James Keen

[BRIEF SUMMARY OF MATTERS OF CONCERN] (1) During the inquest the court was advised that the untrained support workers at the supported accommodation would conduct physical health checks including taking a temperature, oxygen saturation readings and pulse. The evidence was unclear as to whether blood pressure readings were taken. It was apparent that there was considerable confusion regarding what readings were being obtained, whether or not the readings were within normal limits, and what (if anything) the staff did with the results. The court was advised the thermometer at the home was broken. I can confirm that there is no expectation for healthcare assistants [HCAs] that work in supported living services to be qualified nurses and all our healthcare assistants have completed all the mandatory training that is required to work in social care settings. However, all our support workers have been additionally provided with adequate training specific to physical health monitoring to enable them to conduct physical health checks and our staff can independently raise concerns when readings appear abnormal by calling paramedics or booking urgent GP appointments including calling GP out of hours. I can confirm that vital signs equipment within the placement are all fully functional. See updated Physical Health training our staff have additionally undertaken attached. (2) There seemed to be a real risk that the observations could give either falsely reassuring information and miss evolving ill-health indicators or be needlessly alarming for residents, by suggesting normal results were in fact abnormal, given the paucity of understanding of the support workers and lack of documentation. Following the above valid statement, all staff have undergone additional physical Health Training. Staff have good understanding of the normal ranges and are able to raise concerns where readings appear abnormal and document accordingly to ensure residents are safely supported with any physical health challenges.[ see attached training certificates ] We have also stepped up engagement with community teams to ensure they are aware that residents with physical health concerns due to ongoing class A substance misuse have now been given eviction notices to terminate the placement as these residents are unable to guarantee their own safety in the community.[ See a sample of attached relevant incident report and eviction letters to this effect] (3) There was no evidence of induction or annual training or checking support workers understanding and ability to effectively carry out this quasi-nursing role, or that the qualified staff appreciated the lack of knowledge displayed in the evidence at inquest. I can confirm that all new support workers are indeed provided with 2-week induction period and have annual mandatory training to effectively work in their role [ see attached staff training matrix]