Sidney Baker
2 Dec 2019 · Coroner Rachel Syed · Manchester (West)
This report repeats 1 earlier warning, and was raised again 3 times later. See the linked reports.
The coroner's concerns
1. lack of contemporaneous referral documentation
“There were no contemporaneous documents that a Dieticians or Falls Team referral had been made by the Care Home personnel in question”
2. incorrect care plan entries and poor record keeping
“There were concerns that entries contained in Mr [name redacted] care plan were incorrect, including vital information contained on his weight monitoring sheet. Furthermore, the general quality of record keeping was poor.”
Linked reports
Closely relatedConfidence 0.85 · high
Earlier report
“Failed to keep accurate records.”
This report
“Furthermore, the general quality of record keeping was poor.”
Closely relatedConfidence 0.90 · high
This report
“There were concerns that entries contained in Mr [name redacted] care plan were incorrect, including vital information contained on his weight monitoring sheet. Furthermore, the general quality of record keeping was poor.”
Later report
“The record keeping was inconsistent and lacked detail on general wellbeing.”
Identical hazardConfidence 0.90 · high
This report
“There were concerns that entries contained in Mr [name redacted] care plan were incorrect, including vital information contained on his weight monitoring sheet. Furthermore, the general quality of record keeping was poor.”
Later report
“That there remain potential issues of poor record keeping.”
Identical hazardConfidence 0.95 · high
This report
“There were concerns that entries contained in Mr [name redacted] care plan were incorrect, including vital information contained on his weight monitoring sheet. Furthermore, the general quality of record keeping was poor.”
Later report
“(1) The record keeping in the home appeasers to be inaccurate and inconsistent”
Responses
2019-0407-Response-by-CQC.pdf ↗· Care Quality Commission
Stated action · 12 months
“We will carry out a further comprehensive inspection within 12 months, to ensure action has been taken and the provider is no longer in breach.”
2019-0407-Response-by-Rosewood.pdf ↗· Rosewood Healthcare Group
2019-0407-Response-by-Wigan-Council.pdf ↗· Care Quality Commission
Stated action · 24th June 2019 to present
“Council's considerations and investigation: Following Mr [name redacted] death, several monitoring and support visits took place at Barely Brook. We considered a sample of referrals that had been made in respect of current residents. Wigan Council can confirm that the recording of referrals of any kind (including dietician and falls team, and referrals to the Later Life and Memory Team) has improved. Barley Brook has demonstrated they are now keeping contemporaneous records and documentation.”