Prevention of Future Deaths reports · 2024

John MacGregor

Regulation 28 report to prevent future deaths, reference 2024-0129, written 6 Mar 2024. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report6 Mar 2024
Reference2024-0129
DeceasedJohn MacGregor
CoronerHugh Bricknell
Coroner areaHerefordshire
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.

H G Mark Bricknell 
Senior Coroner 
for County of Herefordshire 

6th  March 2024 

REGULATION  28 REPORT TO PREVENT FUTURE DEATHS 

THIS REPORT IS  BEING SENT TO: 

, Care  Home Manager, Credenhill Court Rest  Home, 

Hereford. 

1 

CORONER 

I am  Hugh  Gregory Mark Bricknell, Senior Coroner for County of Herefordshire 

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. 
http ://www.legislation.gov.uk/ukpga/2009/25/schedule/S/paragraph/7 
http://www. legislation .gov. u k/u ksi/2013/1629/part/7/made 

3 

INVESTIGATION and  INQUEST 

On  28 April  2023  I commenced an  investigation into the death of John  Patrick MacGREGOR. The 
investigation concluded at the end  of the inquest on  28  February 2024. The conclusion  of the inquest 
was  'Narrative' - Mr MacGregor fell  at Credenhill Court Rest  Home on the 2nd April  2023.  Substantive 
medical intervention did not take place until the 13th April 2023 when he was profoundly unwell. 

4 

CIRCUMSTANCES OF THE DEATH 

Patient admitted with chest pain and shortness of breath after a fall in a care home. He was found to 
have a left sided hydropneumothorax, fractured right proximal humerus and Ll end plate compression 
fracture. A chest drain was inserted and  drained well on the ward and he was  receiving IV antibiotics. He 
was  reviewed by geriatricians and  respiratory physicians, who assisted in optimising his management. He 
was also reviewed  by T&O for his fracture. However, his infection markers did not improve after 7 days 
of IV antibiotics and IV antifungals. 

He  became significantly more unwell with fluctuations in  blood pressure and  increasing oxygen 
requirements. A chest x-ray showed a right sided-HAP.  He was already receiving the antibiotic of choice 
for this with no improvement and  a decision was  made to start him on the end  of life pathway.  There 
was  concern regarding the lapse oftime from the fall to hospital admission. 

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.  -
Evidence was heard regarding: 

(a)  The quality of residents care documentation and its completion . 
(b)  Procedures regarding escalation or non-escalation following a fall and subsequent medical 

intervention 

6 

ACTION SHOULD BE TAKEN 

In  my opinion action should be taken to prevent future deaths and I believe you, 
Home Manager have the power to take such  action . 

, Care 

7 

YOUR RESPONSE 

You  are under a duty to respond to this report within 56  days of the date of this report,  namely by 
1 May 2024.  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; 

. I have also sent it to Herefordshire Council and the CQC who may find it useful or of interest. 

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 

6 March 2024 

Signature n 

I 

\ 

HG  Mark B~ tM  Senior Co1  ner: Herefor  shire

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 Credenhill Court (PDF)
CREDENHILL COURT 
REST HOME 

Credenhill, Hereford, HR4 7DL 

24th April 2024 

HG Mark Bricknell 
HM Senior Coroner 
Town Hall 
St.  Owen Street 
Hereford HRl 2PJ 

Dear Mr. Bricknell, 

Ref: John Patrick MacGregor 

I am writing in response to the regulation 28 report to prevent further deaths dated 6th March 
2024. The following action has been taken: 

•  Credenhill Court Rest Home no longer facilitates respite residents. After reviewing the 

respite care plan we feel, although affective in  its short term use it is not as robust as our 
caredocs care planning system. 

•  Senior care staff have been supported through weekly discussions to ensure they are 

confident in documenting the needs of each  resident, they are able to capture everything 
on a day to day basis and any concerns raised are being addressed and documented. The 
notes are being regularly reviewed and audited. 

•  The falls protocol has been reviewed and we believe it is affective and each fall is taken on 
its own merit, any concerns beyond the parameter of the protocol we seek support and 
guidance from the appropriate health professionals i.e. doctors or paramedics and this 
documented. The falls continue to be audited each  month to highlight any trends and to 
ensure the correct professional has been contacted. Any minor fall that takes place at 
Credenhill Court Rest  Home the senior on duty emails the GP care home ad min group and 
this resident is then reviewed on the weekly ward round and notes are added to their 
individual patient records.  Each  resident regardless of the severity of the fall and their 
capacity have 24-48 hour monitoring in the form of blood pressure, pulse and body map 
notes. 
I have reviewed our weekly ward round and a list of residents that need to be seen are 
emailed to the GP surgery 24 hours in advance. Once the residents have been seen we now 
receive a record of actions taken by the GP/ECP that visited. These actions are then added 
to the individual resident's health notes within their care plan and any omissions can  be 
identified. 

• 

•  The medication processes for residents taking blood thinners has been reviewed by the GP 

surgery and there are no concerns with the process we have in place although we 
ourselves have added an  additional safeguard by including an alert sheet that can  be found 
within the medication administration sheet. 

 
 
 • 

In addition to our verbal handover and residents information board on display to all care 
staff in the office, to facilitate and capture more extensive notes for the daily records we 
have implemented a written daily handover sheet that care staff will complete and this will 
then be added to each residents daily records. 

•  Care plans continue to be regularly reviewed and audited monthly or when required. 
I will carry out daily audits of the daily notes that have been written and continue to 
• 
support staff to ensure that the quality of our written documentation is upheld. 

If you require any further information please do not hesitate to contact me. 

Yours sincerely 

Care Manager

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