Recipient

Fairfield View

First report 18 Jul 2017•Latest report 18 Jul 2017

Recipient record

Reports, concerns and published responses

Private and voluntary organisations · Residential care home. This page brings together reports naming this recipient and response statements clearly connected to concerns raised in those reports.

Reports: 1
Published responses: 0%
Concerns addressed: 0
Stated actions: 0

Reports over time

Reports naming this recipient by issue year.

Evidence profile

Report topics

Share of this recipient’s reports compared with all other recipients.

0%published responses found

0stated actions described

Topic comparisons are not available in the current evidence snapshot.

Concerns and recipient responses

Statements from Fairfield View linked to the concerns in each report. Select any concern, action or position to view the source wording.

18 Jul2017
Manchester South
Concerns raised6
1. Failure to document observations after a fall
2. Failure to comply with escalation processes following a fall
3. Lack of understanding of the trigger for referral to the community nutrition team
1. Inaccurate falls-risk documentation
2. Lack of care home staff understanding of risk assessments
3. Lack of understanding of reviews and required post-fall processes
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.

No linked response statements
No action or position from this recipient is clearly linked to the concerns in this report.
AI-generated summary

Ivy Mitchell · Prevention of Future Deaths report

This summary was generated using AI from the published report. Please read the original report for the complete account.

Report summary

Ivy Mitchell, a care home resident with a history of falls, fell on 29 December 2016 and later developed a subcapital fracture and pneumonia. She deteriorated and died on 26 January 2017; concerns included inaccurate falls-risk documentation, inadequate understanding of post-fall processes and observations, failure to escalate appropriately, and lack of understanding about referral to the community nutrition team.

Read the report on judiciary.uk
Source evidence
How this individual concern was interpreted
PFD Monitor created a concise, searchable interpretation from the report wording shown below. The report was sent to Fairfield View; that does not assign responsibility.
PFD Monitor interpretation
Failure to document observations after a fall
Wider context from the report
“2. There was a lack of understanding amongst the care home staff of risk assessments; reviews and the required process following a fall. This included documenting observations after a fall. ”
Open source report
Source evidence
How this individual concern was interpreted
PFD Monitor created a concise, searchable interpretation from the report wording shown below. The report was sent to Fairfield View; that does not assign responsibility.
PFD Monitor interpretation
Failure to comply with escalation processes following a fall
Wider context from the report
“3. Processes relating to escalation following a fall were not complied with; and ”
Open source report
Source evidence
How this individual concern was interpreted
PFD Monitor created a concise, searchable interpretation from the report wording shown below. The report was sent to Fairfield View; that does not assign responsibility.
PFD Monitor interpretation
Lack of understanding of the trigger for referral to the community nutrition team
Wider context from the report
“4. There was a lack of understanding of the trigger for a referral to the community nutrition team. ”
Open source report
Source evidence
How this individual concern was interpreted
PFD Monitor created a concise, searchable interpretation from the report wording shown below. The report was sent to Fairfield View; that does not assign responsibility.
PFD Monitor interpretation
Inaccurate falls-risk documentation
Wider context from the report
“1. The documentation relating to the falls risk was inaccurate. It did not refer to previous falls and did not reflect her mobility; ”
Open source report
Source evidence
How this individual concern was interpreted
PFD Monitor created a concise, searchable interpretation from the report wording shown below. The report was sent to Fairfield View; that does not assign responsibility.
PFD Monitor interpretation
Lack of care home staff understanding of risk assessments
Wider context from the report
“2. There was a lack of understanding amongst the care home staff of risk assessments; reviews and the required process following a fall. This included documenting observations after a fall. ”
Open source report
Source evidence
How this individual concern was interpreted
PFD Monitor created a concise, searchable interpretation from the report wording shown below. The report was sent to Fairfield View; that does not assign responsibility.
PFD Monitor interpretation
Lack of understanding of reviews and required post-fall processes
Wider context from the report
“2. There was a lack of understanding amongst the care home staff of risk assessments; reviews and the required process following a fall. This included documenting observations after a fall. ”
Open source report

Information checked against published PFD reports and official responses · Data reviewed 7 Sep 2026 · About data quality and limitations

Data last updated 7 September 2026

Reports, concerns and published responses

Reports over time

Concerns raised6

Failure to document observations after a fall

Failure to comply with escalation processes following a fall

Lack of understanding of the trigger for referral to the community nutrition team

Inaccurate falls-risk documentation

Lack of care home staff understanding of risk assessments

Lack of understanding of reviews and required post-fall processes