Prevention of Future Deaths reports · 2019

Jacob Bates

Regulation 28 report to prevent future deaths, reference 2019-0456, written 31 Dec 2019. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report31 Dec 2019
Reference2019-0456
DeceasedJacob Bates
CoronerPeter Nieto
Coroner areaDerby & Derbyshire
CategoryCommunity health care · Mental Health related deaths · Suicide (from 2015)
Organisation namedChesterfield Royal Hospital 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.

Derby & Derbyshire Coroner’s Area

REGULATION 28: REPORT TO PREVENT FUTURE DEATHS (1)

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

The Rt Hon Gavin Williamson CBE MP, Secretary of State for
Education, Department for Education

CORONER

| am Peter Nieto, Area Coroner, for the Coroner Area of Derby &
Derbyshire.

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 17 July 2017 | commenced an investigation into the death of Jacob
Andrew Bates (dob: 5 January -2000; dod: 15 July 2017). ‘The
investigation concluded by way of an inquest hearing from 2: to 5
December 2019 (a copy of the record of inquest is enclosed with the
covering letter to this report). My findings at inquest were as follows: -

' = Medical cause of death: -
ja Ligature around the neck.
1b Mental health issues and autism.

~ Summary of circumstances: -

Jacob died as a result of placing plastic ties around his neck as
ligatures. Although he had not given any immediate indication to
anyone that he was contemplating taking his own life he was
assessed as being at on-going risk of serious self-harm. Due to the
nature of the act, his self-harm history, the on-going assessed risk,
and his leaving of a ‘suicide’ note | found that he had undertaken a
deliberate act with the intention of taking his own life. Just prior to
his death a six month unregulated placement had recently been
ended, and prior to that placement he had spent over two and a
half years ina succession of secure placements.

On the evidence | did not find that factors associated with the
unregulated placement had directly contributed to Jacob's death.

- My conclusion as to Jacob 's death was a short form conclusion of
' guicide.

CIRCUMSTANCES OF THE DEATH

Jacob had diagnoses of autism and mental health problems. Following a
serious ‘overdose in February 2014 he was thereafter placed in a

succession of secure placements under the provisions of the Mental’

Health Act 1983 and the Children Act 1989 until he returned to his home
area of Chesterfield around Christmas 2016 when he was placed, under
the provisions of s.20 Children Act 1989; in an unregulated placement for
young people aged between 16 .and 18 years of age and was also
supported by local authority social care’ and child. and adolescent mental
health services. The Chesterfield placement was not a_ specialist
placement for young people with autism or mental health problems and
the placement had been made in the context of a specialist placement
‘having given very short notice of termination of placement. There had
been many episodes of self-harm following the overdose in February,
some serious, including just two months prior to his death and he was
assessed at on-going risk of serious self-harm. The Chesterfield
placement came to an end following Jacob’s decision to move in to live
with his father where he received on-going support from the agencies.

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.

As | have stated | did not find that the evidence established a causal or
contributory connection between the unregulated placement and Jacob's
death. | found this to be so on the applicable civil law test, the balance of
probabilities. However in my summing-up I did express my serious
concerns that Jacob had been placed in an unregulated placement
despite his history, needs, and risks.

Evidence was given at the inquest hearing by two former employees at
the placement that they had no prior experience of working. with young
people (indeed no experience. of working in any form of care-related
work) and were left in charge of the unit where Jacob was placed after a
very short period of commencing employment (one former staff member
said that he had only completed two shadowing sessions before being
asked to be in sole charge of the unit overnight).

The evidence of the responsible local authority was that it had not sought
evidence from the placement provider as to staff competency and

training, or that suitable policies and procedures were in place; it

effectively accepted the assurances of the provider.

The local authority stated that it now has systems providing for greater
scrutiny and diligence - but it was explained that where
residential/supported provision is solely for young people aged 16 to 18
that provision: falls outside or the statutory regime of inspection and
regulatory compliance as enforced by Ofsted. My understanding is that

the issue of unregulated placements for 16 to 18 year olds has been.
widely highlighted as a cause for concern but the evidence of a senior |

local authority manager at inquest was that she was unaware of any
plans nationally to address the issue despite concerns having been very
widely raised.

‘The MATTERS OF CONCERN are as follows: -

1. Vulnerable young people, aged 16 to 18, are being placed in |.

unregulated placements.

2. Any young person under the age of 18 placed in an unregulated
placement is likely to have very significant vulnerabilities, and it is

likely that young people with complex needs and at significant risk |

are being. placed in such placements; indeed this was the case for
Jacob.

3. As the placements are unregulated there are no statutory
regulations to comply with relating to competency and appropriate
policies and procedures by the provider and there is no regulatory
body to check and assess those providers. This is clearly a very
concerning situation given the very high level needs that some of
the young people will have.

4. The lack of statutory regulation then places an onus. on local
authorities to check that a provider is competent and safe. Whilst
* in making individual placements it must be the duty of a local
authority to satisfy itself as best as it is able that placements are
‘safe’, given the pressures on local authorities it cannot be the
case that they are in a position to mirror the type and nature of
inspection and oversight that might be provided by a regulator
such as Ofsted.

5. In view of the points made above the lack of statutory regulation is
placing vulnerable young people at risk, and. there is a realistic
possibility that deaths may occur. ;

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 27 February 2020. |, 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 sent a copy of my report to the Chief Coroner.and to the following
Interested Persons :

. Susan Cheetham (Jacob’s mother),

Glen Billyeald (Jacob’s father).

. Derbyshire County Council.

. Derby and Derbyshire Clinical Commissioning Group.
Emma House.

Banardos

. Derbyshire Constabulary.

. Chesterfield Royal Hospital NHS Foundation Trust.

ONOaRWNA

| 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. .

Mr Peter Nieto
HM Area Coroner
Derby & Derbyshire Coroner’s Area

|
|
|

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 The Secretary of State for Education (PDF)
% 7 Ss
Sa, we
“Ay rs
a FoR EOU

Rt Hon Gavin Williamson CBE MP
Secretary of State

Sanctuary Buildings Great Smith Street Westminster London SW4P 38T
tel: 0370 000 2288 www.education.gov.uk/help/contactus

Mr Peter Nieto,
HM Area Coroner
Coroner’s Court
. Town Hall
Rose Hill
Chesterfield
$40 1LP
By email: chesterfield.coroner@derbyshire.gov.uk

27 February 2020
Dear Mr Peter Nieto,

Thank you for your correspondence: of 31 December 2019 about the death of
Jacob Andrew Bates. | would like to take this opportunity to say how deeply
saddened | am about Jacob’s death. His loss, at such a young age and in
such circumstances is deeply upsetting and | offer my condolences to those
who knew, loved and supported Jacob.

Your report raises several matters of concern surrounding the use of
unregulated provision.

| believe every child and young person should have access to a stable and
secure placement in accommodation that can meet their needs and, most
importantly, keep them safe. It is unacceptable for any child or young person’s
placement to not meet their needs or keep. them safe, for any amount of time.

| share your concerns that unregulated settings are not always good enough,
and that some children are being placed at risk or in settings that cannot meet
their needs. It is clear that reform is urgently needed, and this is why on 12
February 2020 | launched a consultation on a range of proposals to ensure
that unregulated provision is being used appropriately and meets the needs of
the young people placed there.

| will not tolerate poor provision that fails our most vulnerable children. This is
why these proposals include introducing new checks and balances in the
system, including the introduction of new national standards for providers of
independent and semi-independent provision. The proposals aim to improve
provision and make it easier for local authorities to assess the quality of what
is on offer. We are also consulting on how these standards should be enforced
~ either by mandating local authorities to only use providers that meet the
standards, or by introducing a new quality and inspection regime, overseen by
Ofsted, similar to the regime already in place for children’s homes.

This consultation is an opportunity to shape our proposals and next steps in
terms of what and how we might implement the proposals. It is open for
response until 8 April 2020 and.can be accessed at
https://consult.education.gov.uk/unregulated-provision/unrequlated-provision-
children-in-care/. | would welcome your views, and those of all interested
persons, on the detailed proposals.

It is a priority for this Government that children and young people in care have
the support, protection and care they deserve. The independently led Care
Review will also take a fundamental look across children’s social care with the
aim of better supporting, protecting and improving the outcomes of vulnerable
children and young people. However, | am clear that the issue of unregulated
provision cannot wait and requires immediate and decisive action to be taken.
Following the consultation we will consider the responses received and publish
a response which will include a timetable for any reforms that will be taken
forward.

Once again, | was very sorry to hear of this tragedy and hope our proposed
reforms will help prevent children and young people being placed in provision
that does not need their needs.

Yours sincerely,

aren.

Rt Hon Gavin Williamson CBE MP
Secretary of State for Education

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