Baby died after choking on nursery lunch - coroner warns 'one first aider is a risk'

Oliver Steeper
-Credit: (Image: PA Media)


A coroner has issued a stark warning that regulations requiring only one first-aider per nursery "pose a risk to future life", following the tragic death of a baby who choked on food at a Kent nursery. Oliver Steeper, a nine-month-old infant, sadly passed away in hospital in September 2021, six days after choking on penne pasta and Bolognese at Jelly Beans Day Nursery in Ashford, Kent.

Despite having two partially-erupted teeth, his parents stated he was "nowhere near being able to chew" properly. The incident occurred when a carer at the nursery fed him "finely chopped" food on the tip of a spoon, which he subsequently inhaled and gagged on.

Coroner Katrina Hepburn expressed concern at the inquest's conclusion that even staff with a valid first aid certificate were unable to administer the correct CPR.

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Addressing the Kent and Medway Coroner's Court at Oakwood House, Maidstone, she said: "I have heard evidence that in the regulations covering early years childcare providers, of all the staff on-site, that only one member of staff has to have a valid paediatric certificate."

She highlighted that early years outlets often have between 50 to 80 people on site, and "one staff member would be responsible for providing first aid to all the children". She added that if this person is unavailable or unable to attend an emergency situation, another staff member may have to deal with it, stating: "It seems to me that this must pose a risk to future life."

The coroner highlighted that paediatric certificates are valid for three years, but noted: "It was apparent from the evidence in this case that, when confronted with an urgent situation with a choking child, the staff even those with a valid certificate in place were not able to put in place the recommended (CPR)".

She pointed out that no one performed a mouth-sweep or initiated chest compressions on Oliver, and there was uncertainty among the staff about the force required for back slaps. The coroner's report aimed at preventing future deaths will be directed to the Department for Education within the next 10 days, and they will have a period of 56 days to respond or request an extension.

It emerged during the inquest that Nazia Begum, who was feeding Oliver at the time, had her first aid certificate expire over a year before the tragic incident. Begum testified that she gave Oliver a "light tap" on the back when he began to choke but did not give him any water.

After her initial response, she sought help from the office, alerting nursery manager Debbie Alcock, who then moved Oliver to the garden where paramedics and police were called to the scene. Alcock also provided testimony via video link, explaining to the jury that only "one suitably qualified first-aider" was required for the entire nursery and that her approach was to prioritise training for new staff without first aid certificates before addressing those whose certifications had expired.

She recounted how she had to carry Oliver upside down into the garden in an attempt to dislodge any food stuck in his throat, before giving him mouth-to-mouth and pressing on his chest with the heel of her hand.

Outside Oakwood House, Oliver's mother, Zoe Steeper, shared a heart-wrenching statement: "In court, we were shocked to hear various witnesses give evidence about the scene of total chaos that unfolded that day in front of many other little children."

"Oli was only nine months old he was just a little baby why did this happen? We believe that Oli's death was entirely preventable."

"We entrusted Jelly Beans nursery with our most prized possession our beautiful baby boy. We were assured that they would look after him properly. No parent should ever leave their child at nursery for them not to come home."

"Oli's case has shone a light on what we feel are loopholes in the way nurseries are allowed to care for young children and babies."

Jill Paterson, representing the family from Leigh Day law firm, stated that Oliver's parents are determined to ensure that this devastating event serves as a lesson so that nurseries and other early childhood settings become safer for all.

"Urgent action must be taken by all those involved in the early years sector, including regulators, legislators and childcare providers, to ensure that this appalling tragedy that cost the life of a baby boy never happens again."

The jury concluded that Oliver's death was due to a hypoxic-ischaemic brain injury caused by cardiac-respiratory arrest after choking on food. They ruled his death as misadventure.