Prevention of Future Deaths reports · 2019

Daniel Davey

Regulation 28 report to prevent future deaths, reference 2019-0267, written 16 May 2019. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report16 May 2019
Reference2019-0267
DeceasedDaniel Davey
CoronerDarren Salter
Coroner areaOxford
CategoryState Custody related deaths
Organisation namedMidlands Partnership University NHS Foundation Trust
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.

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

1. Mr Phil Copple, Director General, H M Prison and Probation Service
102 Petit France, London SW1H 9AJ

2. Mr Jim Easton, Chief Executive Officer Healthcare, Care UK, Hawker
House, 5-6 Napier Court, Napier Road, Reading, Berks RG1 8BW

3. Mr Neil Carr, Chief Executive, Midlands Partnership NHS Foundation
Trust, St George’s Hospital, Corporation Street, Stafford ST16 3SR

CORONER

lam Mr D M Salter, HM Senior Coroner for Oxfordshire.

"| 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

At Oxford Coroners Court between 29 April and 7 May 2019 | conducted the
inquest into the death of Daniel Davey at HMP Builingdon. The Jury returned a
Narrative Conclusion as follows:

Mr Davey died on 12 January 2018 at 12:31am at the John Radcliffe Hospital after
taking approximately 63 tablets of propranolol at around 8pm in cell E114 at HMP
Bullingdon Prison.

The Jury concludes that Mr Davey deliberately took an overdose of his propranolol
with the intention to commit suicide.

HMP Bullingdon failed to adequately train prison staff in ACCT management,
assessment and review processes. It also failed to implement national policy
regarding the inclusion of healthcare in the ACCT process and also failed to perform
a search of Mr Davey’s cell upon opening ACCT 2.

Healthcare providers failed to adequately and regularly risk assess ‘in possession’
Medication. Healthcare failed to adequately share risk relevant information given
by Mr Davey on 29 December 2017. Mr Davey’s request to reduce his medication
was based on misleading information relating to a move to Grendon and wasn’t
challenged or adequately assessed by any healthcare professional.

Following the reduction of medication on 4 January and the incident of self-harm
on 7 January, there was no follow up or intervention from the secondary healthcare
team and a system wide failure to recognise a pattern of behaviour and escalating
“cries for help”.

The Jury concludes that there was a failure to act on the sum of information that
was reasonably available to both prison and healthcare personnel in order to keep
Mr Davey safe.

HMP Bullingdon/Prison and Probation Service were legally represented at inquest
as was Care UK (CUK) and Midlands Partnership Trust (MPT). Mr Davey’s father,

was also legally represented. A copy of the inquest file was
available to Interested Persons prior to inquest. For this reason, | am not providing
you with a full copy of the file, but | anticipate that it would be helpful for you to have
a copy of the witness statement for (Prison Governor) and

(Head of Healthcare, Care UK). The statements contain evidence
concerning recommendations made by the PPO and Care Uk’s internal
investigation.

It will be seen that this Regulation 28 Report is being sent to HMPPS, CUK and
MPT because the issues which | raise apply to all organisations albeit to varying
degrees.

CIRCUMSTANCES OF THE DEATH

Daniel Davey was 21 Years old when he was pronounced deceased just after
midnight on 12 January 2018 at the John Radcliffe Hospital, Oxford. The cause of
death following a post mortem examination was ‘Aspiration of gastric contents and
propranolol intoxication’. He initially became unwell at about 10pm in his cell prior
to suffering seizures and a cardiac arrest at the prison and being taken to hospital
by ambulance. Mr Davey said to prison staff at the prison that he had taken an
overdose of his prescribed medication, propranolol. He had been in Bullingdon
Prison since 1 December 2017 (just over a month) having been sentenced to 10
years for sexual offences. It was his first time in prison. He had a history of mental
health probiems including suicidal thoughts.

It will be seen that further circumstances relating to Mr Davey’s death are outlined
in the Jury’s Narrative Conclusion including reference to failures in his care.

CORONER’S CONCERNS

During the course of the Inquest the evidence revealed matters giving rise to
concerns. 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 make this report to you.

During the course of the inquest | heard evidence from members of prison and
healthcare staff. It was apparent that improvements were introduced after the
death of Mr Davey and the system operates differently now. | also heard evidence
specifically about improvements from Governor Blakeman and Ms Lutton. This
helpfully provided a level of reassurance. However, | remain concerned about a
number of issues.

The MATTERS OF CONCERN are in relation to the following:

1.

Healthcare attendance at ACCT reviews — This concern relates to both
the prison and healthcare. It was clear from evidence from prison and
healthcare staff that it was not routine for healthcare to attend ACCT
reviews. This is a significant concern and it is not in accordance with local
and national policy. | understand that there were occasions when prison
staff requested healthcare attendance, but no one was available. The
system of providing advance notification to healthcare about the date of
ACCT reviews was not comprehensive. It resulted in ACCT reviews, as in
this case, taking place without key information being available to the
assessor/reviewer. For example, information about — suicidal
ideation/attempts and other information disclosed to healthcare and also
information about ‘in possession medication’. Encouragingly, the evidence
from prison and healthcare staff was that ACCT reviews no longer take
place without healthcare attendance and/or input (perhaps over the
telephone). It would be helpful if there could be a further level of
reassurance provided about, firstly, communications between prison and
healthcare staff in the conduct of ACCT reviews and, secondly, a process
of auditing ACCT reviews in order to pick up cases where there is no
healthcare input.

Reviews of ‘in possession’ medication risk assessments — The second
concern also relates to prison and healthcare. In particular, it relates to a
prisoner placed on an ACCT. | heard evidence that, initially, a template is
used at the reception healthcare screen to determine if medication should
be held in possession or not. | was told that, now, this is subsequently
reviewed by the prescriber and, on opening an ACCT, there is an automatic
review of the risk assessment in accordance with CUK’s new policy.

In the case of Mr Davey, there was an initial risk assessment at reception
and he was deemed suitable for in possession medication, but this was not
reviewed when he was subsequently placed on the 2 ACCT documents in
December and January or when he disclosed to a mental health nurse on
29 December that he had a plan to kill himself. | understand that new
systems are in place (with healthcare) but it would be reassuring if there is
a system of audit to ensure compliance, namely, that the in possession risk
assessments are reviewed. | appreciate a review might not necessarily
result in medication being taken away. | also appreciate this is a difficult
area in view of patient confidentiality and, of course, the danger that a
prisoners physical or mental health could be put at risk if medication is taken
away.

A related concern is the fact that prison officers did not appear to have in
mind the risks associated with in possession medication. It appeared to be
disregarded because it was information that was not available to them and
it was therefore deemed a maiter for healthcare. | am concerned that there
is a danger in leaving the issue of in possession medication solely to
healthcare. There could be a time delay of several hours or even longer
between a prisoner having a mental health crisis and healthcare

involvement/reassessment. It appears there needs to be joint liaison
between the ACCT case manager and healthcare and a plan to intervene
and remove medicine if necessary.

This leads to a final related concern. There is the question of cell searches
for stockpiled medication and the collection of properly held in possession
medication when there is a change of risk such as an ACCT document
being opened. | did not hear much evidence about practice or policies
relating to searching and potentially removing medication. This is clearly a
task that rests with prison staff and it would be helpful to have further
information about this.

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. | may extend the period on request.

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

| confirm that a copy of this report and your response will be sent to Mr Davey's
family.

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.

Signed Date

. 16/05/2019
Pa rv
r D.M. Salter

HM Senior Coroner for Oxfordshire

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 Care UK (PDF)
HMP Bullingdon 
Patrick Haugh Road 
Arncott 
Bicester  
OX25 1PZ  

HM Senior Coroner, Mr Darren Salter 
The Oxfordshire Coroner’s Office 
Second Floor   
1 Tidmarsh lane 
Oxford  
OX1 1NS 

3 July 2019 

Dear Sir 

Regulation 28 – Prevention of Future Death Report: Mr Daniel Davey - HMP Bullingdon 

I  am  writing  in  response  to  the  Regulation  28  report  which  you  issued  following  the  inquest 
touching on the death of Mr Daniel Davey, a prisoner at HMP Bullingdon. 

Care UK would like to express its sincere condolences to Mr Davey’s family and friends.  

In your report you raised two issues of concern, both of which are addressed to Care UK, in its 
capacity as the healthcare provider, our sub-contractor Midland Partnership NHS Foundation 
Trust, and also to Her Majesty’s Prisons and Probation Service who will respond separately to 
the concerns raised.  

Concern 1:  

Healthcare attendance at ACCT reviews. 

It  would  be  helpful  if  there  could  be  a  further  level of reassurance provided about, 
firstly,  communications  between  prison  and  healthcare  staff  in  the  conduct  of  ACCT 
reviews and,  secondly,  a process  of  auditing ACCT reviews in order  to pick up  cases 
where there is no healthcare input. 

Response 

In your report you highlighted “Encouragingly, the evidence from prison  and healthcare  staff 
was  that  ACCT  reviews  no  longer  take  place  without  healthcare  attendance  and/or  input 
(perhaps  over  the  telephone).”  This  status  continues  to  be  supported  by  Care  UK’s  Local 
operating procedure (“LOP”) for “Healthcare attendance at ACCT’s”.  This LOP was reviewed 
and updated in February 2019 and ensures a member of healthcare staff  is detailed daily to 
attend the day’s planned ACCT reviews. This member of staff can be contacted daily via radio 
from  08.00  until  17.00hrs.  Any  requests  for  healthcare  attendance  at  new  ACCTs  opened 
throughout  the  day  are  communicated  from  the  prison  to  the  Healthcare  Coordinator.  All 
ACCT  reviews  are  added  to  the  SystmOne  Ledger  and  appointments  closed  down  on  the 
system to demonstrate and record completion of the ACCT review.  

Care UK Health & Rehabilitation Services Limited - Registered in England No 10498997 
Registered Office: Connaught House, 850 The Crescent, Colchester Business Park, Colchester, Essex CO4 9QB 

 
 
 
 
 
 
 
 
 
 
 
 
 Care  UK  continues  to  work  closely  with  the  HMP  Bullingdon  Safer  Custody  department  to 
improve partnership working  throughout  the management  of the  ACCT  process.    In  order  to 
ensure continued healthcare attendance to ACCT reviews a new electronic quality assurance 
process  has  been  introduced.    This  is  supported  by  Safer  Custody  staff  spot  checking 
compliance and escalating where necessary. 

Concern 2: 

Reviews of ‘in possession’ medication risk assessments.  

a.   It  would  be  reassuring  if  there  is  a  system  of  audit  to  ensure  compliance, 

namely, that the in possession risk assessments are reviewed. 

b.    I  am  concerned  that  there  is  a  danger  in  leaving  the  issue  of  in  possession 
medication solely to healthcare. There could be a time delay of several hours or 
even  longer  between  a  prisoner  having  a  mental  health  crisis  and  healthcare 
involvement/reassessment.  It  appears  there  needs  to  be  joint  liaison  between 
the  ACCT  case  manager  and  healthcare  and  a  plan  to  intervene  and  remove 
medicine if necessary.  

Response  

I can confirm that HMP Bullingdon is fully compliant with Care UK’s mandatory monthly audit 
in ensuring all prisoners have an ‘in possession status’ recorded on their medical notes from 
reception.  

HMP Bullingdon also adheres to the Care UK “In possession policy for Prisons” which reviews 
‘in possession’ status:  

1.  After any relevant incidents  

2.  If  the  prisoner’s  circumstances  change  or  medication  is  no  longer  deemed 

appropriate  

3.  Following  the  opening  of  an  ACCT  document.  The  “CUK  Health  contribution  to 
ACCT”  template  also  supports  and  prompts  healthcare  staff  to  complete  an  ‘in 
possession’ risk assessment when documenting, an ACCT has been opened and 
to review when attending an ACCT review.  

4.  Or otherwise  when a member of healthcare staff believes it to be necessary, e.g. 

concerns are raised that the prisoner is being bullied. 

I  would  like  to  provide  assurance  that  random  spot  checks  are  undertaken  to  support 
concordance and reduce the risk of diversion or stockpiling for overdose.  

These spot checks are undertaken by a member of the healthcare team supported by prison 
disciplinary  staff.  Where  there  is  a  discrepancy  between  the  numbers  of  tablets  a  patient 
should  have  and  the  number  found,  the  patient  is  reviewed  to  see  if  the  medication  is  still 
required or if it needs to be moved to not in possession. At any point in time, any member of 
healthcare staff having concerns regarding patient safety can ask for the In-possession status 
to  be  reviewed  to  ‘Not  In-possession’  by  contacting  the  prescriber.  This  would  be  clearly 

Page 2 of 3 

 
 
 
 
 
 
 
 
 documented  on  SystmOne.  In-possession  status  can  also  be  removed,  whilst  the  review  is 
pending.  

I have met with the Safer Custody Governor and discussed the need for prison staff to have a 
joint  responsibility  when  considering  ‘in possession’  medication  is  a potential  risk. The  Safer 
Custody Governor is recommending this awareness is included in case manager training and 
is taking this action forward.  

I  trust  this  provides  assurance  that  Care  UK  is  committed  to  working  in  partnership  and 
improving processes to support the safety of men whilst at HMP Bullingdon. If you would like 
to review copies any of the policies or procedures mentioned in this letter please let me know.  

Yours faithfully 

Head of Healthcare, HMP Bullingdon 

Page 3 of 3
Response from Hm Prison Probation Service (PDF)
Phil Copple

Director General Prisons

HM Prison and Probation Service
8'" Floor Ministry of Justice

102 Petty France

London SW1H 9AJ

HM P r ison & Email: DirectorGeneralPrisons@justice.gov.uk
Probation Service

Mr D M Salter, Senior Coroner
Oxfordshire Coroner’s Office
The Oxford Register Office
2nd Floor

1 Tidmarsh Lane

Oxford

OX1 1NS

05" August 2019
Dear Mr D M Salter

Thank you for your Regulation 28 Report dated 16 May 2019, following the inquest into the
death of Mr Daniel Davey at HMP Bullingdon. | am also grateful to you for granting a short
extension to the usual deadline for reply.

| know that you will share a copy of this response with Mr Davey’s family, and | would like
first to express my condolences for their loss. Every death in custody is a tragedy, and the
safety of those in our care is my absolute priority.

| was pleased to read that you were reassured by the evidence that you heard at the
inquest that improvements had been made at the prison. You have raised two outstanding
matters of concern: the attendance of healthcare staff at Assessment, Care in Custody and
Teamwork (ACCT) reviews; and reviews of in possession medication risk assessments,
with a related question about the policy for cell searches for stockpiled medication. | will
deal with each concern in turn.

In June 2019 a new way of operating the ACCT case management system was
implemented at Bullingdon, with a specific case manager being allocated to each ACCT
case. This system allows ACCT reviews to be booked by the case managers on a
spreadsheet that is overseen by the safer custody department. Reviews can be organised
earlier through this booking system, giving healthcare better capability to ensure attendance
at all reviews, ‘and each day an identified member of healthcare staff is responsible for
attending each review or allocating an attendee to go in their place. If there are any issues
with healthcare attendance, case managers are asked to inform the safer custody
department and remedial action is taken.

Although this new process is still being embedded, early indications are that healthcare staff
are now attending all reviews. The allocation of a dedicated case manager allows for a
consistent review and key information is much more likely to be available. Additionally, once
the key worker model, in which officers are responsible for managing a small number of
offenders, is fully implemented, these staff will have a good knowledge of the individual and
will be able to feed into the ACCT reviews. Where possible this will be by attending, but it
could also include.a verbal or written submission to be included in the review.

New electronic quality assurance checks are to be introduced and embedded by the end of
August 2019, and these will include checking healthcare attendance at reviews. In the
meantime, the safer custody department is performing spot checks to monitor progress.

At national level we are working to improve the ACCT case management system and
piloted a new version of the form and associated guidance in ten prisons during the spring
of 2019. We realise the importance of the healthcare contribution to ACCT, and NHS
England, and their Welsh equivalents, have been involved in this pilot project. The revised
form and guidance are clearer about the expectations of healthcare staff. We are currently
evaluating the pilot and plan to implement the new model nationally during 2020. We will
ensure that the learning from this case is used to inform the development of the materials
that are used to inform the national roll out of the new model.

Your second concern relates to reviews of in possession medication risk assessments. |
understand Care UK and Midlands Partnership NHS Foundation Trust will be replying to
you separately on this point. At Bullingdon, if the ACCT case manager is concerned about
the immediate welfare of an individual they are required to conduct a review immediately,
and to ensure that there is healthcare input to that review. The prison has issued guidance
to all case managers stating that in possession medication is one of the topics that should
routinely be discussed in ACCT reviews, and that a risk assessment must be conducted,
informed by the advice of healthcare staff. If this advice is not immediately available then
ACCT case managers can at their discretion remove in possession medication until they
can confirm that it is safe for the prisoner to continue to have it in their own possession.

Lastly, you asked about the policy for cell searches for stockpiled medication. The safer

’ custody department has distributed a safety briefing on in possession medication to all staff
to ensure that they are aware of the risks and know what action to take if they discover

. unusual amounts of in possession medication when conducting fabric checks or cell
searches. In future, the issue of stockpiled medication will also be covered in the local
ACCT case manager training so that, when immediate actions plans are completed,
consideration is given to the need to check for and remove in possession medication as a
temporary measure before a full assessment and review has taken place.

This is in line with existing national policy, and we will ensure that this continues to be the

case, and that it is prominent in the guidance that is issued when the revised version of

ACCT is rolled out, so that the learning from Mr Davey’s tragic death is shared as widely as
_ possible.

Thank you again for bringing these matters of concern to my attention. | hope this response
has provided reassurance that they are being fully addressed at Bullingdon and at national
level.

Yours sincerely,

Ko apple

PHIL COPPLE

Director General for Prisons
Response from Midlands NHS Trust (PDF)
INHS

Midlands Partnership
NHS Foundation Trust
A Keele University Teaching Trust

Neil Carr

Chief Executive
Trust Headquarters
St George’s Hospital
Corporation Street
Stafford

ST16 3SR

Tel: 0300 790

Mr DM Salter

HM Senior Coroner for Oxfordshire
Coroner’s Office

Oxford

Dear Mr Salter

RE: Daniel Davey

Thank you for your letter dated 16"" May 2019, reporting a matter to us, in
accordance with Regulations 28 and 29 of the Coroner's (Investigations)
Regulations 2013.

May | take this opportunity to reassure you that following Mr Davey’s death, we
undertook a thorough investigation into the care delivered by the Trust.

Following discussions with all parties, | am now in a position to respond to your
concerns.

Matter of Concern 1: “Healthcare attendance at ACCT reviews: It was clear
from evidence from prison and healthcare staff that it was not routine for
healthcare to attend ACCT reviews. This is a significant concern and it is not
in accordance with local and national policy. Encouragingly, the evidence
from prison and healthcare staff was that ACCT reviews no longer take place
without healthcare attendance and/or input (perhaps over the phone).” You
would like “reassurance provided about firstly, communications between
prison and healthcare staff in the conduct of ACCT reviews and, secondly a
process of auditing ACCT reviews in order to pick up cases where there is no
healthcare input”.

Jogether we are making life

better for our communities

Response;

We continue to work with colleagues in Care UK and the prison to ensure we
support attendance at ACCT reviews and maintain the improved processes. We
comply with the Care UK Local Operating Policy for Healthcare and Subcontracted
teams input into the ACCT process.

The Local Operating Procedure identifies there is an expectation that the staff
attending the ACCT record this on SystmOne and future reviews are diarised for
attendance.

We will actively contribute to quality assurance checks of compliance with this
Local Operating Policy including those done as part of the PROTECT audits and
are committed to improving our service delivery in response to any actions
identified within these checks. In addition we will work with Care UK and the prison
in the development of procedures for escalation should healthcare, for any reason,
be unable to attend an ACCT review.

Matter of Concern 2: “Reviews of mental health “in possession medication
risk assessments: relates to a prisoner placed on an ACCT. Initially a
template is used at the prison healthcare screen to determine if medication
should be held in possession or not. This is subsequently reviewed by the
prescriber and, on opening an ACCT, there is an automatic review of the risk
assessment in accordance with CUK’s policy. In the case of Mr Davey, there
was an initial risk assessment at reception and he was deemed suitable for in
possession medication, but this was not reviewed when he was
subsequently placed on the 2 ACCT documents in December and January or
when he disclosed to a mental health nurse on 29"" December that he had a
plan to kill himself. You would like reassurance that the in possession risk
assessments are reviewed. A related concern was that information about in
possession medication was not available to prison officers thus there could
be a time delay between a person experiencing a mental health crisis and
healthcare involvement/reassessment, potentially leaving the person with
access to in possession medication at a time of crisis.”

Response:

As was stated at the inquest, our prescriber's always record on the prescription
form whether the medication they are prescribing should be held in possession.
We have reminded our staff to ensure when they are reviewing any medication that
they, where necessary, include an update of the ‘Medication In possession risk
assessment’ which goes onto SystmOne, which in turn will feed into the ACCT.
This ensures that both dispensing staff and prison staff are aware of any changes
and respond accordingly, this will include the removal of any medicines currently
being held.

As part of the ACCT LOP we are committed to working with colleagues in Care UK,
Pharmacy and Safer Custody regarding medication reviews and “stop checks”.

In addition, this case has been reviewed with the staff involved and the learning
shared that whenever a patient indicates changes in presentation in relation to
serious self-harm, such as changes in suicidal ideation or a plan, that in all
circumstances this will trigger the opening of an ACCT.

| hope this response helps to address your concerns. However if you require any
further information please do not hesitate to contact me

~~ Neil Carr
Chief Executive

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