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Extra training at care home after resident died after not receiving proper nutrition and hydration

Downshaw Lodge care home in Ashton.

Staff at an Ashton care home have received extra training after an inquest revealed that poor hydration and nutrition contributed to a resident's death.

The investigation into the death of James Astley in January revealed he died from natural causes contributed to by dehydration an lack of nutrition.

He had dementia and was immobile and was a resident at Downshaw Lodge care home in Ashton.

The inquest heard his nutritional status declined significantly from November 2023.

In December, it was found he had difficulty swallowing and his condition deteriorated which to him becoming increasingly frail.

He saw a doctor and was prescribed antibiotics, but his condition continued to worsen.

He was admitted to Tameside General Hospital where he was treated for a serious kidney infection and dehydration. Despite treatment he continued to deteriorate due to his frailty. He died at Tameside General hospital on January 22.  

In a prevention of future deaths report, South Manchester coroner Alison Mutch said details and charts on Mr Asley's eating sand drinking were poor.

She said: "As a consequence he became increasingly frail and the risk to his overall wellbeing and physiological reserves continued."

Ms Mutch added that documentation at the home was limited and lacked essential details.  

In a response this month, the management at the home said steps had been taken to improve record keeping and staff had received full training.

A letter to the coroner said: "All staff have now completed the training courses and we are confident they are competent and understand the level of detail required when completing fluid and nutrition intake charts.

"The staff also understand how to escalate when a resident experiences a significant weight loss."

The home added that regular 'spot checks' were now carried out into the nutrition of residents and the quality of food has been inproved.

Health watchdog the Care Quality Commission (CQC) said there were 'a number of shortfalls' regarding the levels of detail, frequency and accuracy of reports at the home.

A spokesman said: "CQC have reviewed two weeks of daily records in relation to Mr Astley's eating and drinking for the period of December 2023.

"The service has been unable to locate other records relating to this time period, in particular we have not been able to review the daily records in relation to Mr Astley’s hospital admission where the evidence is that there was a dramatic deterioration in Mr Astley’s health and presentation.

"The records reviewed indicated that Mr Astley had been monitored regarding his eating and drinking and was supported and encouraged to eat and drink by staff throughout the day.

"Some documentation was not available for review as the provider was not able to locate these.

'"The quality of the records varied, and it was not possible to determine to what extent Mr Astley’s nutritional needs were met, although records indicate he was prescribed a supplement drink to increase his nutritional intake on a daily basis."

In conclusion, the CQC said: "Overall documentation at the home was limited and lacked detail."

The watchdog is currently preparing a further report into the home.

 

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