Joyce Crompton

Dear Ms Griffin Joyce Crompton Deceased acknowledge receipt of your letter dated 6 December 2016 and the Regulation 28 and 29 report to prevent future deaths_ acknowledge that the conclusion of the Inquest was choking on regurgitated food with the underlying cause of Vascular Dementia. note the Coroner's matters of concerns and would Iike to provide you with my response: No written Guidance regarding referrals to outside agencies such as SALT can confirm that Belong does have a set of Policies and Procedures that provides clear guidelines for staff about when to refer to other professionals. policy 'Nutrition and Hydration' provides staff with clear guidelines about when to refer individuals to the Speech and Language Therapist (SALT) The policy states that: "advice should always be sought to assist staff with swallowing strategies and appropriate positioning and to minimise the risk of aspiration or choking for the person with an unsafe swallow" The guidance also references a flow chart in Appendix that provides information about 'When to refer to the Speech and Language Therapy team for Dysphagia'. In addition to this guidance we have the following documentation: is part of CLS Care Services Limited, a Registered Society under the Co-Operative and Communities Benefit Societies Act 2014, registered number 27346R. Registered in England & Wales at Pepper House, Market Street; Nantwich, Cheshire CWS 50Q, INVESTORS IN PEOPLE Your Our Belong

Marvellous Mealtimes policy section 15 'Swallowing Difficulties' Refer for a swallowing assessment and advice from the Speech and Language Therapist SALT): MUST Assessment for the risk of Malnutrition 'A person who has swallowing problems notify GP; ask for referral to speech and language therapist Document on care plan'. Daily Food Intake records all reference the national descriptors of food type that has been prescribed. Life Plan Food and Drink a section for 'These are the difficulties that have' to be documented_ Care Practice Guidelines Food and Drink acknowledge that whilst we have the necessary Policies, Procedures Guidelines and documentation in place staff have failed to refer to them when caring for this lady and have failed to seek external advice from healthcare professionals and to document any changes can confirm that the following actions have taken place: AlI Belong Managers and Nurses have been reminded of the importance of following the Organisation's policies and procedures and reminded to raise awareness with their staff teams Staff have been requested to reassess all residents risk of choking and ensure follow up referral are made to SALTs with immediate effect. meeting is held on Wednesday, 21 December with all Belong Registered Managers to review the Policies, Procedures and Guidance and discuss how we can be more effect in our delivery of safe care_ Staff at Belong Atherton have received update training about Dysphagia and this will be cascaded throughout the organisation: The Learning and Development team will review induction procedures and resources for 'learning will be evaluated;, as will frequency of updates. All Support Workers have been reminded of the correct procedures to follow and how to seek advice from outside professionals and when they need to escalate health concerns. This is incorporated into the care practice training for all staff; to include staff induction, supervision, life plan review and audit trust that my response will provide you with the reassurance that we have reviewed and communicated our procedures following the Coroners concerns over the death of Joyce Crompton, and therefore improved the safety of our practice.