Care home firm fined after resident choked to death on doughnut 6

Care home firm fined after resident choked to death on doughnut

The UK’s biggest care home provider has been fined £640,000 by a Scottish court after one of its residents choked on a piece of doughnut and died.

HC One Ltd – which is ultimately owned in a tax haven – pleaded guilty to failings under the Health and Safety at Work Act this week after a 65-year-old resident died in Orchard Care Home in Tullibody, Clackmannanshire.

We reported in 2017 that more than 100 complaints against HC One had been upheld by The Care Inspectorate in the prior three years. A total of 33 homes, out of the 44 operated by the firm in Scotland, had 108 complaints upheld against them. This total was greater than any other care provider in Scotland.

The woman who died in Orchard Care Home, Tullibody, was on a specialist diet of easy to swallow food after a severe stroke and vascular dementia left her at risk of choking. The resident had been assessed as having a high risk of choking on 2 December 2018. Bread products are not suitable for the modified diet she was on as they cannot be mashed small enough.

On 7 August 2019, however, she was given a piece of jam doughnut as a snack from the tea trolley, which she choked on. Despite efforts of care home staff and paramedics to remove the food, the resident died.

Prior to her death, the resident had frequently been given sandwiches from the snack trolley, repeatedly putting her at risk, said the Crown Office and Procurator Fiscal (COPFS) in a statement. Main meals at the home were prepared by the kitchen and labelled with each resident’s name. 

However, the snack trolley did not have information on modified diets or food suitability. Staff in charge of the trolley had also not had sufficient training on modified diets, said COPFS. 

HC-One Limited was fined at Falkirk Sheriff Court on Wednesday. The firm has since made changes at the home to ensure the snack trolley has suitable food for all residents. Training has also taken place.

Alistair Duncan, head of the health and safety investigation unit of the Crown Office and Procurator Fiscal Service, said: “The death of this vulnerable care home resident could have been prevented if suitable training and procedures were in place. HC-One Limited left all residents at risk by failing to ensure modified diets were adhered to and staff had the relevant knowledge to keep those in their care safe. 

This prosecution should reiterate the need for all care homes to protect their residents and remind them they will be held accountable if they fail to do so.

Alistair Duncan, head of the health and safety investigation unit of the Crown Office and Procurator Fiscal Service

He added: “This prosecution should reiterate the need for all care homes to protect their residents and remind them they will be held accountable if they fail to do so. Our thoughts are with the family of the resident at what must be a difficult time for them.”

James Tugendhat, chief executive officer of HC-One said: “First and foremost, we offer our heartfelt condolences and apologies to Mrs Hughes’ family and loved ones. It was vitally important to us that lessons were learned when this occurred in 2019. Additional safeguards are now in place across all our homes to prevent a repeat of an accident like this, and Colleagues now complete additional and specific training focused on supporting residents who have modified diets. 

He added: “The Care Inspectorate has recognised this work across our homes, as well as the very good care provided at The Orchard today. We are clear that this tragedy should never have happened, and we hope today’s judgement provides Mrs Hughes’ family with some comfort and closure.

In 2020 The Ferret reported that HC One was ultimately owned by a firm based in the Cayman Islands, which is renowned as a tax haven. 

In reply then, HC-One said it was committed to providing “the kindest care” and that it had an impressive record with the industry regulator, the Care Inspectorate, with four of its homes in Scotland judged as “excellent” in at least one assessment area.

Photo Credit: iStock/Jasper Chamber

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