Prevention of Future Deaths reports · 2015

Elsie Clarke

Regulation 28 report to prevent future deaths, written 20 Aug 2015. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report20 Aug 2015
DeceasedElsie Clarke
CoronerJohn Pollard
Coroner areaManchester (South)
CategoryCare Home Health related deaths
Sourcejudiciary.uk record · original PDF
Responses publishednone published

The report

Text recovered by OCR from a scanned PDF. OCR is imperfect: check anything you rely on against the source PDF. Reproduced verbatim, including the scan's own layout.

Southgate House, Archer Street, Darlington, County Durham DL3 6AH Telephone: 01325 351100 Fax: 01325 351144 www.meridiancare.co.u

Mr J S Pollard

Senior Coroner
Coroner's Court

1 Mount Tabor Street
Stockport

SKI 3AG

17% September 2015

Dear Mr Pollard
Re: E Clarke Deceased — Hurst Hall

| write to formally respond to your letter of the 19% August 2015, in which you have
set out matters of concern which the staff at Hurst Halll needed to take action
against following the death of Mrs E Clarke at the Care Home. | have detailed
below each of the matters of concern and the action taken in relation to them in

the order they appear in your letter:

1. There was an apparent lack of training for the staff at Hurst Hall in the
appropriate use of calling either 999 or 111.

Action taken
The senior staff at Hurst Hall had previously attended first aid training which

did cover appropriate use of 999 but they have also attended further
refresher training on 21/7/15 which clearly explained the actions that need to
be taken and the circumstances when these are required.

2. The staff did not know how to arrange for the attendance of a GP for a
resident who was not fully registered with a local GP. In particular they
appeared completely ignorant of the existence of q ‘temporary GP

registration form’.

Action taken
Staff had sent a new patient registration document to the Surgery. They were

not aware of the existence of a temporary registration form. We did receive
these forms from the Surgery after the client's inquest. All senior staff have
now attended training in relation to the action they need to take when a
Residents’ GP is out of the area, and protocols are now in place to ensure

that this does not happen again.

3. The level and quality of observation of the Residents were very poor and did
not include even some of the most basic issues such as whether the Resident

was warm, thirsty etc.

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Action taken
The Care Home has undertaken supervision with all of the staff explaining the

importance of clearly recording detailed information about the welfare of the
Residents. These records are monitored weekly by the Home Manager and
checked daily by the senior team to ensure compliance from staff in their

effective completion.

. There seems to be a complete lack of understanding about the legal
requirements for prompt reporting of such matters as occurred in this case to

the Care Quality Commission.

Action Taken
The Home Manager did not submit the required notification until the 17/2/15.

This was a clerical oversight and systems are now in place centrally to ensure
that when a death is recorded there is a check made to ensure that the
required notifications are sent to the Care Quality Commission immediately.

. When a local GP was visiting another Resident at the Care Home, the staff
seemed unaware that they could and should have asked that Doctor to look

at this Resident.

Action taken
Senior staff have undertaken additional training to ensure they are aware

that they can ask another Doctor or the District Nurse to check a Resident
they have concerns about if they are on the premises. They have been
further advised that if they are in any doubt that they should request an
ambulance. This continues to be monitored by the Home Manager, the
Operations Team and Quality Assurance Team to ensure ongoing

compliance.

. There was a complete failure to maintain food and hydration records.

Action taken
Protocols are in place ensuring that all staff are aware that they need to

clearly record what the Resident has had to eat and drink, particularly when
they are on thickened fluids or if they are underweight or having any
nutritional difficulties. Assessments have been completed to identify Residents
who are at higher risk such as Mrs Clarke, particularly those who require
specialist diets and food and fluid charts are now in place as required. These
are reviewed daily by the Senior Team to ensure ongoing compliance and
are further monitored during regular visits from the Operations Team and the

Quality Assurance Team.

. There was a failure to keep proper and sufficient notes of the care provided
to each Resident.

Action taken
Care plan training has been undertaken with all staff ensuring they clearly

document the care each Resident has received. This is checked following
the admission of any new Resident to the Care Home and where changes

have been identified in a Resident's care and treatment needs. As a
minimum all care plans are fully reviewed every month to ensure their

ongoing relevance and effectiveness.

8. There was a failure to give full and effective ‘handover’ at each shift.

Action taken
A new handover process has been introduced which enables staff to share

key information at the changeover of every shift. In addition, the Home
Manager holds daily flash meetings with all members of the team to update
them on any significant changes and identify any specific events or activities
required that day. The flash meeting also updates the team on any Residents
who require close monitoring. These meetings are documented and the
records are held in the Care Home for review.

| trust you find that we have taken all appropriate action in relation to the matters of
concern arising from the inquest into the death of Mrs E Clarke. Should you require
any further information please do not hesitate to contact me.

Yours sincerely

_

Operations Director

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