Gwinya
Can preventable choking deaths in UK care homes be brought down to zero?
- Domain
- Care · preventable harm
- Method
- Service design · ethnography
- Artefact
- Protocol · training · tools
- Status
- Piloted in care settings
Choking is one of the leading causes of preventable death in UK care homes. Most incidents follow a recognisable pattern — a missed swallowing assessment, a meal served in the wrong texture, a moment without supervision.
Where in the care pathway could a small intervention — a tool, a checklist, a piece of training — close the gap between what staff know and what happens at the table?
The work was built around the actual rhythms of a care home: staff turnover, mixed acuity, mealtimes under pressure. Service design with care providers, ethnographic observation at mealtimes, and a small set of physical and digital tools made for the people doing the work.
Gwinya — a kit of training, signage, and a lightweight digital record that helps care staff catch swallowing risk before it reaches the plate. Pilot homes reported faster handovers between shifts and earlier escalation of swallowing concerns to clinical teams.