Prevention of Future Deaths reports · 2019

Catherine Horton

Regulation 28 report to prevent future deaths, reference 2019-0143, written 15 Jan 2019. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report15 Jan 2019
Reference2019-0143
DeceasedCatherine Horton
CoronerSarah Ormond-Walshe
Coroner areaSouth London
CategoryMental Health related deaths
Organisation namedSouth London and Maudsley NHS Foundation Trust
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.

5

REGULATION 28 REPORT TO PREVENT FUTURE DEATHS

THIS REPORT IS BEING SENT TO:

Ms Cressida Dick

Commissioner for the Police of the Metropolis
New Scotland Yard

35 Victoria Embankment

Westminster

London

SWIA 2JL

L

[

CORONER

Tam Miss Sarah Ormond-Walshe, HM Senior Coroner, South London
jurisdiction

CORONER’S LEGAL POWERS

2009 and regulations 28 and 29 of the Coroners (Investigations) Regulations
2013,

I make this report under paragraph 7, Schedule 5, of the Coroners and Justice Act

|

are
=n

INQUEST: Ms Catherine Anne Horton

LI

| cRcUMSTAN CES OF THE DEATH

A jury found the medical cause of death was: 1a) Suspension
II) Paranoid Schizophrenia

How, by what means and in what circumstances, when and where did the death occur:

The evidence shows Miss Catherine Horton died in ee. sometime
between the 16th and 24th of July 2017, by hanging herself, as a paranoid
schizophrenic patient under section 3 of the Mental Health Act 1983. It is reasonable
to expect that Catherine should have been under the direct care and supervision of
Gresham 1 Ward, Bethlem Royal Hospital. The evidence suggests that the
circumstances which contributed to Catherine's death were as follows:

- Catherine absconded frorn Bethlem Royal Hospital at 01:36 on the 10th July 2017.

- There was a failure by ward staff on night shift duty from 9th July 2017 - 10th July
2017 to adequately observe Catherine, note her absence and report her absconsion.

- The administrative EPJS was ineffective in recording the date of receipt and content of
notes Catherine handed to staff. These notes were known to be Catherine's primary
method of communication whilst on the ward. They failed to be correctly fed into the
relevant patient notes and reports.

- Catherine's risk assessment was not correctly updated and did not accurately reflect
the risks that were relevant in her case.

- The grab pack prepared on the 10th July 2017 to assist the police was unacceptable
and contained serious omissions and inaccuracies.

- The management structure of the ward failed to provide adequate leadership and to
correctly delegate responsibility to individuals to co-ordinate the safe return of
Catherine to the ward.

- There was a deficiency in the understanding of how to execute a section 135(2)
warrant once it was obtained. This led to an unacceptably long period of time between
obtaining and executing the warrant.

- The above failures and omissions were causative of Catherine's death.

- There was no effective care plan for Catherine We cannot say one way or the other if
this failure was causative of Catherine's death.

Conclusion:

A suicide conclusion proved on the balance of probabilities, to which neglect
contributed.

CORONER’S CONCERNS
The MATTER OF CONCERN is as follows. -

During the course of the investigation, the evidence has revealed a matter giving
rise to concern that in my opinion means that there is still a risk that future deaths
will occur unless action is taken. In the circumstances it is my statutory duty to
report to you.

There were multiple failures in the days leading up to Ms Horton’s death. During
the evidence it was made clear that a mistake was made in relation to closing a
missing person investigation relating to the deceased (before a Safe and Well check
had been undertaken). This occurred at a time when staffing was low and the

| expectations of the Officer or Officers working on particular days was well above |
what was achievable. Particularly, on the day the investigation was incorrectly
closed was one where the unit was dealing with 28 missing person enquiries.

I strongly suspect that resources are stretched in every department of the MPS,
However, the missing persons’ unit may not be seen as readily as other
departments as a life-saving department. Of course it is because of the vulnerable
nature of the persons missing and I am told that Croydon has the highest figures
of missing persons in Europe. At the time of Ms Horton’s death, an error was
made that coincided with staff being relocated elsewhere and the senior officer
giving evidence said that the error was made due to pressure of work.

I have sufficient concern about a wider issue which warrants the writing of this
Prevent Future Death Report (CJA 2009, Schedule 5, Paragraph 7; Regulation 28
Coroners (Investigations) Regulations 2013) to be sent more centrally.

| |

6 | ACTION SHOULD BE TAKEN

In my opinion action should be taken to prevent future deaths.

Iam asking the MPS to ensure the missing persons unit has sufficient Officers
working in it at busy times, so as to make their job achievable, and to minimise the
likelihood of mistakes happening.

ly Hook RESPONSE

You are under a duty to respond to this report within 56 days of the date of this
report, namely by 12" March 2019 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.

If you require any further information or assist: ‘ontact
the Coroner’s Officer, on!

8 | COPIES and PUBLICATION |

T have sent a copy of my report to the following Interested Persons:

The family of Catherine Horton
[ South London and Maudsley NHS Trust

rt Police Conduct

Tam 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.

[DATE] [SIGNED BY CORONER]

15" January 2019 DP foresve

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 Metropolitan Police (PDF)
METROPOLITAN

POLICE
PROFESSIONALISM HQ

Miss Sarah Ormond-Walshe, Matthew Horne

Senior Coroner, Deputy Assistant Commissioner
South London Coroner’s Office, 6" Floor

2" Floor, Davis House, New Scotland Yard

Robert Street, Victoria Embankment

Croydon, London

CRO 10Q SW1A 2JL

Coroner’s Clerk: Email: |

Tel: 020 7230 1417

Your ref: 01/CO0/19/000249
Our ref: IX/83/17/ 1902_23

Date: 14th March 2019

“Deer Miss Gruuncl - oatahe ,

| am Deputy Assistant Commissioner Professionalism in the Metropolitan Police Service
(MPS). | write in response to your Regulation 28 Report to Prevent Future Deaths dated 15'"
January 2019. Your report was sent following the conclusion of the inquest into the death of
Ms Catherine Anne Horton.

In drafting this response the relevant subject matter experts have been consulted, principally:

Detective Superintendent a South Area BCU Safeguarding; Detective Chief

Inspector NN Safeguarding (Transformation); Assistant Commissioner
HEE | rontline Policing and Chief Superintendent (ga Transformation.

Response to Matter of Concern:

There were multiple failures in the days leading up to Ms Horton's death. During the evidence
it was made clear that a mistake was made in relation to closing a missing person investigation
relating to the deceased (before a Safe and Weill check had been undertaken). This occurred
at a time when staffing was low and the expectations of the Officer or Officers working on
particular days was well above what was achievable. Particularly, on the day the investigation
was incorrectly closed was one where the unit was dealing with 28 missing person enquiries.

| strongly suspect that resources are stretched in every department of the MPS. However, the
missing persons’ unit may not be seen as readily as other departments as a life-saving
department. Of course it is because of the vulnerable nature of the persons missing and | am
told that Croydon has the highest figures of missing persons in Europe. At the time of Ms
Horton’s death, an error was made that coincided with staff being re-located elsewhere and
the senior officer giving evidence said that the error was made due to pressure of work.

! am asking the MPS to ensure the missing persons unit has sufficient officers working in it at
busy times, so as to make their job achievable, and to minimise the likelihood of mistakes
happening.

The structure, working practices and resourcing of MPS Missing Persons Units (MPUs) have
changed significantly since 2017. The MPS has now implemented a programme to
incorporate thirty two boroughs into twelve Basic Command Units (BCUs), providing resilience
and consistency across London to help the MPS meet its financial and operational challenges.
The design of the new MPUs under this programme is intended to resolve some of the historic
issues that have been raised which involves an investment of additional posts into MPUs
across the MPS. Considering the financial constraints the MPS is operating within, we believe
this to be a significant commitment to what is acknowledged as an area of risk.

Under the delivery of this new policing model for London, each BCU has established a MPU
that is resourced according to local demand. Each MPU works to a set of minimum standards
of operational procedure, staffing levels, skills and supervision. The responsibility of
implementing the model and operational delivery lies with local leadership teams, ultimately
BCU Commanders. This does however involve balancing available resources at times against
operational demand, and flexing resources to respond to peaks and critical issues. The BCU
Commanders are best placed to make decisions where vacancies are held, taking into account
all the risks being dealt with by the BCU as a whole and by Safeguarding the most vulnerable
in particular.

MPUs are located within a new BCU Safeguarding Hub, which has combined policing units
that deal with the most vulnerable together under a single command structure. This allows the
local safeguarding senior officer, who is a Detective Chief Inspector rank in the Safeguarding
Hub, to take a holistic approach to short and longer-term risk management. The local Duty
Detective Inspector has the flexibility to increase officer numbers in the MPU at times of high
demand due to the flexibility of the new BCU model. Safeguarding hubs also deal with mental
health, child sexual exploitation and referrals from local authority adult and child safeguarding
services.

The MPS has invested significantly in safeguarding focused police officer posts as part of the
new BCU model, which has resulted in an increase of dedicated MPU officers. The MPUs are
now integrated with local command and control functions via a local operations room in each
BCU that monitors live and incoming risk at all times. Any new missing person who comes to
the notice of police will continue to be risk assessed and monitored by the emiérgency
response team Duty Inspector. Any high-risk missing pérson will immediately be passed to
the Safeguarding MPU under the direction of a Detective Inspector who will utilise all relevant
and available resources to ensure priority actions are addressed. Safeguarding investigation
teams across London are resourced 24 hours a day following the implementation of a
corporate shift pattern. This delivers greater operational resilience to the Duty Inspector
overnight to ensure that crucial lines of enquiry can be conducted with the required urgency.

Following the implementation of BCUs, led by the Assistant Commissioner for Frontline
Policing, the Deputy Assistant Commissioner for Local Policing will conduct a three month
review of their progress; this provides the opportunity to check that all the elements of the BCU
including MPUs are working effectively. This will be followed by a full review (June to
September 2019) and recommendations will be provided on how to further improve the model
taking into account pressures that have been experienced and address any risks or issues
that have been identified.

The MPS has reviewed and updated its policies and standard operating procedures for on-
going risk-assessments, investigations and interviews with returning missing people.
Interviews with returned or found missing people are aimed at prevention of further missing
episodes. Information that could prevent the person going missing again, along with any other
information affecting their welfare, is disseminated to our policing and partner agencies, which
allows for early intervention.

investigator toolkits have been updated and are now readily available via response officers’
standard issue mobile-devices. Further advice and support is available from a safeguarding
officer attached to every BCU Operations Room, who will have had the safeguarding induction
course and will be substantive detectives.

All officers posted to MPUs must attend a mandatory week-long training course that was
redesigned in 2018 and is now being delivered to officers in every BCU. Three day bespoke
training is also being delivered to BCU Duty Inspectors.

South Area (SN) BCU incorporates the boroughs of Croydon, Sutton and Bromley. The South
Area MPU has had an uplift of officers with a pian to increase staffing levels further in the near
future. High risk missing person cases should attract a BCU response and a senior detective
within the Safeguarding Hub will lead the investigation. There are currently some challenges
regarding the investigation of low and medium graded missing person reports before they
reach the MPU, however this is now being addressed as a matter of urgency.

In Conclusion

Since 2017 the MPS has undergone a significant restructure with the implementation of a BCU
model. BCUs now have dedicated Safeguarding Hubs staffed by trained officers and a chain
of command that addresses the changing demands of each BCU in order to manage the day
to day risks. The MPS has invested in additional staff in MPUs and provided access to 24
hour support to afford the necessary flexibility and resilience to the investigation of missing
persons.

| trust this provides the reassurance that the MPS has considered the points you have raised,
and that we have moved promptly to make such improvements.

Please do not hesitate to contact me if | can be of further assistance.

Yours sincerely,

Deputy Assistant Commissioner

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