Prevention of Future Deaths reports · 2017

Ann Maguire

Regulation 28 report to prevent future deaths, reference 2017-0417, written 22 Nov 2017. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report22 Nov 2017
Reference2017-0417
DeceasedAnn Maguire
CoronerKevin McLoughlin
Coroner areaWest Yorkshire (East)
CategoryAccident at Work and Health and Safety related deaths · Other related deaths
Sourcejudiciary.uk record · original PDF
Responses published1

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.

ANNEX A

REGULATION 28: REPORT TO PREVENT FUTURE DEATHS (1)

NOTE: This form is to be used after an inquest.

REGULATION 28 REPORT TO PREVENT FUTURE DEATHS
THIS REPORT IS BEING SENT TO:

1. The Office for Standards in Education, Children’s Services and Skills

1 | CORONER

lam Kevin McLoughlin, Assistant Coroner for the coroner area of West Yorkshire
(Eastern).

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 13" May 2014 an investigation was commenced into the death of Ann Maguire aged
61 years. The investigation concluded at the end of the inquest on 22" November 2017.
The conclusion of the Inquest was that she was unlawfully killed. She died from

1(a) Shock and haemorrhage due to 1(b) Stab wound to the neck severing jugular vein

4 | CIRCUMSTANCES OF THE DEATH

On 28" April 2014 Ann Maguire was stabbed by a 15 year old pupil as she taught
Spanish at Corpus Christi Catholic School, Leeds. She sustained some 7 stab wounds
and died within two hours at Leeds General Infirmary. The boy who carried out the
attack, [EE subsequently pleaded guilty to murder and is currently serving a
life sentence with a minimum term of 20 years.

Prior to the attack, i informed other children in his class of his intention to
kill three teachers and showed some of them the large kitchen knife he had taken from
home to use as a weapon. None of the 10 children concerned informed a teacher or
other adult of his intention or that he was in possession of a knife.

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. —

The need to prevent weapons such as knives being brought into schools in the UK is
axiomatic. How schools perceive the risks associated with weapons and manage them,
appears to be the subject of widespread variation.

The Inquest heard evidence from an OFTSED Inspector who visited the school in June

2013, some 10 months before the murder took place. Over the two days of the
inspection, the team of inspectors inevitably had to prioritise those aspects of the school
they would scrutinise. No indication was given to them from teachers, pupils or parents
that knives were a problem in that school; indeed the OFSTED report commented
students felt “very safe”.

OFSTED inspections already consider the issue of safety. In order to give greater
prominence to the need to control any weapon being brought into a school, OFTSED
are asked to consider making it mandatory for their Inspectors to review and report on
the way a school manages the safety of its pupils and staff and protects them from the
risk of violent attack. In this way OFSTED may be able to contribute to the
dissemination of good practice, for example, by publishing a prohibited items list and
reinforcing the need for children to report anything untoward to a teacher.

6 | ACTION SHOULD BE TAKEN

In my opinion action should be taken to prevent future deaths and | 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 17 January 2018. |, the coroner, may extend the period.

Your response must contain details of action taken or proposed to be taken, setting out
the timetabie for action. Otherwise you must expiain 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:

Leeds City Council -—=_

Corpus Christi Catholic College carn
West Yorkshire Police —- Superintendent Millar
SEE Solicitor

ee of Health and Safety, DFE

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

NOapRON >

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 | 22 November 2017 K done °

Responses

1 response 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 Respondent Not Named (PDF)
Aviation House T 0300 123 1231

125 Kingsway Textphone 0161 618 8524 _ Direct T 0300 013 1044
Lendon enquiries@ofsted.qov.uk Direct F 0207 421 6546
WC2B 6SE www.gov.uk/ofsted sean. harford@ofsted.gov.uk
raising standards
29 January 2018 improving lives

i Sean Harford HMI
Mr K Mcloughlin National Director, Education

Assistant Coroner, West Yorkshire (Eastern)
Coroner’s Office and Court

71 Northgate

Wakefield

WFi 3BS

ay
Our ref: KM/KLA/1154/14 4 oy

Dear Mr Mcloughlin
Inquest touching the death of Ann Maguire (deceased)

Thank you for your letter of 22 November 2017 following the inquest on the death of
Ann Maguire, who was a teacher at Corpus Christi Catholic College in Leeds. May I
thank you for providing an extension to the deadline for this response to the coroner.

We have noted the enclosures relating to your communications to government
departments and Amazon. This response deals specifically with your Annex A
covering Regulation 28, which is directed to Ofsted to consider.

We agree with the Coroner's concern regarding the need to prevent weapons being
brought into schools. In relation to the specific recommendations for Ofsted, the
need for inspectors to report on the arrangements in schools for protecting pupils is
already a mandatory part of our inspection process. Our current inspection
framework for education inspections is undergoing a review with a view to having a
revised framework in place for September 2019. We will, as part of that review,
consider whether it is possible to give more focus to the specific matter of protecting
pupils and staff from the risk of violent attack.

Ofsted’s cross remit Safeguarding Group has a responsibility to keep under review
the effectiveness of our school inspection process in so far as it relates to
safeguarding. The chair of this group has been made aware of the coroner's
concerns and these will be taken into account in future reviews,

In terms of the second part of the recommendation about Ofsted publishing a list of
prohibited items, to do this would be going beyond Ofsted’s responsibility as an
inspectorate. Such matters are relevant to the Department for Education (DfE), as
the lead government policy department with responsibility for schools. I note that a

similar request to publish a list of prohibited items has been directed to the Secretary
of State for Education and confirm that this is the appropriate place for such matters
to be considered. We are in regular contact with officials at the DfE and will, as
always, ensure that our inspectors are aware of any specific guidance that is issued
by government in relation to the safety of pupils and staff in schools.

Yours sincerely

L Mapas

Sean Harford HMI
National Director, Education

Se, 2017-0057479POS0S

Gr )
SPetewe ron gVee

Rt Hon Damian Hinds MP
Secretary of State

Sanctuary Bulldings Great Smith Street Westminster London SW1P 3BT
tel: 0370 000 2288 www. education.gov.uk/help/contactus

Kevin McLoughlin
Assistant Coroner, West Yorkshire (Eastern)

By email: hmcoroner @ waketieid.gov.uk

Your ref: KM/KLA/1 154/14

De Me MS angie

Thank you for your letter of 22 November, addressed to my predecessor,
following the inquest into the death of Mrs Ann Maguire.

You highlight some extremely important issues in the report you have enclosed, |
share the concems you have identified and it is important that we take whatever
steps we can to help prevent future tragedies of this kind from occurring. Your
Teport highlights two specific actions that you have éancluded would help address
your concems. These are:

(1) the Secretary of State is asked to consider circulating a prohibited items
list to schools nationally in order that the lesson arising from this case can
be disseminated io all educational establishments; and

(2) to consider a national campaign to highlight the need for children to report
to an adult any matter which concems them {along the lines, “see a knife,
tell a teacher’, or the broader message used on National Rail and the
London Underground, “see it, say it, sorted”),

| would like to assure you we are committed to making schools as safe as we
Possibly can. That is why we introduced new measures for schools in the
Education Act 2011 to give staff extended powers to search a pupil, or their
Property, if they believe they are carrying dangerous items. A list of prohibited
items is set out in legislation, in sections S50ZA to 550ZD of the Education Act
1996 (as amended by section 242 of the Apprenticeships, Skills, Children and
Learning Act 2009 and section 29 of the Education Act 2071), and includes

knives and weapons.

The prohibited items list and the associated search powers are important
components in ensuring pupil and staff safety in schools, My department's
published advice, Behaviour and discipline in schools: guidance for headteachers
and staff, includes the list of prohibited items and sends the important message
te schools that the power to search for these items is an integral component of
their behaviour policies. The advice is available online at: tinyurl.com/PP9vcus.

To help schco!ls with the implementation of these powers, we also set out the list
of prohibited items in my department’s guidance, Searching, screening and
confiscation: advice for schools. This advice explains to schools their statutory
power to set rules governing pupil behaviour and their duty as employers to
manage the safety of staff and pupils. This advice is available at:

tinyurl.com/m3msoQf.

! fully understand the thinking behind a national campaign. The culture of carrying
knives amongst our young people is a problem that we must address. As you
know, issues relating to knife crime and the associated culture extend beyond
schools, and the Home Office leads on these matters. The Home Office launched
a consultation in October containing legislative proposals to tackle knife crime.
This included proposals to restrict the online sale of knives to prevent sales to
under 718s, and to extend the possession of knives and offensive weapons
offence to education institutions other than schools. The consultation closed on 9
December and the Home Office is now considering the responses.

The Home Office is also taking forward an immediate package of non -lagislative
actions, including a new national anti-knife crime campaign in the early part of
this year. Although this campaign will not focus exclusively on the matters
addressed in your report, it will undoubtedly be relevant to young people of
schoo! age.

~ I share the sentiments set out in your report that it is important for schools io
have clear policies and properly promote them. This is vital to ensure that young
people know exactly what to do if they become aware of potentially harmful
matters. The Home Office's campaign provides an opportunity for us to consider
how to get this message into schools most effectively, and how we can ensure
that pupils are comfortable with sharing information about knives and other items
that may be used as weapons.

My department will be reviewing both Behaviour and discipline in schools:
guidance for headteachers and staff and Searching, screening and confiscation:
advice for schools. We will also review Advice on schoo! security: access to, and
barring of individuals from, school premises, which we are planning to update.
This guidance is available at: tinyud.com/zo3olv4. Revising this guidance, and
the associated communications we will have with schools, will enable us to
ensure that we have a strong and consistent message to promote to schools,
which addresses the issues you highlight in your report.

| consider the issues you raise to be of utmost importance and propose to have
changes to the aforementioned published advice in place for September 2018. |
will ensure you are kept informed of progress with this work.

Thank you for writing on this important matter.

CDR relay

Rt Hon Damian Hinds MP
Secretary of State for Education

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