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*Independent investigation into the care and treatment of Mr R: May 2012

Midlands
Published 01 May 2012
Trust Independent investigation into the care and treatment of Mr R: May 2012 This is thereport of the independent investigation into the care and treatment of Mr R.At the time of the homicide Mr R was under the care of Northamptonshire Healthcare NHS Foundation Trust
Subject Mr R

This is thereport of the independent investigation into the care and treatment of Mr R.At the time of the homicide Mr R was under the care of Northamptonshire Healthcare NHS Foundation Trust. Mr R had previously had contact with Nottinghamshire Healthcare NHS Trust. The following action plans are available:

Report PDF Action Plan NHS England Source
Acceptance Status
Accepted 2
Partially Accepted 1
Action Plan Published 8
Total Recommendations 11
About this data

Acceptance Status tracks whether the trust accepted or responded to each recommendation.

Independent health investigation reports and reviews commissioned by government or NHS England.

Recommendations (11)

Action plan published. 3 of 11 per-recommendation responses extracted from the action plan. View action plan
1.5.1 Commissioners of services
Accepted
Recommendation
Commissioners of services must ensure the early involvement of clinical teams with patients when the first steps of planning movement between services are proposed and to monitor attendance of the appropriate staff at any planning meetings. Early dissent on the … Read more
Current Provision Required: It is the responsibility of the provider to ensure local care co- ordinators are invited to all CPA reviews whilst an individual is in secure care. In 2013/14 commissioners developed a CQUIN indicator to ensure the CPA process is effective. This has included the monitoring of invitees and attendees at CPA reviews, and the requirement for an action plan to be developed to address any areas of shortfall. Further Actions: None
1.5.10 Commissioners of forensic services
Accepted
Recommendation
Commissioners of forensic services should acknowledge the time-consuming nature of this work and plan to commission services accordingly. An audit of the time taken in planning for the support and assessing ongoing risk factors of patients returning to the community … Read more
Current Provision Required: Commissioners would be happy to be involved in the strategic review that Northamptonshire Healthcare NHS Foundation Trust are recommended to undertake. Further Actions: Invite Trust 2 representation from NHS England. Review Date: June 2014. Current Provision Required: The accountable commissioner responsible on the High and medium secure Clinical Reference Group (CRG) will be briefed on the recommendations of the report to inform the future work of the group. Further Actions: Brief NHS England commissioner on the CRG. Review Date: June 2014.
1.5.11 Trust 1 and 2
Action Plan Published
Recommendation
Trust 1 and 2 should reacquaint themselves with the guidance ‘Information Sharing and Mental Health’, Department of Health, September, 2009.
1.5.2 Trust 1
Action Plan Published
Recommendation
Patients with a diagnosis of personality disorder admitted to secure units from HSH care on six months Section 17 leave should have this amount of time allowed to pass before accepting the full legal responsibility for them. In the case … Read more
1.5.3 Secure Units
Action Plan Published
Recommendation
The Guidance for Social Supervisors and Guidance for Clinical Supervisors (Ministry of Justice, 2009) should inform good practice and be adopted by all clinical staff and operational managers in secure units when discharging all patients to community settings. Read more
1.5.4 Trust 2
Partially Accepted
Recommendation
Trust 2 should undertake a review of services for offenders with a personality disorder. This should be conducted taking into consideration the policy guidance of the ‘Consultation on the Offender Personality Disorder Pathway Implementation Plan’ Department of Health and Ministry … Read more
Current Provision Required: Commissioners would be happy to be involved in the strategic review that Northamptonshire Healthcare NHS Foundation Trust are recommended to undertake. Further Actions: Invite Trust 2 representation from NHS England. Review Date: June 2014.
1.5.5 Local MAPPA
Action Plan Published
Recommendation
Local MAPPA should be given as much notice as possible and information of returning offenders from secure care and recommend a minimum of six months prior to discharge is adopted in all cases.
1.5.6 Trust 1
Action Plan Published
Recommendation
Trust 1 should record the source of information regarding the detail of offences committed by patients, checking the detail of the offence(s).
1.5.7 Trust 1
Action Plan Published
Recommendation
Trust 1 should closely examine offences and offending behaviour described by the patient, making appropriate enquiries to verify the patient’s account.
1.5.8 Trust 1
Action Plan Published
Recommendation
Trust 1 should consider peer review of patients with personality disorders who are to be discharged into the community without statutory supervision.
1.5.9 Trust 1
Action Plan Published
Recommendation
Trust 1 should always consider if a Community Treatment Order would be appropriate in all cases of patients being discharged from secure hospital care who are not subject to supervision on a restriction order.