Recipient

Epsom & Ewell Borough Council

First report 21 Sep 2017•Latest report 21 Sep 2017

Recipient record

Reports, concerns and published responses

Local government · English district council. This page brings together reports naming this recipient and response statements clearly connected to concerns raised in those reports.

Reports: 1
Published responses: 0%
Concerns addressed: 0
Stated actions: 0

Reports over time

Reports naming this recipient by issue year.

Evidence profile

Report topics

Share of this recipient’s reports compared with all other recipients.

0%published responses found

0stated actions described

Topic comparisons are not available in the current evidence snapshot.

Concerns and recipient responses

Statements from Epsom & Ewell Borough Council linked to the concerns in each report. Select any concern, action or position to view the source wording.

21 Sep2017
Surrey
Concerns raised8
1. Failure to require trainee Telecare Operators to obtain approval before closing calls
2. Failure to persist in offering and persuading service users to accept help after alarm activation
3. Failure to inform emergency contacts of the service user’s control over whether they are telephoned
1. Failure to take further action when follow-up contact after an unanswered alarm call fails
2. Insufficient background information available to Telecare Operators for assessing service user needs
3. Lack of pro forma questions for assessing needs after alarm activation
4. Allowing trainee Telecare Operators to take calls without direct supervision
5. Failure to keep alarm calls open until service users are safely recovered from falls
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.

No linked response statements
No action or position from this recipient is clearly linked to the concerns in this report.
AI-generated summary

Derek Clifford Dudley · Prevention of Future Deaths report

This summary was generated using AI from the published report. Please read the original report for the complete account.

Report summary

Derek Clifford Dudley was found deceased from hypothermia outside the back door of his home on 6 March 2017, after previously activating his community alarm following a fall. Concerns included the call being ended before he had got up, limited follow-up after a later unanswered call, unsupervised trainee operators, the absence of pro forma questions, and insufficient background information for assessing service users’ needs.

Read the report on judiciary.uk
Source evidence
How this individual concern was interpreted
PFD Monitor created a concise, searchable interpretation from the report wording shown below. The report was sent to Epsom & Ewell Borough Council; that does not assign responsibility.
PFD Monitor interpretation
Failure to require trainee Telecare Operators to obtain approval before closing calls
Wider context from the report
“The Telecare operator who took Mr Dudley’s call was in her probationary period with the Service but was able to take the call without direct supervision and did not need to seek approval before closing the call. ”
Open source report
Source evidence
How this individual concern was interpreted
PFD Monitor created a concise, searchable interpretation from the report wording shown below. The report was sent to Epsom & Ewell Borough Council; that does not assign responsibility.
PFD Monitor interpretation
Failure to persist in offering and persuading service users to accept help after alarm activation
Wider context from the report
“Mr Dudley was only offered an ambulance once during the course of the telephone conversation and no attempt was made to persuade him to accept any help. ”
Open source report
Source evidence
How this individual concern was interpreted
PFD Monitor created a concise, searchable interpretation from the report wording shown below. The report was sent to Epsom & Ewell Borough Council; that does not assign responsibility.
PFD Monitor interpretation
Failure to inform emergency contacts of the service user’s control over whether they are telephoned
Wider context from the report
“The court heard evidence that Mr Dudley’s emergency contacts believed they would be telephoned automatically if Mr Dudley activated his alarm, and stated they had signed a form agreeing to be called at any time of day or night. Mr Dudley was not asked if he wanted his emergency contacts to be telephoned and ████████ CSS Telecare Service Manager, stated they would not be contacted unless the service user requested this. ”
Open source report
Source evidence
How this individual concern was interpreted
PFD Monitor created a concise, searchable interpretation from the report wording shown below. The report was sent to Epsom & Ewell Borough Council; that does not assign responsibility.
PFD Monitor interpretation
Failure to take further action when follow-up contact after an unanswered alarm call fails
Wider context from the report
“The operator attempted to contact Mr Dudley by telephone again 1.5 hours later, which ████████ again stated was in breach of Telecare’s policy, but there was no answer and no further action was taken. ”
Open source report
Source evidence
How this individual concern was interpreted
PFD Monitor created a concise, searchable interpretation from the report wording shown below. The report was sent to Epsom & Ewell Borough Council; that does not assign responsibility.
PFD Monitor interpretation
Insufficient background information available to Telecare Operators for assessing service user needs
Wider context from the report
“████████ also confirmed that whilst an extensive assessment of new service users is undertaken with their next of kin, this information is not accessible to the Telecare Operators who are provided with a very brief sentence describing the service user’s requirements. ”
Open source report
Source evidence
How this individual concern was interpreted
PFD Monitor created a concise, searchable interpretation from the report wording shown below. The report was sent to Epsom & Ewell Borough Council; that does not assign responsibility.
PFD Monitor interpretation
Lack of pro forma questions for assessing needs after alarm activation
Wider context from the report
“Evidence was heard during the inquest that no pro forma questions are provided to the Telecare operators for dealing with calls and call handling guidance is provided to each operator on a USB stick which they can access via their work computer if needed. ”
Open source report
Source evidence
How this individual concern was interpreted
PFD Monitor created a concise, searchable interpretation from the report wording shown below. The report was sent to Epsom & Ewell Borough Council; that does not assign responsibility.
PFD Monitor interpretation
Allowing trainee Telecare Operators to take calls without direct supervision
Wider context from the report
“The Telecare operator who took Mr Dudley’s call was in her probationary period with the Service but was able to take the call without direct supervision and did not need to seek approval before closing the call. ”
Open source report
Source evidence
How this individual concern was interpreted
PFD Monitor created a concise, searchable interpretation from the report wording shown below. The report was sent to Epsom & Ewell Borough Council; that does not assign responsibility.
PFD Monitor interpretation
Failure to keep alarm calls open until service users are safely recovered from falls
Wider context from the report
“The call was terminated without Mr Dudley having got up from his fall, which ████████ confirmed was in breach of the policy of CSS Telecare Service. ”
Open source report

Information checked against published PFD reports and official responses · Data reviewed 7 Sep 2026 · About data quality and limitations

Data last updated 7 September 2026

Reports, concerns and published responses

Reports over time

Concerns raised8

Failure to require trainee Telecare Operators to obtain approval before closing calls

Failure to persist in offering and persuading service users to accept help after alarm activation

Failure to inform emergency contacts of the service user’s control over whether they are telephoned

Failure to take further action when follow-up contact after an unanswered alarm call fails

Insufficient background information available to Telecare Operators for assessing service user needs

Lack of pro forma questions for assessing needs after alarm activation

Allowing trainee Telecare Operators to take calls without direct supervision

Failure to keep alarm calls open until service users are safely recovered from falls