Prevention of Future Deaths reports · 2020

David Clark

Regulation 28 report to prevent future deaths, reference 2020-0023, written 6 Feb 2020. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report6 Feb 2020
Reference2020-0023
DeceasedDavid Clark
CoronerNeil Cronin
Coroner areaLancashire & Blackburn with Darwen
CategoryMental Health related deaths · Community health care
Organisation namedLancashire Care 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.

for Lancashire & Blackburn with Darwen

REGULATION 28 REPORT TO PREVENT FUTURE DEATHS

THIS REPORT IS BEING SENT TO:

The Chief Executive Officer

Lancashire Care NHS Foundation Trust
Sceptre Point

Sceptre Way

Walton Summit

Preston

PR5 6AW

CORONER

| am Neil Cronin Assistant Coroner , for Lancashire & Blackburn with Darwen
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.

http://www. leqislation.gov.uk/ukpga/2009/25/schedute/5/paragraph/7
http://Awww.legislation.gov.uk/uksi/2013/1629/part/7/made

INVESTIGATION and INQUEST

On the 37 July, an investigation into the death of David Clark aged 64 commenced. The
investigation concluded at the end of the inquest on the 6"" February 2020. The conclusion of the
inquest was that he had taken his own life.

CIRCUMSTANCES OF THE DEATH

The deceased was compulsorily detained at the Orchard Hospital under section 3 of the mental
health act. He had a diagnosis of personality disorder. On the 26" June 2019 at around 19.26
hours he left the Orchard on unescorted leave and was found the following morning and in the
Lancaster canal. The cause of death was drowning.

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 documentation in relation to leave was not completed fully and incorrect forms used
(2) That the AWOL procedure was not followed.

(3) That a handover was not undertaken between Safety and Security workers.

(4) That there was a lack of training on policy and procedure.

(4) That there remains outstanding an appropriately sufficient action plan.

Coroner's Court, 2 Faraday Court, Faraday Drive, Fulwood, Preston, Lancashire, PR2 9NB.
Tel 01772 536536 | Fax 01772 530752

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.

YOUR RESPONSE

You are under a duty to respond to this report within 56 days of the date of this report, namely by
2™ April 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:
Farleys, Solicitors for the family

| 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 06/02/2020

Signature NS

for Lancashire & Blackburn with Darwen

Coroner's Court, 2 Faraday Court, Faraday Drive, Fulwood, Preston, Lancashire, PR2 9NB-
Tel 01772 536536 | Fax 01772 530752

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 Lancashire and South Cumbria NHS Foundation Trust (PDF)
Lancashire & South Cumbria NHS Foundation Trust 
Sceptre Point 
Sceptre Way 
Walton Summit 
Preston 
PR5 6AW 
Tel: 01772 695300 
lct.enquiries@lancashirecare.nhs.uk 

16 April 2020 

PRIVATE AND CONFIDENTIAL 

Neil Cronin 
Assistant Coroner 
coroners@lancashire.gov.uk 

Dear Neil 

Re: Prevention of Future Death Report Following Inquest into the Death of David Clark  

Please find a response to the regulation 28 you issued to the Trust dated 06 February 2020 
along with the action plan. The action the Trust has taken in relation to the matters of concern 
you raised are summarised below: 

1.  That documentation in relation to leave was not completed fully and incorrect forms 

used. 

Unit Level 

o  The Orchard WM and Matron are auditing compliance with Safety & Security (SaS) 

documentation weekly (attachment 2). 

Trust Level 

o  Monitoring and reporting of Mental Health Act documentation - The Mental Health Law 
Team monitor the status of all detained patients daily and send a daily status report to 
each  ward  for  review.  The  report  is  sent  to  Responsible  Clinicians,  Matrons,  Ward 
Mangers, Deputy Ward Managers, Nursing staff, Medical Secretaries, Pharmacy and 
any additional staff as appropriate (attachment 3).  

o  Section 17 leave - An inpatient safety matrix which will audit this practice at ward level 
includes a section of Section 17 Leave. The audit tool has been developed and agreed 
with Ward Managers (attachment 4). However implementation has been paused due 
to COVID 19 (new target date September 2020) once implemented compliance will be 
reported on a monthly basis through the Senior Leadership Team.   

 
 
 
 
 
 
 
 
 
 
 
 
 o  Work has been undertaken to the new electronic care record RiO which now includes 
a pre and post leave assessment form. This is in place in Secure Services and is to be 
rolled out across the Trust by March 2021. 

o  A  practice  note  has  been  issued  to  Ward  Managers,  Lead  Nurses  and  Doctors 
reminding them of their accountability in following MHA documentation and Trust policy 
(attachment 5). 

2.  That the AWOL procedure was not followed. 

Unit Level: 

o  The Trust policy and procedure for AWOL has been updated and in line with this staff 
agree with service users the time they will return from leave. If the service user has not 
returned by the agreed time AWOL procedures are implemented (SaS documentation, 
attachment 6). 

o  AWOL  procedure  has  been  discussed  at  the  Orchard In-Patient  Development  days 
and followed up with email to ensure all staff understand new process (email re AWOL 
procedures, attachment 7).  

o  The Head of Nursing has completed a supervision session with the Ward Manager and 

Matron. 

Trust Level: 

o  The Trust policy and procedure for AWOL has been reviewed and reflects the learning 

from the investigation (attachment 8).   

3.  That a handover was not undertaken between Safety and Security workers. 

Unit Level: 

o  The SaS handover has been reviewed and new forms disseminated which include the 
SaS  worker  agreeing  that  the  handover  has  taken  place.  The  SaS  paperwork  is 
audited weekly and demonstrates that handovers are consistently being undertaken 
(SaS handover documentation, attachment 9). 

Trust Level: 

o  Learning  regarding  the  handover  has  been  shared  with  the  rest  of  the  Trust.  SaS 
handover is part of the Trust’s Safety and Security Procedure and an audit is planned 
for Q1 2020/21 to ensure that the wards are using the correct documentation and this 
is being completed appropriately 

o  A rapid improvement event to review the role and to revise documentation, if required, 
was due to be undertaken in March 2020 however this has been paused due to COVID 
19; the new target date is July 2020. 

 
 
 
 
 
 
 
 
 
 
 
 4.  That there was a lack of training on policy and procedure. 

Unit Level: 

o 

In-Patient Development days included discussion regarding AWOL procedures (follow 
up email, attachment 7). 

o  All new staff are inducted to the SaS procedures (attachment 10)  

Trust Level: 

o  Ward Managers Task & Finish Group established which includes looking at Policy and 

Practice.  

o  Clinical  risk  assessment  training  -  A  practice  note  was  sent  out  trust-wide  on 
31/01/2020 clarifying the training expectations of all mental health staff. Clinical risk 
training  has  now  been made mandatory for  all clinical  staff  delivering mental  health 
services (attachment 11).  

5. 

That there remains outstanding an appropriately sufficient action plan. 

The Trust acknowledges that further work needed to be undertaken to the action plan to reflect 
the additional views of you and Mr Clark’s family. The strengthened action plan is attached. 
The Trust Quality Committee will oversee this action plan going forward.  

Furthermore 2 additional actions that have been undertaken: 

•  A  debrief  with  the  staff  involved  in  the  care  of  Mr  Clark  following  learning  from  the 

inquest on 12 February 2020 has been undertaken.   

•  Learning in relation to this serious incident and the concerns regarding the care of Mr 
Clark have been shared with the Ward Manager and the Matron in supervision on 19 
February 2020 by the Head of Nursing, Mental Health. 

I  am  mindful  of  the  impact  of  the  Trust’s  response  to  COVID-19,  in  the  Trusts  ability  to 
complete actions in a timely manner, please let me know if you require any further information. 

Yours sincerely 

Director of Nursing and Quality 
Enc 
Cc: 

Caroline Donovan, Chief Executive 

Director of Improvement and Compliance

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