Charles Evans
25 Aug 2022 · Coroner Joanne Lees · Black Country
This report repeats 2 earlier warnings, and was raised again 1 time later. See the linked reports.
The coroner's concerns
1. lack of CPR training among carers
“None of the Carers employed at Hibiscus House had any training in CPR”
2. absence of registered first aider
“There was no Registered First Aider at the premises”
3. lack of defibrillator availability
“There was no defibrillator on site”
4. absence of emergency communication device
“There was no emergency bell/alarm or telephone in the residents' dining room”
5. inadequate CQC follow-up on improvement plan
“Post inquest, the Coroner noted the CQC Inspection report for Hibiscus House Domiciliary Care Agency dated July 2019 which rated the facility as 'requiring improvement'”
Linked reports
Identical hazardConfidence 0.90 · high
Earlier report
“the law currently does not require care providers to ensure that carers in a care home have had first aid training”
This report
“None of the Carers employed at Hibiscus House had any training in CPR.”
Closely relatedConfidence 0.90 · high
Earlier report
“buzzer/alarm in the deceased room had been removed/disabled due to a previous incident where the deceased had attempted to place the cord around her neck.”
This report
“There was no emergency bell/alarm or telephone in the residents' dining room.”
Identical hazardConfidence 0.90 · high
This report
“None of the Carers employed at Hibiscus House had any training in CPR.”
Later report
“No ongoing training had been provided to prison officers since initial training on basic life support or first aid, meaning that officers confronted”
Responses
2022-0345-Response-from-Care-Quality-Commission.pdf ↗· Care Quality Commission
2022-0345-Response-from-Hibiscus-House.pdf ↗· Hibiscus Housing Association Limited
2022-0345-Response-from-Wolverhampton-City-Council.pdf ↗· Wolverhampton City Council