Before lunch, after the second set of videos were shown, and the jury were explained the first set of legal directions, the prosecution called their first witness, Olivia Davies. Ms Richardson took her through her evidence.
In 2018 and 2019 she was working as a researcher for the BBC. She had worked at BBC Wales since she was 16 and had been working on undercover films, and a producer she’d worked with previously introduced her to Joe Plomin, in June 2018. He was a producer for BBC Panorama and wanted Olivia Davies to work as an undercover reporter for them.
She explained that she could tell no-one, not even her friends or family members, what her assignment was and she moved a considerable distance from where she was working to be closed to Barnard Castle, where Whorlton Hall was based.
She told the jury that the BBC had Editorial Guidelines that they set out, and there were lots of discussions between Ms Davies and Mr Plomin about what the guidelines set out, and what could and could not be done in her guise as an undercover reporter, while working as a care worker at Whorlton Hall.
She confirmed to Ms Richardson that prior to going to Whorlton Hall she had not taken part in any of the evidence gathering process for the documentary, but that she had read some of the evidence. Asked why she responded:
“I did that because I needed to know what evidence the BBC had collected before going in, because I needed to understand what I was looking out for or what to expect”
Ms Davies talked through the training that the BBC provided her for the role, which lasted about 3 or 4 months. It included a three day course on physical restraint. She told the court she’d never worked in the care industry before, had never seen a physical restraint prior to that cause.
“I went on that course because I’d never seen a restraint before, I had no idea what a restraint looked like and mostly for my own peace of mind, so I’d know what I was doing and build my confidence, not only being around people and being comfortable but also knowing what to expect and how best to put a restraint, or do a restraint if need be”.
She confirmed that the BBC conducted a comprehensive risk assessment before she started working at Whorlton Hall, that included how she should conduct herself when at Whorlton Hall and how to respond to different scenarios that she might be presented with. Asked to provide an example of the sort of things that it included by HHJ Smith, she outlined a hypothetical situation where a service user would be at imminent risk of death and how she should act accordingly by the guidelines.
As part of her training she was introduced to other journalists who’d previously worked as undercover reporters and learned how to mentally manage her role as an undercover reporter. She was also given training in how to operate a covert camera, including learning how to use it, when to turn it on, when it was appropriate to do so and consideration of invasion of service user’s privacy, which she said was “very important”. That training took place from September to November 2018 and she explained that she practiced wearing the camera around her home, or in the security of their office, to practice angles, how to shoot things low to the ground, practice different heights and how to change the batteries correctly.
She told the court that in September 2018 she drafted a CV to assist her in gaining a place at Whorlton Hall, and was offered a job after an interview. After being accepted before her official start date, Ms Davies attended a 7 day MAYBO training course supplied by Cygnet, which was a requirement of the job. It covered care plans and physical restraint techniques. During the MAYBO course attendees practiced conducting restraints on each other.
Later when being questioned by Mr Normanton, he put to Ms Davies that she’d described in a video diary how the process of restraining someone felt very unfamiliar to her and it “wasn’t something you ever really got used to”. She confirmed that was accurate.
Olivia Davies started work at Whorlton Hall as a support worker on 17 December 2018. She had to complete a number of e-learning courses to work as a support worker, but her online account wasn’t working, so she completed those at work, in the office at Whorlton Hall. She described how she started the same day as someone else and they were given large ring binders, some service users had two ring binders worth, of care plans to read.
Every service user had a care plan which basically outlined things like, ways to recognise if that person was down that day, or things like that…. I was given all the ring binders and read through their notes.
She then spent her first two weeks shadowing, who she shadowed depended on who was on shift. Asked what her role was as a support worker, by the 28 December 2018 when she had finished her shadowing period she told the court:
My role as a support worker was to spend 6hrs on rotation with a service user and essentially help them through their daily activities, whatever it was they were doing, and just insure they were okay throughout the day.
Each of her shifts were 12 hours long, so she’d support one service user in the first half of the day, and a different one in the second. Asked to describe her hours she told the court that she’d set an alarm for 5am, she’d sit with her producer and discuss the day, what it might look like or entail, then she’d get her kit ready, take it off charge, put it on and test it was working. She’d leave the house just after 6ish and drive the 50mins to Whorlton Hall. She’d usually get there just before 07:30, where she’d sit in the handover meeting and be allocated which service user she’d be looking after for the first half of the day.
She’d work a 12 hour shift, from 8am to 8pm, supporting two different service users, then at the end of her shift, she’d drive the 50mins back home. Then she’d pass any material she’s recorded that day to her producer, they would back it up twice, on two drives. She told Ms Richardson what happened next:
“I would sit and verbally explain how my 12 hour shift looked to my producer. I would then make a contemporaneous note, which I had a notebook and every day would date it and write down what I’d experienced. And then I would sit and record a video diary with whichever producer was on shift at home I suppose, and I would relay again what I had seen, witnessed that day, and we just kept a thorough log of everything we’d done”.
Asked what the purpose of the video diaries was she explained when you’re filming with a camera concealed on your body you’re not getting a personal response to what you’re seeing and witnessing, so by sitting and articulating what she’d seen she found it help to document in a storytelling way, but also to highlight what she’d seen and experienced and keep a record.
“I think recording a video diary helped me outwardly express what I’d seen, which I think I’ve always struggled a bit with expressing myself, so to sit in front of a camera and talk helped get that mental bit”.
Ms Davies explained to the jury that some service users had one to one support, some two to one and some had four support workers working with them at any one time. She never had a say in which service user would be allocated to her, a nurse would tell her that in the handover meetings.
Ms Richardson talked her through floor plans, confirming to the jury the layout of Whorlton Hall. Ms Davies said that everyone was given a set of keys, she couldn’t say for certain whether the key allowed them access to all places or just some but she said you could get your way around using the keys.
She also described the safety alarm fob, in questioning from Ms Richardson. You’d pull something on the fob if you needed extra support, and the expectation was if an alarm sounded and any staff were available they’d run to it, as it meant something was happening and extra support was needed.
“Typically if you pulled your alarm everyone ran to you, but I do remember a time when I pulled it and nobody responded”.
Asked if in her opinion staffing was sufficient while she worked at Whorlton Hall, Ms Davies commented:
“In my opinion, on paper there were, but to me it felt like there should have been more support. It felt thin”.
She was often paired with female service users because she was female, asked if she was given a reason for it, she said she couldn’t specifically say she was:
“but I was constantly put with, very often put with, female service users because I’m female”.
Ms Richardson’s final question for Ms Davies related to when she finished working at Whorlton Hall. She confirmed that she worked her final shift on 4 March 2019 and resigned with immediate effect the next day.
Mr Josh Normanton, counsel for Karen McGhee, was the first defence counsel to question Ms Davies. He asked Ms Davies whether she filmed every day she worked at Whorlton Hall from 17 December 2018 to 4 March 2019, and how she decided when to film. She confirmed that she did not wear the camera every day to begin with:
“I believe the first week I started on the job I didn’t wear a camera because evidentially there were standards we had to meet in order for the BBC to feel it was appropriate for us to enter with cameras”.
She also explained that she only turned the camera on when she felt it was essential for evidence gathering.
JN: We were aware that there was over 200 hours of capture, does that sound about right?
OD: yes that does
JN: and those were recording of what was happening on the floor, where the residents lived, but you also captured meetings you were in, yes?
OD: yes
JN: and did you also capture for example training that took place?
OD: yes, but not all training, just the select restraint parts of that training.
JN: Alright, we’ll look at that in due course. You also produced, you were asked about your video diaries?
OD: yes
JN: You also wrote a written diary?
OD: yes
JN: You also produced a witness statement in September 2020?
OD: yes
JN: Have you produced anything else? Any other record of your time at Whorlton Hall?
OD: no
JN: Did you find working at Whorlton Hall to be an easy job?
OD: No, it wasn’t an easy job
JN: It was a very difficult job, would you agree?
OD: yes
JN: We’ve seen at least one example of a resident becoming violent in a video we’ve seen. That happened a lot didn’t it?
OD: yes it did
JN: Sometimes many times a day?
OD: yes
JN: And each time that happened the resident was placed at risk, staff were placed at risk and very, very often, in fact almost every time it was necessary to restrain that resident?
OD: ummm, yes
JN: You hesitate. Were there times when residents were violent but it wasn’t necessary to restraint them?
OD: No, it was more things escalated when it didn’t seem, to someone junior like me, it didn’t seem they were necessary.
HHJ Smith checked whether there was more than one kind of restraint and suggested to Mr Normanton that might need exploring. Mr Normanton went on to discuss different types of restraint with Ms Davies, part way through this discussion this exchange took place:
JN: what may happen is other people are talking and shouting but you may not focus on that because you’re focused on what you’re doing, holding this person down, who’s being violent
OD: yes
JN: restraints would happen at Whorlton Hall frequently on some days
OD: yes
JN: is that fair?
OD: yes
JN: In one of your video diaries you say you’ve just had three restraints in five minutes, is that right?
OD: yes
JN: Not infrequently then. Sometimes quieter, sometimes a fairly constant stream of restraints?
OD: I wouldn’t say. Some days you could go without any restraints, then other days were just bad days and there were numerous.
JN: At Whorlton Hall, you’ve used the word complex, there were people with complex behaviours, and severe mental health disabilities, think there was about 16 people on site, I can count 16 bedrooms in that plan, is that about right?
OD: It was a big building, yes
JN: You were new. You had a mentor, but then started as a support worker. We’ll come onto care plans in a bit, but to you the reason people were acting violently was perhaps not always well understood by you
HHJ Smith: when you say people do you mean service users?
JN: yes, your honour is right.
HHJ asks him to repeat his question
JN: To you, the reasons service users were acting violently, was not always well understood by you?
OD: By me personally? I don’t think that’s it, when you see something in a situation and you see the way someone reacts, and the way everything else is handled, I don’t think it’s fair to say that
HHJ: We’re going to have to be careful, when you say someone I don’t necessarily know who you’re talking about, so useful if we talk about service users and staff if there needs to be a distinction. Shall we look at that again Mr Normanton?
JN: What I want to ask about in this context, to make it more clear. You are as you’ve described on for 6hrs with a service user, supervising them, in that time what can happen is their behaviour changes, and they become more violent, is that something that happens?
OD: yes, that’s fair
JN: these are service users with complex problems
OD: yes
JN: my suggestion to you, which you can agree or disagree with, is that it was not always clear to you why they’d become violent
OD: yes I think that’s fair
JN: part of your job as a support worker was to be on constant alert that if their behaviour was a deterioration. Is that a fair description of your job, that you had to be on alert?
OD: yes
JN: because no matter whether you were friendly with a service user, or perhaps developed a bond with them, the time very likely would come where you’d have to physically restrain them
OD: yes (hesitantly)
JN: and that was a near daily reality in the environment of Whorlton Hall, have I got that right?
OD: yes, but I think it would also be fair to say, that because it’s such a big building you never get the real context of how a service user might start to behave in a certain way. You’re seeing someone react who has complex needs and you’re not necessarily seeing the beginning of how that happened.
Mr Normanton, a little later, moved on to discussing staffing. The court heard there were about 20 support workers on each shift, and two nursing staff. There was also a deputy manager, Stephen Robdrup, and a manager Chris Shield. When asked by Mr Normanton about extra shifts, Ms Davies explained you could ask for extra shifts, so it would be possible there were people working 18 hour shifts. Ms Davies would generally pick up an extra day, so she’d work 6 shifts in a row “because of the timeframe the BBC had given for how long we could stay at Whorlton Hall… because it meant more time to be able to see what was happening there”.
Mr Normanton moves on to asking Ms Davies about management:
JN: Just considering the roles of people involved, I want to ask you about the management and what they did. They were senior to all other staff?
OD: Yes
JN: Including senior to the nursing staff?
OD: Yes
JN: I just want to share you a video, one of your video diaries 25 January 2019
HHJ: have we got a transcript Mr Normanton?
JN: I don’t think we have yet.
HHJ: We’ll try to capture this are we? We’ve lost the sound capture, but don’t worry we’ve a couple of solutions.
JN: this is an excerpt from one of your video diaries from 25th January. You’re about a month into your work there, these were recorded after each shift?
OD: Yes
JN: And they were recorded with a producer from the BBC?
OD: Yes
JN: In this section you’re going to describe management
Video diary: The more senior management, the actual manager of the building and the deputy manager, you barely see them, particularly the actual manager himself. He sits in his office all day, might shuffle in… I’m on my 20th shift, I’ve never spoken to him before, keeps himself to himself. In the time I’ve been there I’ve never seen him interact with a patient… he’ll walk past them and scurry back into his office. There’s no presence of senior management in any way I’ve seen so far.
JN: Short clip there, did that situation with management improve?
OD: Urgh, no I think, my memory of it now is not brilliant. But I would agree with what I say, I think its accurate
JN: Very well. Management had offices in the building, so if we have a look at our tab 2…. We can see at the bottom, next to ISS, Intensive Support Suite, just above that is managers office next to business support admin?
HHJ: ground floor, the yellow part, above the word corridor is room labelled managers office, you see that?
OD: Yes, yes
JN: That’s where a manager would be located, during a shift if they were there. Is that right?
OD: I feel like they would have been where it says clinical team, that was the nurses base, then office above it
JN: Below kitchen?
OD: I’m pretty sure management, or part of management, sat in there
JN: Ok
OD: But I honestly can’t remember
JN: That’s fine. Managers were never there at the weekend?
OD: I cant remember I’m sorry
HHJ: its alright
JN: I want to, we’ve established really through that video, that managers were not really present during shifts
OD: Yes
JN: I just want to ask you about the attitude of managers to residents and staff, but I’ll ask Mr Jenkins to play a short clip where you describe it, it may assist your memory.
Video diary: Ummm so then at one point I went downstairs to the nurses office and the Deputy Manager was there, and again Darren another staff member was downstairs he was basically talking about one of the patients who lived upstairs in seclusion. He was saying he’s developed such a fascination with women, and he was speaking to the manager to say can we start using women with that patient. His response, although you could see his thinking, this patient is so used to working with solely men, but the negativity and the way in which the manager responded, he basically argued, “ok I went in and worked with this patient the other day but when you start working with this patient you can’t trust him as far as you can throw him”, really negative things. One thing that really jumped out at meet was he said we can put agency female staff in with this patient because ultimately we don’t have to pay them sick leave. You can’t say that, you’re meant to be managing and operating, does that make sense?
JN: Did you feel supported by management?
OD: No. I think it’s fair to see in that video I wasn’t supported
JN: Did you think they had a good attitude towards service users?
OD: I can only say based on the fact that they weren’t really around… no.
We heard that anything up to 50% of staffing, sometimes more, on any one shift could be agency staff. Mr Normanton described how the nurses on duty “were using what they had, the amount of female staff they had, amount of agency staff they had, to allocate to particular residents” and Ms Davies agreed. She described the role of “responders” which was for two support workers to float and respond immediately when someone pulls an alarm “they are on hand to help with a restraint of help calm a situation down”, invariably they would be men because of a shortage of female staff.
Mr Normanton outlined the “different job” of nursing staff.
JN: Nurses then, you said they were around and about during a shift, clearly they had a different job to support staff… [missed bit]
OD: Sorry?
JN: A support worker is sitting with, spending time with a service user for 6hrs on each time, that wasn’t the role of a nurse, they wouldn’t be with a service user for that time?
OD: No, that’s right
JN: Nurses were there to provide healthcare to residents among other things?
OD: Yes
JN: They’d do things like dispense medication, and there was lots of medication to dispense?
OD: Yes
JN: And organising specific treatment, mental health treatment of patients is that right|?
OD: Yes
JN: They’d deal with medical emergencies on site?
OD: Yes
JN: In your evidence earlier to my learned friend, you were saying what would happen if residents went out of the building, nurses would also be involved in risk assessments for leaving the building wouldn’t they?
OD: Yes
JN: They were also required to attend whenever there was a restraint yes?
OD: Yes
JN: So press your buzzer and a nurse should come in and assist?
OD: Yes
JN: Their job in a restraint was to make sure everyone was safe medically, do you agree?
OD: Yes
JN: Did you understand what their job was in restraint?
OD: I mean, to administer PRN after a restraint
JN: What’s PRN
OD: A medication that was often given after a restraint, or a service user had been extremely distressed for any reason, and it medically calmed them down. Nurse involved after restraint to dispense that PRN medication, then we’d write up notes.
JN: We’ll come back to those in due course. During restraint when person being physically restrained do you agree nurse was there to oversee to ensure everyone was safe?
HHJ: When you say everyone?
JN: Staff and service users were safe, I suggest to you?
OD: Yes
JN: So, a number of different roles as you’ve described, but only two of them on any shift
OD: Yes
Mr Normanton went on to explain one of the registered nurses, Claire Ferguson, was pregnant, so “she spent most of her time in the office rather than on the floor”, Olivia Davies confirmed she remembered that. Mr Normanton put to Ms Davies that another nurse, Natalie Robdrup, the Deputy Manager’s wife, had a foot operation that required her to spend a lot of time in the office, but she could not recall. His final comment on the challenges faced by nursing staff was as follows:
JN: Do you recall situation if nurse was on shift with Claire Ferguson, it would be other nurse who went out and about and saw patients?
OD: It does ring a bell that would be the case
JN: What might happen, on what you describe as a bad day, when a number of restraints, you might be dealing with the restraint of your service user, but the nurse is having to go to that restraint, the next restraint and all other restraints on site, in addition to carrying out all their other activities?
OD: Yes
Mr Normanton then took Ms Davies to some footage she’d recorded of training being delivered by the Deputy Manager, Stephen Robdrup on 18 January 2019. It is filmed in a room where you can see the table, a colleague sat next to Olivia, and then Mr Robdrup, who is in front of a large wall with vinyl words stuck all over it.
Mr Normanton described them as “positive words”. The words I could spot included: success, accountable, equality, inspiring, person-centred, rights, communicate, meaningful, respect, fun, safe, expectations, choice, strength, hope.
He plays a minute of the footage.
JN: so was bit about care plans there, we’ll come back to, clearly training going on about care plans and size of them, that is Mr Robdrup isn’t it?
OD: Yes
JN: All the health stuff he says nurses sort that and that’s up to them, but physical interventions is what you do. He was telling you nurses would focus on health stuff and your role as support workers would be more focused on physical intervention side of things?
OD: Yes
He played a further minute of the footage.
JN: What he’s talking about there is the service user Patient 6?
OD: Yes
JN: And the context of his care, he is saying, um, I say to nurses if it’s not an incident, and you’re not giving meds, I don’t want you in there, you’re not providing direct care. So, was distinction between what nurses did and what support workers did, which was direct care? Yes
OD: Yes (hesitantly)
JN: With nurses, each resident had a named nurse didn’t they, do you recall that?
OD: Yes, I do
JN: That was a nurse specifically allocated to them and responsible for their healthcare while in Whorlton Hall?
OD: Yes
Mr Normanton used Patient 1’s Positive Behaviour Support plan as an example.
JN: Let’s go back to named nurse and think about what their responsibility is, one of theirs is the updating of a resident’s care plan, would you agree?
OD: When you say updating, you mean writing the meds that had been taken?
JN: Healthcare assistants and support workers would provide daily observation records wouldn’t they?
OD: Yes
JN: Better way of putting it. It was named nurse who was responsible for the care plan for a particular service user?
OD: Yes
JN: Observation records would go into care plan and should be reviewed by the relevant named nurse, would you agree so far as you’re aware?
OD: So far as I’m aware yes
JN: We’re coming onto care plans now, we’ve heard that word a lot, I’ll try to establish with you what it is. You’ve described as a ring binder, a large ring binder
OD: Yes, it looked just like this
Mr Normanton then details how much was contained within care plans.
JN: We recall the words of Mr Robdrup… there’s behaviour stuff, physical stuff, they’ve got a lot of care plans, a lot to get through. Was it right that care plans were there among other things to describe complex and sometimes nuanced behaviours of service users?
OD: Yes
JN: But they’d also contain details for example of service user’s medication?
OD: I believe so
JN: Their personal history?
OD: Yes
JN: Other personal information?
OD: Yes
JN: As you said they were large. Sixteen service users on site, so sixteen care plans to wrestle with for you. Is that right?
OD: Yes, it’s a lot
JN: Want to ask you about your first experience with them. You say in your witness statement when you started on 17 December you were sat down and asked to read all of those documents?
OD: Yes
JN: You didn’t start shadowing people until 19th, is that because you were reading the care plans within those 2 days?
OD: Yes I started with somebody else, we both sat in a room with a lot of these ring binder folders with care plans in them. It’s a lot of information to have to take in because they’re so thick.
JN: Very well. Care plans were stored in the nurses’ office is that right?
OD: Yes I think so
JN: Care plan documents were always stored together in same ring binder, they weren’t for example stored in residents’ bedrooms?
OD: No, they were handed out towards the end of the 6hr observation, you’d write in what their day was like
HHJ: If there were 3 or 4 of you looking after a service user on a 6hr shift, did you all have to write them or did one person take responsibility?
OD: It was just one person your honour
A little later Mr Normanton broached the subject of how support workers could feed back changes in resident’s behaviour.
JN: Another way in which information could be fed back, you were asked questions about handover meeting at start of each shift, although led by nurse, was opportunity would you agree for support workers to feed back on the condition of service users?
OD: Yes, if they saw something that they didn’t like or were concerned, was open opportunity I suppose to have a conversation.
JN: Nurses were reliant, because they weren’t with service users all the time, they were reliant on support workers bringing that information back?
OD: yes [hesitantly], yes, but they were also around as well, so they were able to see things that were happening or changing too.
JN: But if it was situation where a single nurse walking the floor with 16 service users on suite, certainly support workers were better positioned than a nurse dealing with that and all other responsibilities described?
OD: Yes but they also, if they were responding to an incident that required restraint, they’d know or have a sense of what it was that caused that behaviour. So they would see changes too.
JN: But they wouldn’t be with the service user, the reality of their job, they wouldn’t be with service user, probably at time of trigger that led to exacerbation of behaviour.
OD: No, but they’d get notes at the end of day to feed over to next handover, so they would see what was written.
JN: So would be support workers writing the notes, and they’re reliant on that?
OD: Yes
Mr Normanton played another extract from the training footage.
JN: Secondary strategies, what are they, to assist our understanding?
OD: I think secondary strategies were a way, before implementing restraint, if someone is distressed, they’re ways to change their thinking and navigate around, maybe taking them to a calm place, trying divert from them having a full distressing moment which would involve then restraint
JN: So Mr Robdrup there is saying, making clear to you nurses are reliant on you as a support workers to explain how you’re dealing with service users initially during restraint?
OD: Yes
JN: And the place you’d record that would be in your observation record?
OD: Yes, yes
JN: Just want to have a look at the training you received about preparing these observation records.
Mr Normanton played another extract from the training footage in which Mr Robdrup appears to instruct the support workers to copy what is in the care plan into records, saying that if someone dies within 24 or 48hrs would be immediately classed as a restraint related death.
JN: Slightly longer section, will break it down. What training is on is preparation of observation records?
OD: Yes
JN: And the training you’re receiving is that you’re being told in the preparation of those observation records to simply copy the care plan?
OD: He says copy, yes
JN: I think he says you can if you’re using strategies not in care plan uyou should say but I think he says its risky. In his training he’s saying that. He uses the example of Patient 6 dropping down dead as a result of not following right strategy
OD: Yes
JN: He says if you copy down what’s in the care plan your back is covered… was your impression of this training that you’re being encouraged to be litigation averse, to protect yourself by copying down what’s in the care plan?
OD: Going by what he says there, I don’t have personal recollection, but he does say you just copy what’s above.
JN: Because, was the, if you have no recollection or it’s difficult do say, do you remember this or that bit, my suggestion is what management were saying to you is cover your own back in the way in which you prepare observation records. Is that fair?
HHJ: I think Mr Normanton your observation is, the video says when writing out observation notes, you should copy out what’s in the care plan, seems to me copying the care plan could mean follow the care plan?
JN: We can look again, i’m putting to the witness, suggestion given was copy out of care plan into observation records, do you recall that?
OD: I can only go by that video, I don’t know, I’m sorry.
HHJ: was there every a time when anybody looked at one of your observation notes and said why’ve you not copied it out the care plan?
OD: No
HHJ: No
Mr Normanton then played one of Ms Davies’ video diaries where she described being told that a patient had been restrained in a prone position and a member of staff had put his knee in his back. She had mentioned it to him and he denied it but said to her that even if someone watched the CCTV back he wasn’t afraid because only if he’d done something wrong should he be worried or ashamed. Ms Davies tells her diary that she spoke to the staff member who had watched it on CCTV and they’d told her they reported the restraint, but he’d not mentioned the knee in the back, but if senior staff watched the CCTV they’d see it themselves.
Mr Normanton then discussed Patient 1 with Ms Davies. She was asked to supervise her on a number of occasions.
JN: She was someone who could be very difficult to manage?
OD: Umm, yes, but if you read her care plan you’d see that there are things you can do, certain things that would trigger her, or things you could do such as repeating words back to her, which would soothe her so she didn’t escalate to point where she’d be difficult to manage.
JN: In her care plan, it showed lots of triggers, likes, preferences and so on
OD: Yes
JN: We’ve seen a video where she’s restrained, she becomes louder and louder, shaking hands, and then she comes to hit you or Sarah Banner, do you recall that happening?
OD: Yes I do
JN: She would become violent on occasions?
OD: Yes she would, but that’s why secondary strategies were put in place to try and manage how elevated her mood got. For example if she said a letter to you, you could say it back, she was complex, but that’s what care plans are for, to help you treat her the way she should be treated
Mr Normanton continued to discuss care plans and the information in them in relation to patients, using Patient 1 as an example.
JN: It would appear from your video diary that Patient 1’s care plan certainly had some grey areas?
OD: Yeh but, I feel like there are so many, it’s such a broad thing, you could never contain everyone’s problems in a care plan.
JN: In a care plan and someone like Patient 1, who tragically has all these problems, and these specifics ways of acting, it was in your view difficult to reflect those properly in a careplan?
OD: That’s what I’m saying in that video yes
JN: I want to ask about Patient 1 and her care by female staff, will come onto that topic. Will play your section from video diary, useful aide memoires, your impression from 29 January.
Video diary: Certain patient work with quite regularly, she is well known, its well known she doesn’t like to have 2 men on observations, she’s a 20yr old, clearly states in her care plan she prefers having women… but when I went in recently I discovered that she’d actually had two men on observations on a night shift because of a lack of women on shift that night to be able to cover her… only one female on shift…. one female was given to one of the female service users, so this, I can’t get my words out sorry, this patient had been given 2 male staff members on a night observation, one female staff member on shift that entire night, so likelihood of going to her was very slim anyway. So today, I can’t speak.
[producer asks question – cant hear]
That’s fair to say, this week I’ve known of two separate occasions where only males have been doing this one patient’s observations, clearly states in her care plan she has a preference for women on observations, from what I can gather her response hasn’t been
JN: First what we’re seeing is video diary process of you and producer, giving you prompts to help you prepare your video diary?
OD: I don’t, if you watch the video diaries back, I’d been up since 5am, I’d driven there for an hour, got there, done 12hr shift, come out and because I’m doing two jobs, driving home for an hour, coming back, debriefing, writing my notes, doing video diaries, take till 9pm and then wake up at 5am. They’re not prompting me because they’re like say this or say that.
JN: It’s no criticism, really trying to understand why we’re hearing second voice there.
Seems to be picked up on 29 January, this service user Patient 1 has been with men this week and that hasn’t gone particularly well?
OD: Yes, that’s what I’m saying in that video
JN: And also seems to be case going back to staffing issue discussed earlier, reality of staff on that means she’s had to have men?
OD: I do remember she had two men, and as a young girl having two men sit at the door of your room. No-one really goes into room, everyone tends to sit a long time outside her room, it literally is just observations
JN: At this time 29 January, you’re giving this account in your video diary you’ve noticed her behaviour when she’d been placed with men has worsened?
OD: Yes
JN: That’s why you’re describing what you are on the video diary
OD: Yes
JN: You described it at that stage as a preference she had?
OD: Yes I think that’s fair
JN: Given what we’ve seen and heard it wasn’t always a preference that could always be accommodated, depending on staff on shift
OD: Yes that’s correct
JN: Do you recall an occasion where you were placed with Patient 1 each day in a week and tried to switch shifts away from her and couldn’t because there was no female staff?
OD: Yes I do remember that
JN: We’ve seen in recent video you were allocated rotas and you were told you’d be with Patient 1 for a shift, but would be no one else with you because wasn’t sufficient staff?
OD: Yes that did happen
JN: Sounds like that was a fairly familiar situation?
OD: Yes
JN: 29 Jan you appear to realise this is, her being placed with men, is distressing her?
OD: Yes, you could see it, she didn’t like it, you just knew she didn’t like it
JN: Knowing your obligation as a support worker which we looked at earlier how did you raise that in your observation records?
OD: Through my training with the BBC because I’m doing two jobs, working as a journalist and being a care worker, through my BBC training I always had to stay baseline what you’d expect from a care worker at all times, if I behaved in way which was too involved then nobody would want to talk with me. By nobody I mean staff I’m working with, I’m there to observe their behaviour to allow what they do to happen without encouraging them in any way.
So I’d written up observation notes, or I’d either ask someone to do it so I didn’t have to, or I’d write them and ask others suggestions so I wasn’t solely writing them
JN: Was this an issue you’ve thought carefully about before giving evidence?
OD: No it’s not
JN: You were aware at this time Patient 1 being placed with men on observations was making her unsettled and unhappy, you were the support worker spending a great deal of time with her?
OD: Yes
JN: Others may have but you were placed with her regularly, you were under obligation in your role Olivia as support worker, to report to nurses, changes in physical, mental state of service users… there’s no record we could find that you did that
OD: That I wrote any notes?
JN: That you wrote I’m aware Patient 1 was placed with men making her unsettled
OD: But I’m not a man, I don’t understand, I’m sorry
JN: You did your video diary, you were aware she was unhappy, how did you become aware of that?
OD: That she was distressed? Because she’d scream a lot, she didn’t like men, other people would say it too, people who’d worked there a lot longer than I had. It was known. It doesn’t take much if a young girl who…
JN: Just considering your first hand impression, your experience of it
HHJ: Mr Thornton it might be me, I’m not quite sure I understand this. The witness is saying she’d write in notes, at end of 6hr session in care plan of the service user she’d been looking after
JN: Yes your honour
HHJ: You’re asking her about times Patient 1 was distressed where she wasn’t supervising staff, she can’t have been, because you’re saying she’s simply being assisted by men?
JN: Your honour is right which is why I asked…
HHJ: You criticised her for not putting it in the observation notes
JN: I may have jumped forward too far, will establish this point first. You become aware how?
OD: Can’t remember specifically first time, if I asked question of someone else they’d say yeh she doesn’t like men, she doesn’t like men on her obs, become aware from staff who know her a lot longer
JN: And your record late January, is that she was more distressed because she was placed with men on two separate observations?
OD: Yes
JN: Did you experience that distress first hand?
OD: Yes
JN: How?
OD: I was filming it
JN: Having experienced that distress, and how she felt about the care of men, did you write anything in the observation records about that?
OD: I honestly can’t remember. Have I written it somewhere?
HHJ: I think Mr Normanton is suggesting he can’t find anything in the notes
JN: We don’t believe you have, I’m focused on that, the focus is this, you did not raise anything in the notes about this distress did you?
OD: No
JN: Wasn’t that a breach of your obligations as a support worker?
OD: No
JN: your honour I can see its twenty past, I’m moving onto a new topic.
At that point the jury were sent home for the evening and court was adjourned.
I’m unable to join first thing tomorrow due to a clashing commitment, but the case is being covered variously by the Northern Echo, BBC, Press Association and the Guardian, so hopefully others will pick up how this continues.
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