A coroner has issued a warning about the inability of foreign care staff to speak English following the death of a 91-year-old woman who became trapped under a stairlift.
Barbara Rymell died after falling at the Ashley House Residential Home in Langport, Somerset, an inquest heard.
In a 999 call, her two carers, who were Romanian and Indian, were unable to explain to the emergency services what had happened to her and did not understand the difference between the patient being “alive” and “alert”, or “breathing” and “bleeding”.
Their lack of English “severely hampered” the call handler’s response and made a “meaningful” assessment of Mrs Rymell’s condition “virtually impossible”, the coroner said.
Following the call, her case was classified as “serious” rather than requiring an “immediate” response, and when paramedics arrived at the care home she had died.
Samantha Marsh, the senior coroner for Somerset, has written to the Home Office and Helen Whately, the minister for social care, to warn of the potential for future deaths if English standards are not addressed. She said the current English test for foreign health staff was “wholly insufficient”.
The Taunton inquest heard that Mrs Rymell, who had dementia, arrived at the home on Aug 8 2022 from hospital, having suffered a fall in the community, and was known to be frail with blurred vision and at a high risk of falling. “She relied on others to keep her safe,” said the coroner.
She was the only resident with a bedroom on the first floor but was incapable of using the stairs or the stairlift on her own, the inquest heard.
Describing the aftermath of Mrs Rymell’s fall, Mrs Marsh said in her report: “At 7.27pm, one of the carers called 999 to request an ambulance.
“It was clear, on the evidence, that Barbara had been left unattended on the mechanical chair for around five minutes. This was clearly contrary to the rules and procedures of Ashley House.
“During those five minutes, she has left the seat of the mechanically operated stairlift (possibly unfastening the seat belt) and proceeded to climb the stairs, which she was unable to safely because of physical limitations and her underlying cognitive impairment.
“She has fallen on the stairs, falling downwards. Barbara has been found, having fallen awkwardly, landing with her head trapped under the chair for the mechanically operated stairlift.”
The report found that neither of the care workers was able to clearly explain the medical emergency and that the call handler selected the wrong pathway for treatment.
“The correct pathway that should have been selected was ‘entrapment’ but at no time during the call did the carer give any information that would have indicated that this was the presenting problem,” said the report.
‘The last thing we expected to happen’
Elaine Curtis, Mrs Rymell’s daughter, told The Telegraph: “We are just heartbroken. She was put in the care home for her safety and for peace of mind. This was the last thing we expected to happen.”
The inquest concluded that Mrs Rymell had died of misadventure as a result of her fall, a combination of her dementia and frailty, and “mechanical obstruction of respiration”.
Mrs Marsh said she had been shown evidence that at least one of the carers’ understanding of English did not meet the standards required to work in Britain, which include proving that they can read, write, speak and understand the language.
“Applicants for a visa must have passed a Secure English Language Test (Selt). It transpired during the inquest that one of the workers on the evening of August 8 2022 had never passed the Selt, so was not qualified or permitted to work in the UK,” the report added.
Addressing the Government in her Prevention of Future Deaths report, Mrs Marsh said: “I am concerned that those working with vulnerable people who are in a position of trust and responsibility must be able to demonstrate a sufficient proficiency in English to enable them to summon appropriate emergency medical attention when needed.”
Mrs Marsh told the Home Office and Mrs Whately that they have until Jan 22 to respond to her concerns.
A spokesman for the care home said: “South West Care Homes would like to express, once again, our deepest sympathies to Mrs Rymell’s family for their loss.
“We worked closely and diligently with the authorities throughout their investigations into the circumstances of this isolated incident.
“We strive always to offer the best possible care to all our residents, and since Mrs Rymell’s death we have instigated a range of management and auditing improvements to further enhance the care we provide at Ashley House.”