FIA Case Study - A catalogue of failures led to death
Like it? Share it!
25 May 2022
At the time of her death, Ashlie Timms was living at Connington Court in Waltham Forest, a residential care home run by Sequence Care Group (SCG). Timms suffered from a personality disorder as well as restricted mobility and had a care package and Personal Emergency Evacuation Plan (PEEP) which required staff to approach her immediately and instruct her regarding evacuation in the event of a fire.
The jury concluded that the actions of Sequence Care Group (SCG), Ramsay Safety Solutions (who carried out the fire risk assessment) and the London Fire Brigade all contributed to the death of Ashlie Timms, following an inquest before Area Coroner Graeme Irvine at Walthamstow Coroners Court. The inquest today death of Ashlie Timms was caused by a multitude of factors, some of which include:
- A fire detection and alarm system which did not have a connection to an Alarm Receiving Centre (ARC) to automatically alert the emergency services
- Ashlie was not evacuated, despite her Personal Emergency Evacuation Plan (PEEP) requiring
- staff to do so
- An incorrect text address location on the alarm display, that Sequence Care knew to be incorrect
- Departures from British fire standards and recommendations, conflicting organisational fire policies and fire risk assessments that went unchallenged
Related training
Related news
Related resources
-
Technical Bulletin Painting of Fire-Resistant Cables
11 March 2024
-
Guidance on installation of vibrating tactile devices
04 March 2024