Mildred Horrex

“During the course of the Inquest it was clear that overall the record keeping in respect of [the deceased] was poor. There was insufficient information taken about [the deceased] by the home before her admission to Pelham House, the information that was taken was at times inaccurate and this lead to an inadequare fall risk assessment being insufficient.”

“Whilst the drugs chart showed that [the deceased] was taking her medication regularly the amount of medication that was found after her death showed that this could not be the case. We were told that monthly drugs audits were apparently carried out but they did not pick up the decrepancies in the recording on the drugs charts and the amount of medication held.”