Prevention of Future Deaths reports · 2025

Jack Brown

Regulation 28 report to prevent future deaths, reference 2025-0593, written 18 Nov 2025. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report18 Nov 2025
Reference2025-0593
DeceasedJack Brown
CoronerSophie Lomas
Coroner areaNorthamptonshire
CategoryHospital Death (Clinical Procedures and medical management) 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

NOTE: This form is to be used after an inquest.

REGULATION 28 REPORT TO PREVENT DEATHS

THIS REPORT IS BEING SENT TO:

1 Secretary of State for Health and Social Care

1

CORONER

I am Sophie LOMAS, Assistant Coroner for the coroner area of Northamptonshire

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 February 2023 I commenced an investigation into the death of Jack Richard BROWN
aged 86. The investigation concluded at the end of the inquest on 24 October 2025. The
conclusion of the inquest was that Mr Brown died due to natural causes.

4

CIRCUMSTANCES OF THE DEATH

Mr Brown was an 86 year old gentleman who had been admitted to a care home following a
hospital stay for heart failure and hyponatraemia. He was suffering from delirium and
required constant 1:1 observations, along with help with all activities of daily living.

Against that background, on the evening of 25th January 2023 Jack was assisted to the
toilet by the night carer. He was sleepy and indicated that he wanted to stay on the toilet.
He remained on the toilet asleep between approximately 9.30pm and 7.30am. Attempts
were made during that time to rouse him but he remained asleep. At 8am on 26th January
2023 a handover of care staff took place and the day carer raised a concern that Mr Brown
was unresponsive. Further staff checked Mr Brown and recognised that he had sadly died.
His death was confirmed by paramedics who attended the scene.

A post-mortem examination concluded that Mr Brown had died due to ischemic heart
disease.

5

CORONER’S CONCERNS

During the course of the investigation my inquiries 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 MATTERS OF CONCERN are as follows:
(brief summary of matters of concern)

At the inquest the court heard evidence that care agencies who provide agency care staff to
care / nursing homes do not need to register with the CQC and are not regulated by any
other body. The activites of such agencies are therefore not inspected or checked to ensure
that they have rigerous recruitment processes and there is no one to report matters to
when a concern is identified.

This gives rise to a concern as care homes may rely on agencies to vet agency carers and

Regulation 28 – After Inquest
Document Template Updated 30/07/2021

 have minimal input into suitability and training for the role. This creates a risk that agency
care staff, who may be wholly unsuitable for the role, are providing care to vulnerable
people without basic checks as to experience and suitability. This places service users at
risk of harm and gives rise to a risk that future deaths could occur.

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 January 13, 2026. 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 Jack Brown

I have also sent it to

Care Quality Commission (CQC)

who may find it useful or of interest.

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.

I may also send a copy of your response to any person who I believe may find it useful or
of interest.

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: 18/11/2025

Sophie LOMAS
Assistant Coroner for
Northamptonshire

Regulation 28 – After Inquest
Document Template Updated 30/07/2021

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 for Health and Social Care (PDF)
Minister of State for Care  

39 Victoria Street  
London  
SW1H 0EU 

8th January 2026 

Sophie Lomas 
HM Assistant Coroner  
The Guildhall 
St Giles’ Square 
Northampton 
NN1 1DE 

Dear Ms Lomas,  

Thank you for the Regulation 28 report of 18 November 2025 sent to the Secretary of State 
of the Department of Health and Social Care about the death of Mr Jack Richard Brown. I 
am replying as the Minister with responsibility for Adult Social Care (ASC).       

Firstly, I would like to say how saddened I was to read of the circumstances of Mr Brown’s 
death and I offer my sincere condolences to his family and loved ones. The circumstances 
your report describes are concerning and I am grateful to you for bringing these matters to 
my attention.  

Your report raises concerns that because care agencies, who supply agency care staff to 
care and nursing homes, are not regulated by the Care Quality Commission (CQC), there is 
a risk that agency care staff “are providing care to vulnerable people without basic checks 
as to experience and suitability”, which “places service users at risk of harm”. 

In preparing this response, my officials have made enquiries with the CQC to ensure we 
adequately address your concerns. 

Matters of concern: 

•  At the inquest the court heard evidence that care agencies who provide agency care 
staff  to  care  /  nursing  homes  do  not  need  to  register  with  the  CQC  and  are  not 
regulated  by  any  other  body.  The  activities  of  such  agencies  are  therefore  not 
inspected or checked to ensure that they have rigorous recruitment processes and 
there is no one to report matters to when a concern is identified. This gives rise to a 
concern as care homes may rely on agencies to vet agency carers and have minimal 
input into suitability and training for the role. This creates a risk that agency care staff, 

 
  
 
 
 
 
 
 
 
 
 
 
 
  
 
  
 
 who may be wholly unsuitable for the role, are providing care to vulnerable people 
without  basic  checks as  to experience  and suitability.  This places  service  users  at 
risk of harm and gives rise to a risk that future deaths could occur.   

Care providers are required to be registered with the CQC where they carry out a regulated 
activity  –  as  described  in  the  Health  and  Social  Care  Act  2008  (Regulated  Activities) 
Regulations  2014.  However,  employment  agencies  do  not  usually  carry  out  regulated 
activity and as such do not typically need to be registered. 

Care homes and nursing homes do typically carry out regulated activity and therefore are 
registered with CQC. CQC requires all health and social care providers registered with them 
to  deploy  enough  suitably  qualified,  competent  and  experienced  staff  (including  both 
registered  and  unregistered  professionals)  to  enable  them  to  meet  all  other  regulatory 
requirements described in Regulation 18 Staffing of the Health and Social Care Act 2008 
(Regulated Activities) Regulations 2014. These regulations apply to providers who recruit 
care staff via employment agencies. It is the responsibility of the regulated provider to ensure 
robust and safe recruitment practices are in place, and to make sure that all staff, including 
agency staff, are suitably experienced, competent and able to carry out their role. 

Providers  must  also  ensure  staff  receive  appropriate  training  and  supervision,  and  are 
supported to obtain further qualifications. Staff who are registered with a health care or social 
care  regulator,  including  health  care  professionals,  social  workers or  other  professionals, 
must be supported to provide evidence to the appropriate regulator to show that they meet 
the professional standards needed to continue to practise. Whilst individual care workers, 
including agency staff, are expected to act competently and in line with regulations, the legal 
duty  to  comply  with  CQC  regulations  sits  with  the  registered  provider  and  registered 
manager. CQC cannot prosecute for a breach of Regulation 18, but CQC can take regulatory 
action such as issuing a warning notice to the provider to make improvements. 

Further to those regulatory safeguards, the department is committed to enhancing the skills 
of  staff  working  in  adult  social  care,  including  those  employed  by  agencies.  It  is  vital  to 
ensure  that  the  care  provided  is  of  good  quality,  fair,  personalised,  and  accessible.  The 
department  is  supporting  the  professionalisation  of  the  workforce  through  a  range  of 
activities which agencies can access for their employees. We recently revised and expanded 
the Care Workforce Pathway, the first national career structure for adult social care. This 
sets  out  the  knowledge,  skills,  values,  and  behaviours  needed  to  work  in  the  sector  and 
provides a framework for progression and development.  

The department also launched the Adult Social Care Learning and Development Support 
Scheme in September 2024, backed by up to £12 million this financial year for eligible care 
staff to undertake courses and qualifications, including the new Level 2 Adult Social Care 
Certificate. Developed from the Care Certificate standards, the Level 2 Adult Social Care 

 
 
 
 
  
 
 
 
 
 Certificate has been designed to support people in care roles to have the most up to date 
knowledge and baseline skills required to support people to succeed in their roles. To ensure 
training undertaken is of good quality, we also launched the Quality Assured Care Learning 
Service  which  supports  individuals  and  employers  to  easily  identify  trusted  learning  and 
development opportunities which meet the needs of the sector.  

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

Yours sincerely, 

MINISTER OF STATE FOR CARE

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