'˜Profound impact' on staff after care home resident died from choking on orange

Downpatrick Crown Court also heard the South Eastern Health Trust continues to have a working partnership with Seeconnell Private Village since 57-year-old Mervyn Patterson died more than four years ago.

At an earlier hearing Corriewood Private Clinic Ltd, who own the nursing home on the Clonvaraghan Road in Castlewellan, pleaded guilty to a single count of failing to ensure the health and safety of a non-employee on March 20 2014.

The charge arose, prosecuting counsel Laura Ievers told the court, as a result of the “tragic and sudden death” of Mr Patterson who suffered from severe autism and learning difficulties and who choked on a piece of orange.

He had spent 50 years in Muckamore Abbey Hospital in Antrim before he was transferred to Seeconnell in December 2013 having been assessed under the Community Integration Project as “suitable for transition back in to community care”.

An “essential lifestyle plan” was put in place and for the first few days following his move, staff from Muckamore were present to advise his new carers, but in January and February 2014, concerns were raised about his ability to eat and swallow.

Following an assessment by a speech and language therapist, it was decided that Mr Patterson “should be upright and alert when eating and drinking and that he was to have a soft, mashed, moist texture D diet”.

“Staff had to ensure that he had swallowed that which was in his mouth before taking more, and that he was not to be given any hard, dry, stringy or chewy food,” said the lawyer, adding that an advice leaflet was produced and shared with his carers which “highlighted any problematic foodstuffs and indicated, for example, that fruit should be peeled”.

It was also decided, the court heard, that Mr Patterson “should be directly supervised at meal times” but just after 9pm on March 20, he started to choke.

The staff began CPR and the paramedics arrived within 20 minutes but tragically, “the choking resulted in Mr Patterson’s death within a short period of time”.

A pathology report revealed there was “still a segment of orange including the peel within the back of his throat” and its presence would have interfered with his breathing and “rapidly induce a serious degree of asphyxia causing death”.

Mrs Ievers highlighted that up until the incident, “there had been no relevant concerns raised about the residential facility ... and a review conducted in January of that year was positive”.

As a result of an investigation by the police and local council, it transpired that while it was available, the teenage support worker who prepared the supper that night “had never read Mr Patterson’s care plan nor been given time to do so” so she wasn’t aware of his dietary requirements.

Her male colleague said he gave Mr Patterson his medicine in a cup of yoghurt but had left him unsupervised while returning the medicine cups to the office.

Despite returning to his patient “within a minute,” it was while he was away that Mr Patterson began to fatally choke.

He told investigators he knew Mr Patterson had issues with food as it was in his care plan but that he believed “an orange would have been a suitable food stuff”.

Mrs Ievers said it also transpired that while a poster had been produced with dietary recommendations on it, the details were passed on verbally to staff, while a month before the incident a speech and language therapist “expressed her concerns about the lack of food awareness training that was given to Seeconnell staff”.

She told the court while there is evidence that steps have been taken to address problems identified as a result of the tragedy, there was a list of failings at the time which led to Mr Patterson’s death including a lack of staff training in swallowing awareness, no system for ensuring all staff knew each resident’s needs, a lack of knowledge of Mr Patterson’s care plan, and a failure to adequately supervise him while he ate.

Giving evidence to the court on Wednesday Marie McGrady, listed as the “responsible person” for the care facility, told defence QC Turlough Montague in the immediate aftermath of the tragedy and on a continuing basis, assessments and reviews have been conducted and changes implemented to ensure nothing like this happens again.

She told the barrister and Judge Piers Grant that in the days following the death and until training was available in swallowing awareness, some food stuffs were completely withdrawn from the residents.

In addition, while the national recommendation was for a three-day induction for new staff, theirs had a two-week induction with mandatory completion of swallowing awareness courses with senior management “signing off” on the various other competencies.

As regards residents’ various dietary requirements, each resident had their own file listing their needs, any changes they had experienced and staff were allowed time to read and comprehend those files along with each residents’ requirements being listed on a place mat at the dinner table.

She told Mr Montague that Mr Patterson’s death has had a “profound impact” on both the company and staff.

Adjourning passing sentence to next Thursday, Judge Grant said he wanted to review all of the matters which had been placed before him.