Prevention of Future Deaths reports · 2021

Maziellie Mackenzie

Regulation 28 report to prevent future deaths, reference 2022-0005, written 31 Dec 2021. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report31 Dec 2021
Reference2022-0005
DeceasedMaziellie Mackenzie
CoronerPhilip Holden
Coroner areaLancashire and Blackburn with Darwen
CategoryHospital Death (Clinical Procedures and medical management) related deaths · Suicide (from 2015) · Mental Health related deaths
Organisation namedLancashire & South Cumbria NHS Foundation Trust
Sourcejudiciary.uk record · original PDF
Responses published1

The report

Text extracted from the PDF text layer. Reproduced verbatim, including the scan's own layout.

REGULATION 28:  REPORT TO PREVENT FUTURE DEATHS (1) 

NOTE: This form is to be used after an inquest. 

REGULATION 28 REPORT TO PREVENT FUTURE DEATHS 

THIS REPORT IS BEING SENT TO: 

1. Lancashire and South Cumbria NHS Foundation Trust
2. Family of Maziellie MacKenzie

1 

CORONER 

I am Philip Holden Assistant Coroner, for the coroner area of Lancashire and Blackburn 
with Darwen. 

2 

CORONER’S LEGAL POWERS 

I 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. 
[HYPERLINKS] 

3 

INVESTIGATION and INQUEST 

I commenced an investigation into the death of Maziellie MacKenzie. The investigation 
concluded at the end of the inquest on 01st November 2021. The conclusion of the 
inquest was  

A) Narrative conclusion.
B) Short f orm conclusion - Suicide

1 

 4 

CIRCUMSTANCES OF THE DEATH:- 

Maziellie Mackenzie (‘MM’) was a looked after child and had been under the care 
of Cumbria County Council since 2016. She had a history of Mental Health issues 
and  had  been  diagnosed  with  PTSD,  Attachment  Disorder,  Anxiety  and 
Depression.  

Following a number of foster and residential placements which had broken down 
she had been placed in a  tier 4 hospital catering for young people with Mental 
Health issues between the ages of 13 and 18 at the Cove Heysham and had been 
there since the 29/05/18. 

She had a history of self harm which started initially with
in the Cove there were several incidents of 

. Whilst 

On the 23/06/18 she went on a third period of leave that day with 3 other residents 
and 2 members of staff to a 

. 

At the end of the leave all residents including Maisie refused to return to the Cove. 
One member of staff was able to persuade one of the residents to return with her. 
The other member of staff followed two of the other residents who made off in a  
different direction to MM.  

MM was  discovered a few hours later by a  group of youths in a 

 despite CPR an attending paramedic confirmed her death at 23 03 

hours. 

She  took her own life and  a  subsequent note found in  her room at  the Cove 
evidenced her intention to do so. 

In the Narrative conclusion  failings at the Cove were identified  in that  :- 

1. 

2. 

Formulation and risk management plans were not revisited when self-harm incidents 
occurred and did not include Mazie’s needs and how they were to be met. 

Her  risk assessment held limited risk history and management plans in regard to 
Mazie's risk of going missing. 

3. 

There was no written standardised procedure for agreeing and facilitating leave. 

4. 

Communication  of   relevant  inf ormation  and  record-keeping  did  not  meet  the 
required standard. 

5. 

There were insuf ficient staff members with the 4 residents who were on leave. 

2 

 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 5 

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.  –  

[BRIEF SUMMARY OF MATTERS OF CONCERN] 

Expert evidence was heard (and accepted) at inquest that there was no written 
policy/document  in place by the Trust which set out :- 

(1)  The circumstances in which group leave from the Cove ( and other tier 4 units) is 

granted and who is responsible for the granting of such  leave. 

(2)  That a mandatory risk assessment is required and setting  out  a  list of 

f actors/criteria  that must be  considered before any group leave is granted. 

(3)  Setting out the staff to patient  ratios for any group leave and identifying the criteria to 
be considered. 

6 

ACTION SHOULD BE TAKEN 

In my opinion action should be taken to prevent future deaths and I believe you [AND/OR 
your organisation] have the power to take such action.  

7 

YOUR RESPONSE 

You are under a duty to respond to this report within 56 days of the date of this report, 
namely by [DATE]. 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. 

8 

COPIES and PUBLICATION 

I have sent a copy of my report to the Chief Coroner and to the family of Maziellie 
MacKenzie. 

I 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 
f orm. 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. 

9 

[DATE]      31/12/21                                        Philip Holden 

4

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)
PRIVATE AND CONFIDENTIAL 

Mr Philip Holden 
Assistant Coroner 

Safety Department 
Lancashire & South Cumbria 
NHS Foundation Trust 
2nd Floor 
Lingmell House 
Water Street 
Chorley 
PR7 1EE 

21 February 2022 

Dear Mr Holden 

Re: Prevention of Future Death Report Following Inquest into the Death of Maziellie 
MacKenzie  

Further to the inquest of Maziellie MacKenzie, which concluded on 15 December 2021, I am 
providing you with a response to your concerns detailed in the Prevention of Regulation 28 
Notice,  dated  31  December  2021.    Please  be  assured  the  Trust  has  taken  this  extremely 
seriously.  

We  are  disappointed  that  we  did  not  deliver  care  and  treatment  to  the  level  expected  for 
Maziellie at the time of her death and I reiterate the Trust’s apologies regarding this. I hope 
my response provides you with the assurance that we have implemented improvements that 
prevents similar incidents from occurring. 

The circumstances in which group leave from the Cove (and other tier 4 units)

1.
is granted and who is responsible for the granting of such leave.

The Trust have developed a written procedure (enclosed), which identifies the circumstances 
in  which  group  leave from The  Cove  is granted. The  Cove  is the only  Tier 4  CAMHS unit 
within the Trust. The procedure was approved at the Specialist Network Governance Group 
on 3 February 2022 and has been subsequently shared with staff.  Until the procedure was 
ratified,  group  leave  at  The  Cove  was  temporarily  suspended,  following  receipt  of  your 
Regulation 28 notification.  

Whilst  the  procedure  has  been  shared  with  staff,  there  are  further  engagement  events 
planned, which includes ensuring every member of staff has this discussed with them as part 
of  their  supervision  and  also  ensuring  that  this  procedure  is  part  of  the  unit’s  induction 
programme, so this is highlighted to new starters also in the unit going forward. 

 
 
 
 That  a  mandatory  risk  assessment  is  required  and  setting  out  a  list  of 

2. 
factors/criteria that must be considered before any group leave is granted. 

The enclosed procedure (section 5.15) sets out that young people with approved escorted 
group leave must have a pre-leave risk assessment completed prior and documented as a 
narrative  entry  on  RIO  (the  Trust’s  clinical  record  system).  This  is  to  make  sure  that  any 
potential risks or changes in a young person’s presentation are acknowledged and so that 
the necessary safeguards are put in place. The procedure states that “risk assessment should 
consider the presenting level of risk and the care plan (including the number of escorts where 
identified).” 

Prior to the risk assessment being completed, any period of group leave must be discussed 
and  agreed  by  the  multi-disciplinary  (MDT)  meeting  and  be  included  as  part  of  each 
individualised care plan and have an identified therapeutic purpose.  The MDT discussion 
should capture the risk mitigation factors and the risk aggravating factors in relation to the 
mix of the group, irrespective of the legal status of the young person. 

The procedure also identifies that young people will only be eligible for group leave if they are 
being nursed on general observation levels and any change in observation that occurs after 
the  decision  to  grant  group  leave,  but  before  the  planned  group  leave  will  result  in  the 
individual being unable to access group leave. 

The  procedure  also  includes  that  an  individual  young  person’s  participation  in  the  MDT 
agreed group leave can be cancelled by the shift leader if there are concerns about individual 
or  group  risks  which  were  not  previously  known  or  have  changed  since  the  decision  was 
made by the MDT.  In the event a young person does not agree to the conditions of group 
leave, the individual’s participation in the intervention should be reviewed by the shift leader, 
in conjunction with the MDT as necessary. 

Setting  out  the  staff to  patient  ratios  for any  group  leave  and identifying  the 

3. 
criteria to be considered. 

The  procedure  specifies  that  the  MDT  must  agree  in  advance  on  the  specific  staffing 
requirements  to  safely  support  a  period  of  group  leave  and  this  should  be  based  on  the 
combined  dependency  needs  of  individuals  in  the  group.    In  the  event  that  the  required 
staffing  levels  cannot  be  achieved,  leave  should  be  cancelled  and  an  incident  form 
completed.   The mandated pre-leave risk assessment is also to include the number of escorts 
needed. 

We have shared this procedure with other North West of England Tier 4 CAMHS providers, 
in the interests of shared learning. 

The Trust would like to once again apologise to the family of Miss MacKenzie for her tragic 
death.  

 
 
 
 
 
 
 
 
 
 
 
 
 I would also like to re-affirm our commitment as a Trust, to continually develop and improve 
our services for the young people in Lancashire.  

Please let me know if you require any further information in relation to this matter. 

Yours sincerely 

Chief Improvement and Compliance Officer  

Enc

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