Prevention of Future Deaths reports · 2013

Christine Williamson

Regulation 28 report to prevent future deaths, reference 2013-0371, written 18 Dec 2013. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report18 Dec 2013
Reference2013-0371
DeceasedChristine Williamson
CoronerJohn Ellery
Coroner areaShropshire, Telford & Wrekin
CategoryOther related deaths
Sourcejudiciary.uk record · original PDF
Responses published3

The report

Text recovered by OCR from a scanned PDF. OCR is imperfect: check anything you rely on against the source PDF. Reproduced verbatim, including the scan's own layout.

LH¥———__—

T REGULATION 28 REPORT TO PREVENT FUTURE DEATHS

THIS REPORT JS BEING SENT TO:
1. Managing Director Telford & Wrekin Borough Council
Telford & Wrekin Council, Addenbrooke House, ironmasters Way, Telford TF3 4NT
2 Assistant Chief Constable West Mercia Constabulary
West Mercia Police Head Quarters, Hindlip Hall, PO Box 55, Worcester WR3 8SP
i- South Staffordshire & Shropshire Health Foundation Trust
Trust Headquarters, St. George's Hospital, Corporation Street, Stafford ST16 3SR
4 EE. Telford & Wrekin Clinical Commissioning Group
Telford and Wrekin CCG, NHS Telford and Wrekin, Halesfield 6, Halesfield, Telford, TF7
4BF

1 ~~ | CORONER
(am John Penhale ELLERY, Senior Coroner, for the coroner area of Shropshire, Telford &
Wrekin

2 CORONER’S LEGAL POWERS
| make this report under paragraph 7, Schedule 5, of the Coroners and Justice Act 2009
and regulations 28 and 29 of the Coroners (Investigations) Regulations 2013.

3 INVESTIGATION and INQUEST
On the 13" November 2012 ! commenced an investigation into the death of Christine
Ann WILLIAMSON aged 62 years. The investigation concluded in an inquest on the 16"
December 2013. The conclusion of the inquest was ‘The deceased died from a physical
assault by her husband who by reason of his lack of mental capacity was unaware of his
actions or its consequences. If earlier action had been taken the deceased may have
been protected and her death was preventable’.
The medical cause of death was:
fa Subdural Haematoma
following mild blunt head trauma
It Warfin therapy for recurrent deep vein thrombosis

4 “| CIRCUMSTANCES OF THE DEATH
Mrs Williamson was 62 years of age when she died following an assault upon her by her
husband who was suffering from advanced onset of Alzheimer’s dementia and was
unaware of his actions or its consequences.
The assault on the 18” October 2012 was the last of 5 recorded assaults between the
6" December 2011 and the 18" October 2012.

——

5 CORONER’S CONCERNS
During the course of the inquest the evidence revealed matters giving rise to concern.
In my opinion there is a risk that future deaths will occur unless action is taken. In the
circumstances it is my statutory duty to report to you.

The MATTERS OF CONCERN are as follows. -

(1) A referral and assessment should have been made that the deceased was a
Vulnerable Adult at risk from her husband. Such a referral and assessment could have
been made before or after Apri! 2012, but most notably on or around the 2" - 4** April
2012 when the deceased’s GP made a direct referral to social services. This should have
led to an assessment as a Vulnerable Adult but if not as the victim of domestic violence.

(2} Had such an earlier assessment as a Vulnerable Adult been made then discussions
would have taken place with all concerned with everyone having significant information
sharing it with others. This would have increased the likelihood that preventative
measures would have been put in place with the deceased being better or fully
informed as to the increased risk she was putting herseif in by continuing to live with
her husband whose condition was deteriorating. The best illustration of this lack of
shared information is that the evidence given at the Inquest when all relevant witnesses
were present, should have taken place in a meeting before the situation became
critical.

(3) An independent domestic homicide review has been undertaken and the author of
the report gave evidence at the inquest including authors or representatives of the
relevant individual management reviews. Recommendations were made which |
endorse.

| __
6 ACTION SHOULD BE TAKEN

In my opinion action should be taken to prevent future deaths and | believe you or your
organisation have the power to take such action.

7 YOUR RESPONSE

You are under a duty to respond to this report within 56 days of the date of this report,
namely by 12" February 2014. I, the coroner, may extend the period.

Your response must contain details of action taken or proposed to be taken, setting out
the timetable for action. Otherwise you must explain why no action is proposed.

——|.
8 COPIES and PUBLICATION

| have sent a copy of my report to the Chief Coroner and to the following interested
Persons:

a :.,
PY — Independent Overview Author i

Service Delivery Manager, Cohesion, Darby House, s* Floor, Lawn Central, Telford TF3
4LE

The Chief Executive - West Midlands Ambulance Service |
Trust Headquarters, Millennium Point, Waterfront Business Park, Waterfront Way,
Brierley Hill, DYS 1LX

— GP Charlton
Medical Practice, Lion Street, Oakengates, Telford TF2 6AQ

Superintendent For Telford & Wrekin Safeguarding Board
Malinsgate Police Station, Malinsgate, Telford, TF3 4HW

1am also under a duty to send the Chief Coroner a copy of your response.

The Chief Coroner may publish either or both in a complete or redacted or summary
form. He may send a copy of this report to any person who he believes may find it
useful or of interest. You may make representations to me, the coroner, at the time of
your response, about the release or the publication of your response by the Chief
Coroner.

a
18" December 2013 Jofin Penhald Ellery

Responses

3 responses published against this report on judiciary.uk. A response is a body's written reply to the coroner's concerns; publication is at the discretion of the Chief Coroner's office, so an absent response does not mean nobody replied.

Response from Telford Wrekin Clinical Commissioning Group (PDF)
- 5 FEB 2018

INHS|

. Telford and Wrekin
Clinical Commissioning Group

Halesfield 6
Telford
Shropshire
TF7 4BF
ce
Direct Line:
4th February 2014 Your Ref: JPE/EJW

Mr J P Ellery

Senior Coroner

H.M. Coroner’s Service
3rd Floor

Guildhall

Frankwell Quay
Shrewsbury SY3 8HQ

Dear Mr Ellery,

Re: Christine Ann WILLIAMSON deceased
Inquest: Telford Register Office, 16th December 2013 at 10am
Report to prevent future deaths

Thank you for your letter of the 18th December 2013 under Regulation 28 (Report to
Prevent Future Deaths) of the Coroners (Investigations) Regulations 2013.

As you will be aware, the Clinical Commission Group actively participated in the
Domestic Homicide_Review_ commissioned by Telford & Wrekin Safer Community
Partnership led by J within the review are 8 recommendations for
future learning and action by all agencies involved in Mrs Williamson’s care.

This Clinical Commission Group has taken this very seriously and has agreed to work
with all agencies to prevent future deaths. As NHS England now commission Primary
Care Service the CCG is working with colleagues to address the recommendations.

The actions we have taken are as follows:

1) The Adult Safeguarding Policy and Thresholds has been recirculated to all GP
Practices in Telford & Wrekin to raise awareness of this guidance.

2) Domestic abuse leaflets and guidance has been circulated to all GP Practices.

TAKING CARE OF TELFORD AND WREKIN
Every patient experience matters - Every clinician is involved

3) An education and training event for all Telford & Wrekin GPs and Practice
Nurses will be funded and delivered with a focus on safeguarding requirements
and domestic abuse. | have written to all GPs to request full attendance as far as
possible. This event is part of the CCG’s Protected Learning Time Programme
and will be delivered on 14th May.

The training will be multi agency and we have invited the Domestic Abuse Team to
present to the attendees ensuring that Royal College of General Practitioner's Guidance
is fully referenced in accordance with the DHR recommendations.

In addition, the CCG Lead Nurse for Adult Safeguarding has established a link with the
Admiral Nurses to ensure that referrals figures are monitored. The Admiral Nurses will
be invited to the education event to talk to GPs and Practice Nurses about their service,
therefore promoting improved understanding for future patients.

Furthermore, the CCG Safeguarding Team has a programme of audit for primary care
providers in relation to safeguarding compliance, and this year’s review is currently
underway.

In order to address future issues around the growing prevalence of dementia the CCG
has in place a dementia strategy which focuses on how provision of health services will
be delivered.

The plan is for a report on all recommendations from the domestic homicide review to be
discussed at the Safeguarding Adults Board in June and the CCG Executive Nurse is a

member of this Board. This safeguarding is regularly discussed with the CCG and its
governing body

I trust this gives the necessary level of assurance and commitment in this matter.

Yours sincerely

Chair of Telford and Wrekin Clinical Commissioning Group

TAKING CARE OF TELFORD AND WREKIN
Every patient experience matters - Every clinician is involved
Response from Telford Wrekin Council (PDF)
a.co-operative
council

4.4 FEB 2016 Telford & Wrekin

Richard Partington Managing Director

Addenbrooke House
Mr JP Ellery Ironmasters Way
Senior Coroner for the Shropshire, lem
Telford & Wrekin area
HM Coroner’s Service
The Guildhall (3 Floor)
Frankwell Quay
Shrewsbury SY3 8HQ

Contact: Telephone: Fax:
Your Ref: Our Ref: RP/CoronerCAW Date: 7" February 2014
Dear Mr Ellery

Re: Christine Ann WILLIAMSON (deceased)
Inquest at Telford Registry Office on 16° December 2013
The Council’s Action Plan following Regulation 28 report, to prevent future deaths

| refer to your letter of 18" December 2013.

Following the above Inquest and the Council's receipt of your Report under Regulation 28, we
have compiled a plan of action, which is submitted to you as directed, along with this letter.

The planned actions, m j already well under way to implementation, build upon
those recommended by in his Domestic Homicide Review report, which was
available to the Inquest. The plan was drafted by senior representatives of the Council’s Adult

Assessment and Case Management, Adult Safeguarding and Community Cohesion services, and
endorsed at a meeting of the Senior Management Team on Monday 3” February 2014.

Going forward, it has been agreed that the implementation of the action plan will be formally
monitored by the Safeguarding Adults Board for Shropshire and Telford & Wrekin, in pursuance of
its remit as the body which brings together all the organisations within the local adult safeguarding

partnership.

| trust that this meets with your approval.

Yours sincerely

visit us @ www.telford.gov.uk

* | foliow us at www.twitter.com/telfordwrekin
or www.facebook.com/telfordwrekin

COUNCIL
Response from West Mercia Police (PDF)
Protective Services Report

Title: Coroner Ellery’s letter — Christine WILLIAMSON (deceased)
Prepared by: a
/Detective Chief Inspector PVP

Introduction

This report seeks fo provide a detailed response to Coroner Ellery’s letter to West
Mercia Police dated 18.12.13. West Mercia has a duty to respond by 12.02.14,
under paragraph 7, schedule 5 of the Coroners & Justice Act 2009 and regulations

28 & 29 of Coroners (Investigations) Regulations 2013.

The inquest concerning Mrs Williamson commenced on 13" November 2012 and
concluded on 16" December 2013.

The conclusion of the inquest was ‘the deceased died from a physical assault from
her husband who by reason of his lack of mental capacity was unaware of his
actions or its consequences. If earlier action had been taken the deceased may

have been protected and her death preventable’,

Background Information

Mrs Williamson was 62 years old when she died on 31* October 2012, following an
assault upon her by her husband who was suffering from advanced onset of
Alzheimer’s dementia. The medical cause of death was determined as subdural
haematoma following mild blunt head trauma.

a... unaware of his actions and was removed from the family home
on October 2012 following the incident. He was admitted to a local Psychiatric
Unit and was subsequently sectioned under Section 3 of the Mental Health Act

1983.

In September 2013, the Crown Pros i i ade the decision that no
further action would be taken agains due to his medical condition.
Plans are being made to move him to a secure hospital.

Due to the circumstances surrounding this incident Telford and Wrekin Community

Safety Partnership di Domestic Homicide Review (DHR) appropriate and
appointed as. the independent chair.

DHR

The police Independent Management Review (IMR) was conducted by the Major
Crime Review Team (MCRT). It was established that West Mercia Police had three
contacts regarding the Williamson family between July and October 2012.

Contact 1 - 8" Jury 2012
Police received a call from Shropdoc (out of hours GP) who were attending the

address following a report of an assault, requesting a police escort, Intelligence
checks were conducted with no risk factors identified.

As a result the decision was taken in conjunction with Shropdoc not to deploy
Officers to the incident as it was known that there was a dementia suffer at the

address and attendance may aggravate the situation.

Contact 2 ~ 19" August 2012
Police received a call from a neighbour reporting that Screaming and ting

could be heard from the address. Staff attended and established that!
aa was a former police staff member and made enquires to ascertain
whether WMP occupational health would be able to offer any assistance.

A vulnerable adult incident was submitted but no DASH risk assessment. The
rt highlighted the violence suffered by Mrs Williamson; it
recorded her ongoing medical complaints, described her as ‘tearful’ and

‘desperately’ requiring assistance.

MCRT concluded that a DASH tisk assessment was required however this
issi inimi vulnerable adult incident was actioned by the

Contact 3 ~ 18" October 2012
Mrs Williamson contacted police reporting that her husband had assaulted her by

pushing her to the ground, j j her back and riding her as if she was a
horse. During this event PP ] hit his wife about the head.

Officers. attended and witnessed in an agitated manic state. T
ambulance was called checked Mrs Williamson and transported to

gainst her husband (she signed an officer's pocket note book
to that effect) and refused to be taken to hospital for a more thorough examination.
MCRT concluded that force policy was followed in this incident with the completion
of all requirements.

Coroners ~ Matters of Concern
woroners ~ Matters of Concern

During the inquest the Coroner raised concerns that there was a risk future deaths
will occur unless action was taken. The matters are detailed in section 5 of his

letter.

1. A referral and assessment could have been made before or after April 2012,
but most notably on or around 2™ — 4" April 2012 when the deceased GP
made a direct referral to social services.

This matter was not reported to Police. The first contact with the Williamson family
was 8!" July 2012. Evidence was heard at the inquest suggesting that the GP was
aware of domestic violence since December 2011, where bruising to Mrs
Williamson was photographed at the surgery.

2. Had such an earlier assessment as a vulnerable adult been made then
discussions would have taken place with all concerned with everyone having
significant information sharing it with others.

The earliest opportunity for Police to have made any referral to partner agencies
was 8" July 2012; however this was not completed until the second interaction on

19" August 2012.

3. The DHR recommendations are endorsed.

DHR — Recommendations and West Mercia Police Response
Se tications and West Mercia Police Response

The DHR did not make any specific recommendations for West Mercia Police.
There are four ‘All Agency’ recommendations:

Recommendation 1 - Risk Assessments

All Agencies must review their assessment and management of risk for service
users, their carers and significant others in their guidance for staff and provide an
analysis of its effectiveness and how it is being monitored.

Response: This recommendation does not appear to be wholly relevant to West
Mercia Police. Risk Management Plans are used pro-actively to effectively manage
risk, overseen by supervisors to ensure focus is maintained.

Recommendation 6 — Domestic Violence

All agencies must ensure that there are improvements in service responses for all
domestic violence victims (both adults and children), all relevant staff to attend
multi-agency training programme based on the DASH model.

Response: This recommendation is not relevant to West Mercia Police as all
operational staff are trained in the DASH risk assessment process. There are
policies and procedures in place to guide staff and the DASH risk assessment
process is utilised. This process is regularly audited by the Business Assurance

Team with appropriate learning disseminated to staff. A reminder regarding the

requirement to complete DASH, Crime Reports and Vulnerable Adult
documentation will be provided to all operational staff. This will be completed by

31.01.14.

Recommendation 7 — Support Services
All agencies need to review their service responses to people who suffer from

Alzheimer's and other Dementia Diseases and their Carers. This should be done in
partnership with groups such as the Alzheimer’s Society who have significant

knowledge and understanding of the issues.

Response: MCRT commented that current training delivered to operational staff
when dealing with vulnerable adults deals with mental health issues as a whole
and does not individualise conditions such as Dementia and Alzheimer's.

The recognition of a vulnerable adult by Police Officers and staff is considered
sufficient to trigger a referral process for specialised assistance.

The tactical equality and diversity advisor has recently attended a Dementia
Friends workshop to scope the feasibility of additional awareness sessions. This is
captured within the Warwickshire and West Mercia Mental Health Delivery Plan
(action 18) with a completion date of 01.09.14

Recommendation 8 — Support Services

A joint working group to be developed involving all agencies to address the
increasing prevalence of dementia to identify the manifestation of harm to
themselves or others and management plans to address these issues.

Response:
The arrangement of a joint working group will be tasked by the Safer Communities

Partnership to the Safeguarding Adults Board. West Mercia Police will ensure full
participation from specialist staff from the Protecting Vuinerable People
Department. Details are currently awaited regarding the date of the first meeting.

Conclusion
The matters raised as a result of the DHR will be actioned as detailed above.

This will be monitored until completion and discharged via the Strategic Oversight

and Scrutiny Group, chaired by Assistant Chief Constable.

Related reports

Other reports by John Ellery

See all →

More reports categorised “Other related deaths”

See all →

Track John Ellery

See every Prevention of Future Deaths report matching John Ellery, and how often a new one appears.

What would an alert for this have sent me? Search the full text

Free to try — the preview shows the real matches and how many arrived in the last 12 months. Your first email alert is free.

These reports are published by the Chief Coroner's office at judiciary.uk and are © Crown copyright. The text here is reproduced from the published PDF so it can be searched. If something on this page is wrong, or you are a person named in it and want it reviewed, email drcjar@gmail.com and we will act promptly.