwest Ambulance Service to discuss hospital checklist
implemented due to ambulance staff being reluctant to sign receipt of the
documents, meeting held with Stuart Hall NWAS, Alison Ricchiuti, Fyide Coast
Care Home Lead and Lisa Wright Care Home Administrator to discuss.

Actions currently being taken

¢ Digital Care Records are in the process of being implemented.

« Staff are currently being trained in the use of the digital care system.

¢ Senior management inputting all residents’ details to ensure concise accurate
information is inputted, this is checked by a second person.

¢ We have signed up to a Registered Managers Forum to share views and
information to improve our service.

Future actions
e See attached document outlining the suggested implementation of "Urgent
transfer from care home to hospital” docurnent.

Conclusion:

It is my sincere belief that with the implementation of the above listed actions, there is a
minimum likelinocd of the recurrence of the type of death suffered by our resident, TB. !
believe that where there is more than one agency involved in the care of a resident from
a care home, it is vitally important that all parties act collaboratively to ensure the safety
and wellbeing of that resident. As illustrated above, | believe the initiative to be jointly
undertaken between ourselves, other care providers and the local ambulance service
provides critical assurances regarding the safety of residents. The other measures which
we have undertaken contribute significantly towards the minimisation of risk sirnilarly.

In summary, | believe that by the implementation of each of the actions as set out
above, we provide maximum assurance of the safety to our residents, particularly at the
most vulnerable moments. The lessons learned from this tragic event are substantial,
and | believe that we have now addressed each aspect of risk, although we continue to
learn and react accordingly and appropriately.

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