Mohammad Ashraf

1 Sept 2017 · Coroner Louise Hunt · Birmingham and Solihull

The coroner's concerns

1. lack of care plans for pupils with allergies
“care plans are not in place for all pupils that require them”
2. delayed issuance of care plans
“delays in issuing care plans”
3. inadequate communication of care plans to Caterlink
“All issued care plans had not been provided to Caterlink by the school and communication between the school and Caterlink was not as effective as they could be”
4. unsafe lanyard system for allergy identification
“interim measure lanyards had been used to try and identify which food children were allergic to when buying their lunch”
5. unsafe interim lanyard system
“the lanyard system that the school had introduced as an interim measure was not safe”
6. lack of process to communicate recommendations
“local authority has no process in place to ensure that recommendations are immediately communicated to those affected by them so that practices can be changed and processes put in place to rectify the problem”