Woman with dementia died after falling and getting trapped in a stairlift

An elderly woman died after getting trapped under a stairlift when care home staff who dialled 999 didn’t speak English well enough to explain what was wrong.

91-year-old Barbara Rymell, who suffered with dementia, had just moved in to Ashley House Residential Care Home in Langport, Somerset, last August when she fell from the stairlift and got stuck.

Two staff on duty tried but failed to free her – but when they called the emergency services to request an ambulance, ‘neither were sufficiently proficient in English to be able to explain clearly the nature of the medical emergency’, Mrs Rymell’s inquest heard.

Her death was recorded as misadventure and now the coroner has issued a warning about the potential for future deaths if English standards for care workers are not addressed.

Senior Coroner for Somerset, Samantha Marsh, wrote to the Home Office and Health Secretary and called the current English test for foreign health staff ‘wholly insufficient’.

During the 999 call, her two carers – one Romanian and one Indian – were unable to explain to the emergency services what had happened to her, and did not understand the difference between their patient being ‘alive’ or ‘alert’.

Their lack of English ‘severely hampered’ the call handler’s response and made a ‘meaningful’ assessment of her condition ‘virtually impossible’, the coroner said.

Following the call, Mrs Rymell’s case was classified as ‘serious’ rather than requiring an ‘immediate’ response, and when paramedics did arrive at the care home she had already died.

Within her report, coroner Mrs Marsh explained: ‘On the evening of August 8, 2022, two carers were on duty; neither of whom were native English speaking nationals.

‘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.

‘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.

‘Care staff were unable to free her because of the positioning and angle at which she was entrapped within the mechanics.

‘An internal audit by the ambulance service revealed that the call-handler had selected an incorrect pathway.

‘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.

‘The carer repeatedly used the word “blocked” which added no assistance, clarity of explanation of the events that were unfolding.

‘They did not understand the difference between “bleeding” and “breathing”. This made any meaningful triage of Barbara’s condition virtually impossible.

‘[The carers were also unable to] understand the difference between “alert” and “alive”, which presented all of the same problems as referred above.

‘Paramedics arrived on a category 2 response and, on arrival, it was clear that Barbara was beyond medical help.’

The inquest concluded Mrs Rymell had died of misadventure as a result of her fall, a combination of her dementia and frailty and “mechanical obstruction of respiration”.

But Mrs Marsh said she had been shown evidence that at least one the carer’s understanding of English did not meet the standards required to work in Britain.

She explained: ‘Applicants for a Visa must have passed a Secure English Language Test (SELT).

‘It transpired during the Inquest that one of the workers that evening had never passed the SELT, so was not qualified or permitted to work in the UK.’

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 to summon appropriate emergency medical attention when needed.

‘Vulnerable people, by very definition, are unable to often appreciate the need for help; take steps to keep themselves safe and/or summon help for themselves when they need it.

‘By being unable to speak the native language of England with any proficiency I am concerned that deaths will continue to arise where those who are young, disabled, suffering from a mental impairment or who are elderly and in need of urgent medical help will not have this summoned for them if those who are engaging with emergency professionals are unable to communicate effectively.’

The Home Office and Health Secretary Helen Whatley have until January 22 to respond to her report.

A spokesperson for South West Care Homes told MailOnline: ‘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.’

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