Prevention of Future Deaths reports · 2018

Robin Richards

Regulation 28 report to prevent future deaths, reference 2018-0126, written 25 May 2018. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report25 May 2018
Reference2018-0126
DeceasedRobin Richards
CoronerTony Williams
Coroner areaSomerset
CategoryHospital Death (Clinical Procedures and medical management) related deaths
Sourcejudiciary.uk record · original PDF
Responses publishednone published

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.

Tony Williams
Senior Coroner for Somerset

REGULATION 28 REPORT TO PREVENT FUTURE DEATHS

THIS REPORT IS BEING SENT TO:
Peter Lewis, Chief Executive, Somerset Partnership, NHS Foundation Trust, 2" Floor, Mallard
Court, Express Park, Bristol Road, Bridgwater, Somerset TA6 4RN

Rt Hon Jeremy Hunt MP, Secretary of State for Health, Department of Health, Richmond House,
79 Whitehall, London SW1A 2NS

CORONER

| am Tony Williams, Senior Coroner for Somerset

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.

INVESTIGATION and INQUEST

On 03/07/2015 | commenced an investigation into the death of Robin Damien Richards, aged 33
years old . The investigation concluded at the end of the inquest on 09 March 2018. The
conclusion of the inquest was Robin deliberately chose to suspend himself by a belt and on
balance, at that time, he intended that the outcome be fatal. The Jury concluded that issues
contributing to Robin's death included: communication, training, information sharing, discharge
planning, care planning and risk assessment. At about 19.50 on 29th June 2015 Robin Richards
was found suspended by his belt on the staircase at Highbridge Court, Burnham on Sea. He was
unconscious. Emergency care was administered and he was taken to Weston General Hospital
where he died at 09.20 on 3rd July 2015.Cause of death was recorded as severe hypoxic brain
injury secondary to hanging.

CIRCUMSTANCES OF THE DEATH

Mr Richards has a long history of contact with mental health services. He was first assessed
aged 16 years, Mr Richards had diagnoses of Asperger’s Syndrome, Attention Deficit
Hyperactivity Disorder (ADHD) and a learning disability. In addition he had fluctuating
depressive, anxious and psychotic symptoms.

Mr Richards had three admissions under S2 of the Mental Health Act into hospital in quick
succession. The first admission was 12/04/14 to 12/05/14 and the second was from 28/08/14 to
29/09/14. Both admissions resulted from mental and behavioural disorders due to the use of
legal highs. Following each admission Mr Richards returned to supported accommodation.

on 17" February 2015 Mr Richards was admitted for the third time under s2. Mr Richards was
noted to be vulnerable to exploitation, had exhibited aggressive behaviour when under the
influence of legal highs and expressed suicidal thoughts. As in the two previous admissions Mr
Richards improved such that the 28 day detention under S2 was allowed to lapse and Mr
Richards was effectively free to leave the psychiatric ward. Mr Richards had nowhere to go as a
result of his former accommodation no longer being available. Mr Richards had received a
number of warnings from the landlords of his supported accommodation and it was felt the
accommodation no longer met his needs and his placement was not sustainable due to his
previous behaviour.

Mr Richards had no choice but to remain on the psychiatric ward whilst an alternative placement
was found for him. Mr Richards was extremely distressed at being on the psychiatric ward with
no clear idea of when and where he might move. The delay in finding a placement was a source
of frustration to medical professionals.

On 15" June 2015 Mr Richards transferred from the psychiatric ward to Highbridge Court,

Old Municipal Buildings, Corporation Street, Taunton, Somerset, TA1 4AQ
Tel 01823 359271 | Fax 01823 355060

Berrow Road, Burnham On Sea, Somerset. There was no formal handover. Although a
discharge plan was in place it highlighted risks to others rather than to Mr Richards himself. The
evidence was that there was insufficient detail in the plan about the support Mr Richards would
be offered at Highbridge court. Mr Richards exhibited behaviour showing signs of distress and
anxiety, he stepped out in front of cars on two occasions, superficially cut his head with a knife
and tried to access bleach in a locked cupboard. The staff at Highbridge court exercised a
somewhat haphazard observation policy. Follow up from the Mental Health Team was limited
and the Crisis Resolution Home Treatment Team had to be called to Highbridge Court and they
assessed Mr Richards reporting he did not want to return to hospital and that he should be
visited daily for the next five days. This did not happen and there was only telephone contact
with staff rather than face to face meetings with Mr Richards.

On 29" June 2015 Mr Richards was found hanging and he subsequently died on 3° July 2015.

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) That there exists a shortage of suitable supported accommodation for those diagnosed with
Asperger's Syndrome, both in Somerset and nationally. In the case of Mr Richards this shortage
resulted in him being obliged to remain on a psychiatric ward after his discharge under the
Mental Health Act. This was not in Mr Richards best interests.

(2) The suitability of Highbridge Court as a placement for Mr Richards which whilst CQC
registered had not been CQC inspected.

(3) A number of shortcomings on the part of Somerset Partnership NHS Foundation Trust (‘the
Trust’) in Mr Richards mental health care were identified;

a) Poor communication with family and between Trust staff.

b) A lack of clarity in Mr Richards discharge plan and as to what Mr Richards could expect from
his placement.

c) An inadequate handover.

d) Poor communication between Trust staff and Placement Staff and a failure to communicate
with Mr Richards personally at a time of crisis for him.

e) An inadequacy in the Trust's Risk Assessment process and subsequent management of risk
to include only having telephone contact with staff and not speaking directly with Mr Richards

Old Municipal Buildings, Corporation Street, Taunton, Somerset, TA1 4AQ
Tel 01823 359271 | Fax 01823 355060

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.

YOUR RESPONSE

You are under a duty to respond to this report within 56 days of the date of this report, namely by
20 July 2018. |, 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.

COPIES and PUBLICATION

| have senta "t of my report to the Chief Coroner and to the following Interested Persons; i

(Mother)
| 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.

Dated 25 May 2018

Signature
Senior Coroner for Somerset

Old Municipal Buildings, Corporation Street, Taunton, Somerset, TAl 4AQ
Tel 01823 359271 | Fax 01823 355060

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