Dear Mr Gittins , Re: Inquest of Alfred Leonard Hodges 3rd December 2013 With reference to your letter dated January 2014, write to reply to the matters of concern recorded in the Regulation 28 Report to Prevent Future Deaths issued by the Assistant Coroner, Ms Nicola Jones, after the inquest of Mr Alfred Leonard Hodges on 3rd December 2013, and to explain the action taken by the Council: Before do may first express sincere condolences to Mr Hodges' family and friends for their loss May also apolocise thatno officer from the Council attended the inquest Iam aware , of course thatl North Wales Regional Telecare Strategic Manager submitted a written statement in the form of a letter dated 21st October 2013 in response to the request from the Coroner's Officer and, as understand it, there was no specific direction requiring attendance_ However, do think that a Council officer with relevant experience could have been of assistance to the Assistant Coroner in this case and am sorry that this did not happen_ In my letter to you dated 12th December 2013, requested that all future invitations and requests to attend inquests were forward directly to my office and envisage that this will ensure that enquiries are given due consideration and appropriate action taken to prevent a recurrence of this position. now turn to the issues the Assistant Coroner has recorded as matters of concern: Telecare and Assistive Technology are community care services provided under several statutory provisions to individuals in Conwy who have an assessed eligible need. Telecare and Assistive Technology cover a wide range of equipment including detectors, sensors, alarms, pendants etc, as well as services such as assessment; installation, monitoring, call centres and responses, all designed to enable individuals andlor carers to remain safe and independent within their own homes The prescription and utilisation of Telecare equipment by health and social care professionals to meet an individual's assessed need became widespread in Wales on the inception of the Telecare Grant from the Welsh Government in 2006/7 Prif Switsfwrdd Main Switchboard: 01492 574000 MMV COnWk gou uk DX 24628 Conwy 2 Ni ddylid cyflwyno doglennau Ilys drwy ffacs not t0 be used for serving proceedings Oifad Minigyf neu Ffon Testun Minicom or Text Phone: 01492 515892 24th SO, 0L45 'vou Faxi

In Conwy, pre-February 2014, the basic Telecare package comprised the "Lifeline" base unit and pendant The Council provided the linked "Tunstall" smoke detectors on the basis of assessed eligible needs. Individuals who did not have an assessed need were signposted to the North Wales Fire and Rescue Service (NWFRS) for a Home Fire Safety Check, which is free_ In January 2012 Conwy County Borough Council reached an agreement with NWFRS whereby the Council agreed to notify the Fire Service of any new Telecare installations where there was no assessed need for a linked smoke detector so that the NWFRS could carry out Home Fire Safety Check and offer and install a linked smoke detector. Thus, in Conwy from January 2012, the Council has been notifying NWFRS of new Telecare installations and, following a Home Fire Safety Check; NWFRS has been installing the linked smoke detectors to the Lifeline base units in place In 2012-13 Conwy Telecare Service made 41 referrals to NWFRS and 36 between April and November 2013. In addition, Conwy Customer Care Team also refers individuals to the NWFRS for Home Safety Fire Checks_ The Customer Care Team is the first point of contact for individuals making enquiries of Social Services_ In 2012-13 that Team made 2,407 offers of referral to the NWFRS to individuals; 402 accepted the offer and referrals were duly made_ In 2013-14 so far, the Team has made 2,096 offers of referral; 339 accepted and referrals made_ consider that these statistics highlight two concerns for both agencies, the large number of individuals refusing a referral for Home Fire Safety Check in the first place and then the resource implications for the NWFRS to carry out those checks and to do so in a reasonable timescale_ In December 2013 there were approximately 1,880 social care clients in Conwy County Borough Council's area with Telecare equipment installed 910 of whom did not have smoke detectors linked to their Lifeline base units. can report that since then Conwy Telecare Service has installed 105 linked smoke detectors and the Team has also been proactively urging clients to accept the units when they have met with a refusal or disinterest will go on to describe in more detail what action the Council has taken later in this letter_ To read the unfavourable comparison of Conwy County Borough Council's practice as regards Telecare with that of the neighbouring Authorities is, as you would expect; a matter of concern for me and one which have looked into further; My understanding is that whilst the majority of the Authorities (namely , Angelsey, Gwynedd_ Flintshire and Wrexham) do install a linked smoke detector as part of the basic Telecare package, there are some considerable uncertainties about the sustainability of that provision for example, in Gwynedd where the practice is reviewed at present; and in Flintshire where the NWFRS provide the linked detectors at present In Wrexham there are particular concerns about the number of refusals of the linked detectors: The approach in Denbighshire is to install linked smoke detectors on the basis of assessed need_ As understand it, whilst Denbighshire County Council has had discussions with NWFRS, no other arrangements are in place except for referrals for Home Safety Checks_ The conclusion, think, is that there is certainly some inconsistency across North Wales in respect of the basic Telecare package and serious concerns about sustainability of current provision in some Authorities as well as concerns about the number of refusals from individuals who are of course entitled to choose (unless lacking capacity, decision is made in their best 14 have duly being Fire

interests). These are matters which you or the Assistant Coroner well wish to follow up not only with the other Authorities but also with NWFRS and Betsi Cadwaladr University Health Board_ As you will know, Mr Hodges was 97 years old and he lived alone in his own property_ Mr Hodges was wheelchair dependent and was hard of hearing and wore hearing aids_ To meet Mr Hodges social care needs to enable him to stay at home, the Council commissioned comprehensive package of care from a domiciliary care agency which included assistance with all daily living activities including personal care and meal preparation. Mr Hodges' care plan was reviewed regularly and manual handling risk assessments and care plans were in place. The Galw Gofal records show that a "Lifeline" base unit (and pendant) was installed for Mr Hodges' use on October 1998. This was a self referral ie. not as result of a community care assessment. The base unit was upgraded in March 2009. am sorry indeed that Mr Hodges' next of were mistaken in their belief that the smoke alarm in the property was a linked detector: The question have posed is how this mistake arise and how can we be sure it does not happen again. In order to answer the first question, think it might be useful if refer to the Customer Care Team's contacts in respect of Mr Hodges recorded on the Social Services computer system which are as follows 31/3/2011 Enquiry (member of staff) Son stated carbon monoxide detector not working Advised could contact 'Careline Fire safety check offered_ Response: Son declined stated system in place_ 10/1/2012 Enquiry (member of staff) Fire safety check offered Response: Hfsc conducted as reported by son_ 20/2/2013 Significant change case note (member of staff) Enquiry call in from the domiciliary care agency: Fire safety check offered Response: Smoke detectors connected to Tunstall and has Fire Angel installed. You will see that on three occasions in three consecutive years, the Customer Care Team offered referral for a Home Fire Safety Check: In 2012 it appears that Mr Hodges' son informed the Customer Care Team that a Home Fire Safety Check had been carried out by NWFRS cannot comment on why that did not result in linked smoke detector being installed_ In 2013, most unfortunately, it appears that the smoke alarm in situ was mistaken for a linked smoke detector: now tum to address the Assistant Coroner's request for an explanation of action taken by Conwy County Borough Council: The Council and NWFRS reviewed the current practice in October 2013. The NWFRS concluded that it would be beneficial for people in Conwy if a linked smoke detector was installed as part of the basic Telecare package on initial installation, or during regular support visits to those already with a Telecare package The NWFRS donated 900 linked smoke detectors to the Council for the Conwy Telecare Service to install for clients identified as not having a linked detector: Whilst the donated smoke alarms were very welcome, the issue then became the timescale for installation and how and who to prioritise. It was estimated that this installation programme would 14 may 27th kin very could

take the existing installation staff team approximately 12 18 months to complete alongside their normal duties. Officers from NWFRS and Conwy County Borough Council met again on 11th December 2013 and reached an agreement for the funding of a full time post in the Council for 6 months in order to install the linked smoke alarms in considerably shorter timescale_ The NWFRS also agreed to provide 500 smoke alarms during 2014/15 and have provided refresher training for Conwy Telecare Services installers on the correct positioning of smoke detectors in domestic dwellings and, will be providing fire safety awareness training for social services staff. Between December and February 105 detectors have been installed and the new full time officer has now started work In order to raise staff awareness and to request that staff visiting clients at home take note of and test smoke alarms, a briefing note has been prepared for all Social Services staff and has been posted to them via the Council's intranet; the briefing paper includes photograph of the "Tunstall" linked smoke detector used in the County to help staff identify the equipment in situ_ The Council is working hard to meet the social care needs of clients who wish to remain in their homes and_ mindful of our respective statutory responsibilities, we are committed to work in partnership with the NWFRS, the Health Board and other agencies in the best interests of all our residents_ do hope have provided comprehensive response. Please do not hesitate to contact me if there is anything further can assist with: