Resident Chokes to Death

A Manchester care home has been severely criticised after a service user with dementia choked to death on a chicken nugget. The 68-year-old had previously been assessed as requiring a pureed diet by the local Speech and Language Therapy (SALT) team, but a lack of awareness and communication amongst the staff at Fir Trees Care Home, part of the HC-One group, meant that the home failed to provide food of an appropriate texture.

The coroner noted that the service user’s care plan had not been updated to reflect her swallowing difficulties and still indicated that she was able to eat chopped up food. Following the inquest in July, Chris McKinney, the solicitor representing the family said: “The coroner’s conclusion of neglect vindicated the family’s belief that their mother choked to death by attempting to eat a meal that was entirely inappropriate for her.”

Read on to learn the essential steps you must take to prevent a tragedy like this occurring in your own care home.

Reduce the Risk of Choking

Deaths as a result of choking on inappropriate food remain depressingly commonplace in care homes. Just this year, similar cases have come under the scrutiny of coroners in Derbyshire and Northern Ireland. In most cases, a lack of adequate risk assessment along with poor staff training and awareness are found to be the main causes of these avoidable deaths.

5 Steps to Reduce the Risk of Choking in Your Care Home 

  1. Identify those at risk: Some service users are at particularly high risk of swallowing difficulties as a result of their medical history. A history of dementia, Parkinson’s disease or stroke should ring alarm bells and trigger a referral to a Speech and Language Therapist if you observe any problems eating or drinking.
  2. Know the signs: Being aware of the common signs of a swallowing problem will help you to seek help promptly. Regular coughing or choking when eating or drinking, recurrent chest infections, a wet or ‘gurgly’ voice or the presence of pockets of food in the mouth all suggest a swallowing difficulty that could lead to a serious choking incident.
  3. Follow SALT advice: Once a SALT assessment has been completed, this should be followed at all times. Changes to the assessment should only be made by a speech and language therapist and any failure to follow instructions could leave your service liable for any harm that subsequently occurs.
  4. Put a plan in place: It’s essential that your care plans clearly outline the measures that must be taken to help the person in your care eat and drink safely and reduce the risk of choking. These should be available to all staff so that these measures are communicated and understood.
  5. Take practical measures: Supportive measures such as ensuring an upright posture, encouraging thorough chewing of food and arranging for high risk service users to be observed at meal times can all promote safer eating and drinking.

Ensure you are not overlooking anything when it comes to risks and hazards your care service users face – Care Quality Matters provides best practice advice on all aspects of health and safety in care, plus clinical practice advice and actionable guidance on passing your CQC inspections.

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