“The Regulatory Reform (Fire Safety) Order 2005 and the Fire Safety (Residential…”
Dated 20 Apr 2026, from the coroner for West London. Sent to 4 organisations or people.
A coroner wrote this report after an inquest, to warn the organisations below about a risk of further deaths.
The 56-day response deadline
Deadline passedReplies were due by 15 Jun 2026. A reply may have been sent and not yet published.
Organisations that receive a report must reply to the coroner within 56 days, saying what they will do or why they will do nothing. We show whether a response is published on judiciary.uk.
- Report dated20 Apr 2026
- Deadline15 Jun 2026
- Published on judiciary.uk29 Apr 2026
- Today23 Oct 2026
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Responses from each recipient
| Sent to | Response |
|---|---|
| Local Government Association | Deadline passedNo response published on judiciary.uk so far. The 56-day deadline was 15 Jun 2026. A reply may have been sent and not yet published. |
| Minister for Housing Communities and Local Government | Deadline passedNo response published on judiciary.uk so far. The 56-day deadline was 15 Jun 2026. A reply may have been sent and not yet published. |
| National Fire Chiefs Council | Deadline passedNo response published on judiciary.uk so far. The 56-day deadline was 15 Jun 2026. A reply may have been sent and not yet published. |
| Care Quality Commission | Deadline passedNo response published on judiciary.uk so far. The 56-day deadline was 15 Jun 2026. A reply may have been sent and not yet published. |
The coroner’s concerns
1. The Regulatory Reform (Fire Safety) Order 2005 and the Fire Safety (Residential Evacuation Plans) Regulations 2025 do not appear to apply to the individual flats in ECSA because they are private dwellings. The concern is that there is no specific requirement for a PCFRA (or a personal emergency evacuation through the PCFRA) with an agreed format and risk factors, a requirement for emergency equipment and staff training and a timescale for regular reviews (including where the individual circumstances of a person in care change). This concern may apply to others in formal residential care. 2. Staff training is not standardised for ECSA (or sheltered accommodation more generally) and may not include, for example, evacuation strategy, emergency evacuation plans, the use of telecare/fire alarm system and fire suppression systems. 3. Fire Risk Assessments for premises providing ECSA and sheltered accommodation more generally may not contemplate vulnerable residents as forming 'any group of persons identified…as being especially at risk' (see article 9(7)(b) of the 2005 Regulations). Vulnerable residents may be at special risk because of (for example) smoking or cooking practices and may have a compromised ability to self-evacuate. The concern is that Fire Risk Assessments do not take this into account.
An extract. Read the full report, including the circumstances of the death, on the Courts and Tribunals Judiciary website.
- Source
- judiciary.uk, Prevention of Future Deaths reports, 2026-0223
- Added to Minute Book
- 8 Oct 2026
- Reuse
- We show short extracts and link to the original. We don’t host the full report.
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Contains public sector information licensed under the Open Government Licence v3.0. Source: Courts and Tribunals Judiciary, judiciary.uk. Open Government Licence v3.0
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