The minimum level of English language skills required for foreign care workers will not be raised despite the death of a care home resident after staff were unable to explain her critical state to 999 operators. The senior coroner for Somerset investigated the death of 91-year-old Barbara Rymell in August 2022 and found that the primary school standard of English required to get a health and care visa was “wholly inadequate for those working in the direct care and protection of vulnerable people”. But the Home Office has now ruled out any change. Indian and Romanian care workers at the Ashley House care home in Langport could not understand the difference between “bleeding” and “breathing” or “alert” and “alive” when talking to the emergency services after Rymell had a fall. In a prevention of future deaths report, the coroner, Samantha Marsh, warned the government that without tougher tests, “deaths will continue”. Rymell’s daughter, Elaine Curtis, also called for a change in the rules governing language, saying: “I would hate this to happen to someone else’s family.” But the Home Office minister, Tom Pursglove, said: “We do not believe raising the level of the English language requirement for skilled workers would be appropriate.” He told the coroner this would be “very difficult” to assess and manage. Nearly 86,000 foreign care workers and home carers were granted skilled worker visas in the 12 months to September 2023, more than double the previous year’s number. The increase came after ministers relaxed barriers to entry to try to fill 165,000 vacancies in the low-paid sector. Most came from India, Zimbabwe and Nigeria. Care workers are supposed to pass the secure English language test, which requires comprehension equivalent to that of a year 6 pupil. Nurses are required to have a higher level of English to register with the Nursing and Midwifery Council, but there is no requirement for care workers to be registered with a professional body. Rymell, who had dementia, had been left unattended in August 2022 when she fell on the stairs and trapped her head in the stairlift. When the staff called 999, they could not explain the gravity of the situation. Paramedics arrived on a category 2 response rather than the fastest response for life-threatening injuries, and Rymell was pronounced dead at the scene. Care Rights UK, which represents relatives and residents, said it was “beyond comprehension that the Home Office minister does not believe that raising the level of the English language requirement for skilled workers would be appropriate”. Diane Mayhew, a campaign manager at the charity, said: “The coroner has stated that without tougher tests, deaths will continue, and with nearly 86,000 foreign care workers and home carers granted skilled workers visas in the last 12 months alone, that’s a significant number of lives that may be at risk as a result of foreign care workers unable to speak adequate English to explain the critical state a resident is in.” Nadra Ahmed, the chief executive of the National Care Association, said she agreed with the coroner about the need for higher language standards, and the Home Office decision to keep language requirements at the same level was “a cop-out”. She said most care operators ensured staff could communicate well and she urged the government to “disable recruitment by unscrupulous agencies bringing in anybody and everybody”. “We need a much more responsible way of filling these gaps [in the workforce],” she said. “I am not talking about perfect English, but the skills have to be such that they … understand the needs of the individual we support.” Pursglove said it was the responsibility of care companies to ensure their employees had adequate English. He also said tougher language requirements would affect people who arrive under visa schemes for asylum seekers and people from Ukraine, Afghanistan and Hong Kong, who can all work in social care without a skilled worker visa. Requiring better English of these people risked defeating the purpose of those visa routes, he said.