Dear Sir Rei_Inquest regarding the death of John Keith William Shelley I write further to your letter of 31st July 2014, pursuant to Regulation 28 of the Coroners (Investigations) Regulations 2013. In terms of the issues raised in your letter we believe it would assist to differentiate between professionally qualified staff and support workers Firstly, we have programs in place to train all our professionally qualified staff in Immediate Life Support/Basic Life Support training which comprises the recognition and response to the acutely unwell patient and includes response to cardiac arrest_ on to second group of staff, our Healthcare Support Workers, who comprise the majority of the staff employed in this residential unit; they have not routinely been trained in Basic Life Support or "first aid". Although if this had been requested and subject to capacity, this could be undertaken: This has been because the focus of the Simulation & Resuscitation Team has been to deliver training directly to all clinical staff annually within the Health Board_ Risk assessments approved by the Health Board Resuscitation Committee have resulted in prioritising the training to high risk areas. However, since this tragic event all the staff in the residential units have been trained in Basic Life Support. 3wfad echyd Pritysgol Hywel Daa yw gweitnredol Bwrdd Iechyd Lleol Prifysgcl Hywel Dda Hywe Dda University Health Board is the operational name oi Hywel Dda University Local Health Board Mae Bwrdd lechyd Prifysgol Hywel Dda yn amgylchead di-fwg Hywel Daa University Health Board operates smcke free envircniert Moving the

In terms of moving further forwards, we have also looked at other options which may be available for healthcare support staff, where this would be appropriate We are evaluating options for training these staff groups to target "life threatening conditions We feel that a specifically targeted approach to life threatening conditions will provide the best type cover and will be more specific than a generalised first aid course: This course will include recognition & response to life threatening conditions i.e heart attack, choking, serious bleeding including cardiac arrest and is recognised by British Heart Foundation_ We will be taking a risk based approach to determine which staff will require thls level of tralning, which will include if will be working unsupervised without the direct support of trained clinical staff_ Should you have any queries please don't hesitate to contact me_