Prevention of Future Deaths reports · 2022

Carol Cole

Regulation 28 report to prevent future deaths, reference 2022-0033, written 2 Feb 2022. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report2 Feb 2022
Reference2022-0033
DeceasedCarol Cole
CoronerRachael Griffin
Coroner areaDorset
CategoryMental Health related deaths · Suicide (from 2015) · Police related deaths · Other related deaths · Alcohol, drug and medication related deaths
Sourcejudiciary.uk record · original PDF
Responses published2

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.
2.

, Chief Executive of Dorset Council
, Chief Constable of Dorset Police

1  CORONER 

I am Rachael Clare Griffin,  Senior Coroner, for the Coroner Area of Dorset 

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. 

3 

INVESTIGATION and INQUEST 

On the 20th May 2020, an investigation was commenced into the death of Carol 
Patricia Cole, born on the 21st November 1951. 

The investigation concluded at the end of the Inquest on the 21st January 2022. 

The Medical Cause of Death was: 

Ia Combined overdose

II Ischaemic Heart Disease 

The conclusion of the Inquest was suicide.   

4  CIRCUMSTANCES OF THE DEATH 

On  the  15th  May  2020  the  deceased,  who  was  prescribed 

  and 
 medication, and who had a history of depression, unstable personality 
disorder  and  previous  overdoses  of  medication,  was  found  in  a collapsed and 
, 
unresponsive condition in the bedroom at her home address at 
Weymouth. 

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:   

1 

 
 1.  During the inquest evidence was heard that: 

i. 

Following  attendances  upon  Mrs  Cole  by  officers  from  Dorset 
Police in the days and weeks leading up to her death, two Public 
Protection  Notice  (PPN)  were  submitted  to  the  Multi  Agency 
Safeguarding Hub (MASH) within Dorset Police. The first of these 
PPNs raised concerns about Carole’s mental health. 

ii.  When  a PPN is received by the team within MASH, they forward 
the PPN onto the relevant agencies, or people, who can provide 
support to the individual, or take action. One of those to whom 
this can be shared is the person’s General Practitioner (GP). 

iii. 

iv. 

v. 

vi. 

In  Dorset  there  are  2  Local  Authorities  that  cover  the  County, 
BCP  Council  and  Dorset Council. If MASH receive a PPN about a 
resident in the BCP Council area the current arrangement is that 
MASH send the PPN directly to the GP as required. If they receive 
a  PPN  about  a  resident  in  the  Dorset  Council  area  the  current 
process is that they do not send it directly to the GP but send it 
directly  to  the  Dorset Adult Access team at Dorset Council, who 
will then send it to the GP. 

At the time of her death Carole resided within the Dorset Council 
area. A PPN was submitted to MASH regarding Carole on 25.4.20 
which  raised  concerns  regarding  her  mental  health.  The  MASH 
team determined the PNN should be shared with the Dorset Adult 
Access  team to share with the GP in line with the process. 

At the Inquest the representative from the GP surgery confirmed 
there  was  no  record  of  the  PNN  being received by them, which 
led to a missed opportunity for Carole to be assessed by her GP.  

The  process  currently  in  place,  which  I  understand  has  been 
agreed  by  both  Dorset Council and Dorset Police, of preventing 
the  MASH  team  from  sending  the  PNN  directly  to  the  GP,  may 
result  in  the  GP  not  being  informed of the contents of the PPN 
which  may  result  in  a  person  not  receiving  an  assessment, 
support or treatment. I am not aware of a reason why the MASH 
team  cannot  send  it  directly  to  the  GP,  as  they  do  for  those 
residents in BCP council area, to avoid such missed opportunities 
to take action which may lead to a future death. 

2.  I have concerns with regard to the following: 

i. 

There  could  be  missed  opportunities  to  share  PPNs  relating  to 
residents  within  the  Dorset  Council  area  with  agencies  or 
professionals  due  to  the  current  processes  in  place  between 
Dorset  Police  and  Dorset  Council  which  could  lead  to  a  future 
death. I therefore request that Dorset Police and Dorset Council 
review  their  current  processes  in  place  regarding  the sharing of 
PPNs  by  MASH,  especially  to  General  Practitioners  for  the 
residents within the Dorset Council area. 

2 

 
 
 
 
 
 
 
 
 
 6  ACTION SHOULD BE TAKEN 

In  my  opinion  urgent  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, 30th March 2022. 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  following 
Interested Persons: 

(1) Mrs Clough’s family 
(2) Dorset County Hospital NHS Foundation Trust 

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  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. 

9  Dated 

Signed 

2nd February 2022                                       

Rachael C Griffin 

3

Responses

2 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 Dorset Council (PDF)
Chief Executives Office  
Dorset Council 
County Hall 
Colliton Park 
Dorchester 
DT1 1XJ 
   
 www.dorsetcouncil.gov.uk 

Date:  29/03/2022 

   

Rachel C Griffin 
Senior Coroner 
The Coroner’s Office for the County 
of Dorset 
Bournemouth Town Hall 
Bournemouth 
BH2 6DY 

Dear Madam, 

Regulation 28: Prevention of Future Deaths Report Response  
Deceased: Carole Patricia Cole 

I am writing in response to the Regulation 28 report which was issued to both the local authority 
and Dorset Police regarding Carole Patricia Cole. 

I know that you will share a copy of this response with Mrs Cole’s family and I would first like to 
express my condolences for their loss.  

During the inquest, evidence was heard regarding the process for sharing Public Protection 
Notices (PPNs).   The Regulation 28 report raised a specific concern in that: 

i) 

There could be missed opportunities to share PPNs relating to residents within the 
Dorset Council area with agencies or professionals due to the current processes in 
place between Dorset Police and Dorset Council which could lead to a future death.  

The request was made that Dorset Police and Dorset Council review their current processes in 
place regarding the sharing of PPNs by MASH, especially to General Practitioners for the 
residents within the Dorset Council area. We reviewed the current PPN process with Dorset 
Police and Bournemouth, Christchurch and Poole (BCP) Council between 16/02/2022 and 
16/03/22.  This involved members of the operational management team at Dorset Council and 
Bournemouth, Christchurch and Poole (BCP) Council and Dorset Police Public Protection Unit 
meeting to analyse current steps in the process.  This identified the following areas of 
improvement:  

i) 

When a PPN is received by the Multi-Agency Safeguarding Hub (MASH) within 
Dorset Police, information is shared differently depending on whether the person is a 
resident of Dorset Council local authority area or BCP.  If the person is resident of the 
Dorset Council area the MASH team share PPNs with the Adult Access Team who 
then share them with the GP and other relevant organisations.  If the person is a 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 resident of the BCP area MASH share directly with GPs.  This was raised as a matter 
of concern within the Regulation 28 report. When a PPN is received into the Adult 
Access Team and a person is known or open to an Adult social care team, the PPN 
is passed to the relevant team to share with relevant agencies or professionals.  
Having different internal process for people known or not known to Adult Social Care 
could result in a delay in sharing PPNs.  

The following actions were identified: 

i) 

ii) 

iii) 

iv) 

Amend the current process of sharing PPNs between Dorset Police and Dorset 
Council to align with BCP processes. This requires work to ensure the MASH has 
adequate capacity and access to up-to-date information about a person’s GP.  To 
have an immediate impact on the current process, Dorset Council will provide 
additional staffing resources to MASH to assist with the sharing of PPNs to GPs to 
allow time for a wider system review of MASH to be completed. The plan is to 
complete recruitment by end of May 2022.   

A meeting has been arranged between Dorset Council, Dorset Police MASH, BCP 
and health partners including GP safeguarding leads in April 2022 to discuss current 
PPN sharing processes, including what is working well and areas for improvement. 
This was the earliest opportunity to do so, so that all parties could be represented.  

Share learning from the Regulation 28 report at Dorset’s Safeguarding Adult Review 
in April 2022 and seek approval to align a full partnership review of PPN sharing 
within Adult MASH with the Children’s MASH review which will take place in July 
2022. 

Amend Dorset Council’s internal process so that the Adult Access Team forward 
PPNs to relevant agencies or professionals regardless of whether the person is 
known or not known to Adult Social Care.  This was immediately actioned and 
implemented on 25/02/22.  

I hope the above information provides assurance to the Chief Coroner that Dorset Council has 
taken the matter with due concern and an ongoing commitment with Dorset Police and wider 
partners to finding a resolution to this issue and in turn mitigate the risk of future deaths to the 
residents of Dorset.  We would like to propose that we provide a further update after the wider 
system review in July 2022.  

Your sincerely 

Chief Executive 
Dorset Council
Response from Dorset Police (PDF)
Mrs Rachel C Griffin 
Senior Coroner 
Coroner's Office  
County of Dorset 
Town Hall 
Bournemouth 
BH2 6DY 

Chief Constable 

Dorset Police  
Force Headquarters 
Winfrith 
DORCHESTER 
DT2 8DZ 

                             30 March 2022   

Dear Madam, 

Regulation 28: Prevention of Future Deaths Report Response  

Deceased: Carole Patricia Cole 

I write in respect of the above-mentioned report of 2 February 2022 (“the Regulation 
28 report”).  

Firstly, I would like to express condolences on behalf of myself and Dorset Police to 
the family and friends of Carole. 

Secondly, I thank you for sending a copy of the Regulation 28 report that was made 
during the inquest into Carole’s death. As you would expect, we welcome any such 
opportunities for Dorset Police to consider whether there are any improvements that 
can be made to how we work. 

In the Regulation 28 report, you confirm that the matter of concern that you wish to 
raise is that there could be missed opportunities to share PPNs relating to residents 
within  the  Dorset  Council  area  with  agencies  or  professionals  due  to  the  current 
processes in place between Dorset Police and Dorset Council which could lead to a 
future death.  

You  therefore  requested that  Dorset  Police and  Dorset  Council  review  their  current 
processes  in place  regarding the  sharing of  PPNs by  MASH,  especially to  General 
Practitioners for the residents within the Dorset Council area. 

The review took place between 16/02/2022 and 16/03/2022 with partners from Dorset 
and BCP Adult Social Care. This confirmed the process of sharing PPNs between the 
Police and BCP Council and Dorset Council differs. It has been acknowledged that 
the  existence  of  two  different  systems  can  present  a  risk  to  safeguarding  and  the 
consistency of one process would be preferable.  

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
    
 
 
 
 
 
 
 
 
 The review also identified that for the Police to carry out the sharing of PPNs to GPs 
there would be a requirement for Police to have access to the Dorset Care Record 
which it currently does not have.  

On occasions officers will attend an incident whereby the GP is unknown or recorded 
incorrectly  therefore  it  is  necessary  to  confirm  the  correct  GP  details  utilising  the 
Dorset Care Record to ensure personal information is not being passed to the incorrect 
surgery.   

Identification of this risk has prompted a further review with Health partners which is 
scheduled to commence on 12 April 2022. Police, Health and Social Care will work 
together to review the current process, what is working well and where improvements 
can be made based on national best practice from other areas.  

On 28 March 2022, it was agreed that Dorset Council will fund a member of staff from 
Adult Social Care to co-locate with Dorset Police in the MASH.  This role would be 
responsible for sharing with GPs and have access to the Dorset Care Record. In the 
interim  I  am  aware  that  the  Dorset  Adult  Access  Team  promptly  streamlined  their 
working practices in February 2022 to overcome the issue that resulted in the failure 
to share the PPN with the GP in the case of Ms Cole.  

The learning from the Regulation 28 report has been passed to the Safeguarding Adult 
Review  Board  for  further  discussion  and  to  secure  partnership  commitment  to 
delivering the findings of the review.  

As you would expect, correspondence from yourself is taken most seriously by myself 
and we will continue to work with our partner agencies to ensure that our processes 
are  appropriate,  proportionate  and  minimise  any  risk  of  missing  opportunities  to 
safeguard our residents.  

Thank  you  again  for  your  consideration  and  questioning  of  the  Force  through  the 
Regulation 28 procedure and copying the report to us. I trust this response provides 
you with the further information that you require.  Please do contact me should you 
wish for further clarification or information.   

Yours sincerely 

Chief Constable

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