Prevention of Future Deaths reports · 2016

Mihangel ap Dafydd

Regulation 28 report to prevent future deaths, reference 2016-0169, written 3 May 2016. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report3 May 2016
Reference2016-0169
DeceasedMihangel ap Dafydd
CoronerJonathan Layton
Coroner areaCarmarthenshire and Pembrokeshire
CategoryHospital Death (Clinical Procedures and medical management) related deaths · Mental Health related deaths
Sourcejudiciary.uk record · original PDF
Responses published2

The report

Text extracted from the PDF text layer. Reproduced verbatim, including the scan's own layout.

REGULATION 28:  REPORT TO PREVENT FUTURE DEATHS  

REGULATION 28 REPORT TO PREVENT FUTURE DEATHS 

THIS REPORT IS BEING SENT TO: 

Chief Executive West Wales General Hospital Glangwili Carmarthen 
Carmarthenshire SA31 2AF 
CORONER 

1 

I am Jonathan Mark Layton, senior coroner for the coroner area of Carmarthenshire and 
Pembrokeshire. 

2 

CORONER’S LEGAL POWERS 

I 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 18th February 2014 I commenced an investigation into the death of Mihangel ap 
Dafydd. The investigation concluded at the end of the inquest on 29 April 2016. The 
conclusion reached by the jury was a narrative one namely that: 
On 16th February 2014 Mihangel ap Dafydd hanged himself on Morlais Ward Glangwili 
Hospital.  He was properly assessed under the Mental Health Act upon his admission to 
hospital.  His level of observation was appropriate in the circumstances.  The procedure 
for removing items of property which could be used for the purposes of self-harm was 
undertaken incorrectly.  The hospital unit had not been correctly adapted to prevent 
windows being used as a ligature point.  These failings did contribute to his death. 

4 

CIRCUMSTANCES OF THE DEATH 

(1)  On 14th February 2014 Mr ap Dafydd was exhibiting signs of mental illness and 

was assessed as being at risk of self-harm. 

(2)  He was detained under the Mental Health Act and placed under 15 minute 

observations on Morlais Ward Glangwili Hospital. 

(3)  He was checked during the early hours of 16th February and was found hanging 

from a window having used a strap from his bag. 

5 

CORONER’S CONCERNS 

During the course of the inquest the evidence revealed this matter 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 is as follows: 

The windows in service user areas at Morlais Ward are not ligature free and whilst it is 
intended to make them so following the death of Mr ap Dafydd this work has not yet 
been undertaken. 

1

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 6 

ACTION SHOULD BE TAKEN 

In my opinion action should be taken to prevent future deaths and I believe you 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 the 28th June 2016. 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 

I have sent a copy of my report to the Chief Coroner and to the following Interested 
Person: 

Welsh Government Cathays Park Cardiff CF10 3NQ 

I am 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. 

9 

3 May 2016                                             Signed: 

2

Responses

2 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 University Health Board (PDF)
Bwrdd lechyd Prifysgol
Hywel Dda
University Health Board

flOur ref:

Private & Confidential
Mark Layton

Coroner for the Districts of
Carmarthenshire and
Pembrokeshire

Coroner’s Office

Town Hall

Hamilton Terrace

Milford Haven

Pembs SA73 3JW

Dear Mr. Layton
Re: Inquest into the death of Mihangel ap Dafydd

Thank you for your letter dated the 29th April, and the Regulation 28 report for
the Health Board's attention.

I can confirm that the Health Board undertakes an annual point of ligature
audit programme across all of its mental health and learning disability in-
patient units, which includes an audit of Morlais Ward on the West Wales
General Hospital site. The point of ligature audits undertaken following Mr. ap
Dafydd's death identified potential point of ligature risks with windows on a
number of the in-patient units, including Morlais Ward which were reported
through the Heaith Board's Capital programme. The point of ligature
programme is considered alongside all of the annual priorities across the
Health Board, and the replacement of windows was not deemed to be the
greatest priority, as following identification of the risk, steps were taken to
mitigate the risk, including the securing of windows in some areas.

The point of ligature audit programme plans to repeat the audit of all inpatient
units across mental health and learning disabilities in May/June 2016.
Following which a prioritised recommendations will be submitted for
consideration by the 2016/17 Capital programme, for each unit considering

Swyddfeydd Corfforaetho!, Adeilad Ystwyth, Corporate Offices, Ystwyth Building, Cadeirydd / Chair
Hafan Derwen, Parc Dewi Sant. Heo! Ffynnon Job, Hafan Derwen, St Davids Park, Job's Well Road, Mrs Bernardine Rees OBE
Caertyrddin, Sir Gaerfyrddin, SA31 BB Carmarthen, Carmarthenshire, SA31 3BB

Prif Weithredwe/Chief Executive
Mr Steve Moore

replacement, repair or adaptation of the existing windows in line with the
Department of Health Building Note 03-01.

Whilst the programme of work is being developed and prioritised it is essential
that the inpatient units that require adaptations to windows are able to provide
a safe and therapeutic environment for patients. Ensuring patient dignity and
safety are priority for the Mental Health and Learning Disabilities Directorate.
During the programme of work that will be undertaken, inpatient areas will
continue to be subject to regular environmental risk assessment. Where
necessary, actions will be taken to mitigate risks that take into consideration
patient dignity and comfort.

Yours sincerely

SeMooe

Steve Moore
Chief Executive
Response from Welsh Government (PDF)
Val Whiting
Dirprwy Gyfarwyddwr, Cyfalaf, Ystadau a Cyfleusterau/ 
Deputy Director, Capital, Estates & Facilities

Mark Layton
H M Senior Coroner for the Areas of Carmarthenshire & Pembrokeshire
Coroner’s Office
Town Hall
Hamilton Terrace
Milford Haven
Pembrokeshire
SA73 3JW

3 June 2016

Dear Mr Layton,

  Acting  Chief  Medical 
Thank  you  for  your  email  of  3  May  to 
Officer,  enclosing  your  Regulation  28  report  following  the  death  of  Mihangel 
ap  Dafydd  at  Morlais  Ward,  West  Wales  General  Hospital,  Glangwilli.  I  am 
replying  in  my  role  as  the  lead  official  for  NHS  estates  and  facilities  issues 
within Welsh Government. 

I  note  your  report  and  requested  actions  have  been  sent  to  the  Chief 
Executive  of  Hywel  Dda  University  Health  Board.    However,  given  that  you 
have identified issues which are of relevance to all NHS organisations, I can 
confirm  that  we  will  be  issuing  an  addendum  to Health  Building  Note  35  –
“Accommodation  for  People  with  Mental  Illness  Part  1:  The  Acute  Unit 
the 
Ligature  Free  Design”.  This addendum  will  specifically  highlight
requirement  for ligature  free  design in  both  new  and  existing  acute  mental 
health unit facilities in Wales. The addendum to the Health Building Note will 
also widen the requirements to other facilities dealing with acute mental health 
in-patients including Children & Adolescent Mental Health Services (CAMHS). 
This  document  is  in  the  process  of  being  finalised by  Welsh  Government 
officials and our NHS estates advisors and will issue by the end of this month.

In  addition  to  the  above,  I  have  also  requested  that  NHS  Shared  Services 
Partnership  – Specialist  Estate  Services  (NWSSP-SES) undertake  a  formal
review  of HBN  35.  This  will  consider  if  the  HBN  needs  more  substantial 
amendment or if it should be superseded by a revised HBN 03-01, amended, 
where  required,  to  reflect  further  developments  in  Welsh  Government  policy 
and any specific needs of NHS Wales.

 I  will  pick  up  the  individual  circumstances and  actions  taken  by  Hywel  Dda 
University  Health  Board  at  Glangwili  Hospital when  I  next  meet  the  Health 
Board later this month. 

I hope you find this information useful. Please do not hesitate to contact me if 
you have further concerns or queries.

Yours sincerely

Val Whiting

cc: 

, Deputy Director for Mental Health & Vulnerable 

Groups Policy

 Acting Chief Medical Officer

 Director NHS Wales Specialist Estates Services

2

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