Mystery surrounds number of social admissions to Suffolk hospitals after death of 84-year-old, of Diss, due to fall in emergency department at West Suffolk Hospital in Bury St Edmunds

Mystery surrounds the number of social admissions to hospitals following a SuffolkNews investigation prompted by the death of an 84-year-old man.

Joseph Maunick, who had dementia, died after suffering a severe head injury in a fall last March at West Suffolk Hospital’s emergency department where he had been placed as a last resort social admission after exhaustive efforts to find suitable alternative care.

Following an inquest, assistant coroner Peter Taheri raised concerns about the risk of future deaths over a shortage of residential care placements cited at the time and insufficient resources for hospitals.

After the publication of a prevention of future deaths report, SuffolkNews tried to find a record of the number of social admissions in recent years but was told by multiple organisations they did not hold such figures.

When the issue was raised with Healthwatch Suffolk, it said it was not aware of any hospital policy focused on caring for people as a result of a lack of emergency social care access but it would seek to clarify the issue with the relevant authorities to understand the extent to which it may be a developing practice.

SuffolkNews submitted a Freedom of Information request to West Suffolk NHS Foundation Trust for the number of social admissions to West Suffolk Hospital’s emergency department since 2018 after it wasn't possible to find a social care provider or residential home.

The trust said it did not code social admissions.

When we asked the trust for further clarity, given that Mr Maunick’s case was classed as a social admission in the coroner’s report, its FOI team said the trust did not routinely code social admissions.

It said: “However, in this particular case, a thorough investigation of what happened took place ahead of the inquest, which showed in the A&E triage notes, that this was a social admission.”

After questioning why the trust did not routinely code social admissions and how the trust kept a record of this issue to highlight any improvements that needed to be made to the care system to prevent pressures on the hospital, it said there was no requirement for such admissions to be coded and the trust worked with partners to ensure only those that require inpatient care were admitted to its hospitals.

Neither Suffolk County Council nor NHS England held a record of social admissions when asked.

The prevention of future deaths report said it had not been possible to find suitable alternative care for Mr Maunick, of Diss, in residential placements while his wife, and main carer, had unplanned major emergency surgery.

An inquest heard that, during a national care shortage, at least eight social care providers were contacted plus further residential homes, but none could accommodate him.

Staffing at the hospital was at ‘black status’, the worst level, and the nursing assistant who was trying to maintain constant one-to-one supervision had their attention momentarily diverted to another patient experiencing a medical emergency.

In further details provided to SuffolkNews, the trust said its early intervention team provided an urgent community response service to West Suffolk patients, responding within two hours of referral, but Mr Maunick lived out of the area so the team was not involved in his care before his arrival at the hospital.

When the issue was raised with Suffolk County Council, a spokeswoman initially said the case related to an adult from outside the area and so the responsibility did not sit with the council.

After being pressed on the matter, she highlighted the early intervention team at the hospital which supports with all admission prevention and avoidance related work for West Suffolk residents.

She said: “This is an integrated team which includes social care practitioners, nurses, paramedic/s, NHS occupational therapists and support workers.

“The remit of the team includes provision on night sits facilitated by support workers employed by the trust.

“The team also coordinates where appropriate admission into residential settings as an emergency.”

Andy Yacoub, chief executive of Healthwatch Suffolk, said there were undeniable pressures on the health and social care system that were having a negative impact on care and support.

“Every death in a health and care environment is a tragedy, and our thoughts go out to Mr Maunick’s family during what must be an incredibly difficult time,” he said.

“As a Healthwatch, we have not received concerns from the public around these types of ‘social admissions’, and are not currently aware of any hospital policy focused on caring for people as a result of a lack of emergency social care access.

“We will continue to seek clarity about these matters from the local NHS trusts, Suffolk County Council and other commissioners, to understand the extent to which this may be developing practice within our local health and care system.

“We would encourage people with current experiences of care and support to share their feedback with us, so that we can use them to influence future standards of care.”

Following the publication of the prevention of future deaths report, Dr Ewen Cameron, chief executive of West Suffolk NHS Foundation Trust, previously said: “Mr Maunick needed round the clock care, which would have been best provided in a social care setting. However as stated in the report, the capacity in the social care system was unfortunately not there.

“This led to him being admitted to our emergency department as a last resort, where he tragically fell.

“We work tirelessly with social care partners to provide the right care in the right place at the right time for our patients. Sadly, on this occasion we were not able to do this.”

The Department of Health and Social Care was approached for comment.