Terence Davenport
17 Oct 2023 · Coroner Alison Mutch · Manchester South
A similar concern from this report was raised again 2 times later. See the linked reports.
The coroner's concerns
1. unsuitable care setting
“The inquest heard evidence that the acute hospital setting was difficult for Mr [name redacted] due to his dementia and created risks to his health once he was medically optimised. He had to remain there due to a lack of suitable care/nursing beds. This meant that he was in an unsuitable care setting and that a bed that could have been utilised for an acute patient was not available”
2. unsuitable resident placement
“The inquest was told that resident who pushed Mr [name redacted] was not suitable for placement at the care home where the incident happened. The care home where previous incidents had occurred was out of area. The inquest was told that lack of information sharing between two GM local authorities, the care homes involved and GMP meant that the safeguarding issue was not recognised. It was unclear if this was due to an effective information sharing protocol not existing between local authorities/care homes”
Linked reports
Identical hazardConfidence 0.92 · high
This report
“The inquest heard evidence that the acute hospital setting was difficult for Mr [name redacted] due to his dementia and created risks to his health once he was medically optimised. He had to remain there due to a lack of suitable care/nursing beds.”
Later report
“Mr [name redacted] was assessed as being suitable for discharge on 18th December. He remained in an acute hospital setting for a further 4 weeks due to challenges in identifying a suitable care home.”
Identical hazardConfidence 0.90 · high
This report
“He had to remain there due to a lack of suitable care/nursing beds. This meant that he was in an unsuitable care setting and that a bed that could have been utilised for an acute patient was not available;”
Later report
“The inquest heard evidence that [the deceased] was only in hospital at the point of her fall because her discharge had been delayed due to a shortage of a suitable social care placement.”
Responses
2023-0389-Response-from-Greater-Manchester-Integrated-Care-Board.pdf ↗· Greater Manchester Integrated Care
Stated action
“We acknowledge that these factors unfortunately impacted the ability to discharge Mr [name redacted] in a timely manner to an appropriate community placement.”
Stated action
“The Integrated Urgent Care Team is Tameside's urgent response team; they provide rapid assessments for people in the community, with an aim to keeping people in their own homes and preventing hospital admission.”
Stated action
“Tameside locality partners meet weekly in an Executive Length Of Stay meeting to consider any barriers to discharging patients with”
Stated action
“1. Home Finders Team (as described above) that are focussed specifically on supporting timely and appropriate placements for patients ready for discharge.”
Stated action
“Tameside Digital Health Team (based at Tameside ICFT) provide a face to face digital service directly with Residential and Nursing Homes to support residents to remain in the Care Sector with support wherever possible.”
Stated action
“The Integrated Urgent Care Team is Tameside's urgent response team; they provide rapid assessments for people in the community, with an aim to keeping people in their own homes and preventing hospital admission.”