Investigation and inquest
On 2nd July 2016 I commenced an investigation into the death of Jeremiah Obaka. The investigation concluded at the end of the inquest on 25th September 2016. The conclusion of the inquest was that Mr Obaka died from natural causes.
Circumstances of the death
Mr Obaka was 77 years old, with a number of medical conditions including chronic lymphoid leukaemia. He was provided with a package of care commissioned by the local authority whereby carers would visit him at least twice a day. Carers last visited Mr Obaka on 27th June 2016, but received no reply on subsequent visits. On 2nd July 2016 police broke into Mr Obaka’s home and found him dead. There was a dispute as to the number and nature of communications between the local authority and the agency commissioned to carry out the visits.
Coroner’s concerns
There was no agreed and consistent policy or guideline on what should happen in the event that a service user did not reply or could not be found. The local authority (now through a separate Limited company) and the care agency had separate and different guidelines, neither of which had been communicated to the other.