Care home provider Craysell Ltd has been fined £80,000 after a resident choked to death on a meatball.
Margaret Humphreys died in August 2014 after being admitted for a respite stay at Marlborough House in Hampshire, the BBC reported.
Health and Safety Executive inspector Andrew Johnson said: “Had a risk assessment of Mrs Humphreys been carried out, they would have identified the risk that she would have choked if she was fed uncut food.
“It’s a message to the care sector to risk assess and treat respite residents as they would their permanent residents.”
The 84-year-old required supervision when eating as she was unable to chew properly having previously suffered a stroke.
Mrs Humphreys’ daughter Gayle Gunner said staff had been given clear instructions on a laminated sign about her mother’s needs.
She added: “It is a really difficult decision to leave a relative in respite care, but it’s done in the hope that they will get the best quality of care when the family is in need of respite.
“It is therefore crushing to learn how mum died and we feel the care home betrayed our trust.”
Craysell pleaded guilty to breaching health and safety legislation and apologised to Mrs Humphreys’ family.
The company said: “As soon as this incident occurred, we overhauled our processes and procedures and provided re-training for all staff in order to give assurances to residents and relatives.”