The half way point in the defendant’s closing speeches was occupied by Mr Christopher Knox for Ryan Fuller.
[Mr Knox who addressed the jury after lunch on Monday 24 April, had a tendency towards the middle and end of his speech to move around somewhat, and raise his arms, which meant unfortunately I really struggled to hear. I’ve done my best to report what he said and indicate where I missed substantial parts].
Mr Knox started by saying to the jury that “whatever else is cruelty in this case” listening to another barrister at the beginning of the afternoon is pretty cruel. “If you think that of me I’m sorry” he said before telling the jury that he had to put before them some of the same as what they’d heard from his learned friends.
What I put before you is what we think is important for putting Mr Fuller’s case before you.
Mr Knox told the jury that throughout the course of this case they may have gone into areas “you would never have dreamt you’d have heard about in normal life”. He told them that they may have insight into how a Panorama programme is constructed.
You heard this establishment being described as a specialist hospital, you may have thought this isn’t what I normally expect from a small, independent, maximum 17 bed hospital.
But I respectfully invite you to bear in mind I’m coming on behalf of Ryan Fuller, a young man who went to work there with very little experience or training, aged 20.
That’s not an apology, but a fact because you have learnt, I guess, a whole lot about the disabled and the disability of the people you’ve heard referred to variously as service users, but I’ll call them patients.
They were patients, they are patients.
Mr Knox reminded the jury of what Olivia Davies had said after her first shift she’d realised all the staff were going home in their cars “and these unfortunate people were not going home”.
They weren’t going home then and ladies and gentlemen. I’m afraid they aren’t going home, in inverted commas, now.
What you have seen are people who are really very disabled and mentally disordered, but they are people.
My client Mr Fuller you will remember, and when you look at it, treated those people as people all the way through.
Ladies and gentlemen what you need to appreciate, this is one of the things I will press upon you, that everything you hear about this has got to be seen in the context of an extremely unusual environment.
Mr Knox told the jury that he agreed with his learned friend for the prosecution that “this was home for these unfortunate people”.
They were very unfortunate, they were mentally disordered, through no fault of their own.
In reality you may think it’s very unlikely, and it is very unlikely they are able to be cured. Cured in the sense that suddenly they’ll be able to get better, live independently, and live what you might consider normal lives.
This was their environment. These were the circumstances in which they lived. I’m without apology going to take you through some of the realities of their lives.
Reason for that is very simple. What I’ll be suggesting to you is Ryan Fuller was not cruel, was not abusive, did not ill-treat the patients in his care. Not one of them.
He endeavoured with what he had at his disposal, in the context of what he had to do, to work a six hour stretch at a time, to try and provide some sort of life for those people.
Mr Knox told the jury that they’d heard no medical evidence at all about the “reasons why those unfortunate people were in that private specialist hospital”.
We’ve heard nothing about them. We know they were detained under Section 3 of the Mental Health Act. We know they had mental disorder which meant it was not possible for them to live independently. It wasn’t safe for them to be on their own, it wasn’t safe for other people to be living with them.
[It was at this point that I started losing sound periodically, apologies.]
Mr Knox told the jury that to be detained under Section 3 of the Mental Health Act required two registered medical practitioners. [Couldn’t hear the introduction to this but recognised what he read to the court next was an extract from the Mental Health Act, 1983]
This person is suffering from a mental disorder, of a nature or degree which makes it appropriate for him to receive medical treatment in a hospital; and it is necessary for the health or safety of the patient or for the protection of other persons that he should receive such treatment and it cannot be provided unless he is detained under this section.
Mr Knox told the jury that was the background.
He told the jury that the patients had such mental disorder that it “meant it was impossible for them to live normal lives, normally, looking after themselves, looking after other people, in the way frankly you clearly do, otherwise you wouldn’t be on the jury”.
Mr Knox told the jury that they had heard Mr Plomin and his journalist Ms Davies.
Of course Joe Plomin had a very considerable history. They may have thought this was another Winterbourne View.
They may have thought, we don’t know why. We know they came to create an investigative programme. That’s what Panorama does, I’m not sneering.
They’d a clear idea there was some sort of abuse. They were going to uncover, discover and show to the world.
You may think as a matter of common sense they were not expecting to find what they did. Not people being kept in dreadful conditions, not being looked after properly, not being properly fed, not properly warm, not being kept in decent surroundings.
None of us would want to live in circumstances such as there, but they were not unpleasant. They were clean, properly contained, each of those patients with a proper bed, proper private facilities. Was no suggestion they weren’t properly provided for in terms of meals at regular times, being able to have their laundry done, clear decent surroundings.
Mr Knox told the jury that the restrictions was because it was a hospital. He said that the people running this hospital “by which I mean the management”, were taking on the responsibility of these patients on the basis that “these were patients who had very, very real needs”.
In at least two of the cases we’re concerned with were frankly dangerous, that was what they had to be treated on, that basis.
Mr Knox told the jury that patients couldn’t live in an ordinary house. He said there was nothing untrue about the prosecution saying this was a 17 bed private hospital “but they were not giving you the Full Monty as to what was really going on here”.
Mr Knox told the jury that with the exception of Ms McGhee, these were not trained mental health workers.
Ryan Fuller wasn’t a trained mental health nurse. His training was about 7 days and some courses which he had. It’s right that a lot of emphasis was put upon restraint, and MAYBO 1-2-3 … which was the sort of thing necessary in circumstances in which restraint was an everyday reality, if not for all, then for a substantial number of the patients in this hospital.
This was the reality of the world in which they were living.
Mr Knox told the jury that they may think the anticipation of the BBC Panorama programme was that they would be finding physical abuse, or poor conditions. He told the jury that frankly this was not the case. That they knew Olivia Davies spent 38 days working at Whorlton Hall and that perhaps she spent a lot of time with Mr Fuller, because he was her mentor.
You may think actually rather than because he was a horrible person and an unpleasant employee or unpleasant care worker, it was because he was there talking to her, she saw what she saw.
Mr Knox told the jury that Ms Davies saw more of Mr Fuller than others, and what she saw did not involve physical abuse, threats or violence.
Mr Knox told the jury they may have been surprised that there were three counts in relation to teaching someone finger signs to apparent complete lack of distress. He said that they may have been surprised to find that when Mr Fuller took the spectacles of someone being restrained it formed the basis of an allegation.
Mr Knox told the jury that was what the Panorama programme had produced.
What we see here is the way in which this investigation developed, was Panorama decided they’d got material they wanted, they then withdrew Olivia Davies, who all the time had been posing as a care assistant, just like Ryan Fuller was. They then told the hospital, told the police and in practical terms handed their material, all that filming they’d done, and the police were then left to investigate
The police’s investigation, not a matter of complaint but fact, did not go even to the extent of seeing the doctors. Remember shadowy figure in the background Dr Perini, probably signing the certificates to get the certification under the Mental Health Act … all that, the police didn’t ask for, so we haven’t got it, which means you haven’t got it.
Mr Knox told the jury they had a great deal of documentation, and what the police had was documentation which had been supplied to them by lawyers acting on behalf of Cygnet.
Not saying it’s fake.
Not saying it’s false.
But this is not a case in which the police were able to go in straight away and see the files from which these care workers were required to operate.
They didn’t ask the doctors anything. They didn’t even approach the doctors.
Mr Knox told the jury that they did not have to be satisfied that there was harm as a result of the ill-treatment alleged, but the police had not even asked for the medical records of the patients. He told the jury that they have not got anybody to say these people were harmed by what they had to deal with in the hospital.
We say ladies and gentlemen, the reason for that is there was no evidence of harm, and no question here of ill-treatment.
That’s what I’ll say to you … the facts are for you.
Mr Knox told the jury that they have to decide what ill-treatment actually involves, “you set the standards” and telling them they had to decide whether using bad language in front of somebody is ill-treatment. He told the jury that they know teaching finger gestures had caused no harm, distress and he said, did not amount to ill-treatment.
Mr Knox told the jury that it was “absolutely vital” that they appreciated that Mr Fuller started at the hospital when he was 20 years old, and that he had been there for three years by the end of the indictment period.
Mr Knox told the jury that they knew Mr Fuller worked long hours, he’d told them he worked up to 100 hours a month overtime. Mr Knox told the jury that they knew that Whorlton Hall were short staffed and that they had to maintain staff numbers. He told them that there were patients who required four members of staff, three of which had to be eyes on the whole time.
Mr Knox said to the jury that it may have come as a bit of a surprise to them “in reality that person was in a flat, probably under lock and key, for significant proportions”. He said that nobody had suggested that was wrong, and he told the jury that what it said was the thrust of what he’d got to say in his respectful submission. That Ryan Fuller in the three years he was there “formed relationships with those people, I don’t mean relationship in an unpleasant way, he had to learn to deal with those people”.
Mr Knox told the jury that they had seen documents.
You’ve seen some documents which appear to show the dos and don’ts of it. Documents, we’ve supplied to you, a bit more with dangers and difficulties associated with their behaviour. This is not in order to slag them off, or be rude about them, it’s to try and ensure you see the circumstances, Mr Fuller, 20 years old, not in possession of a degree in psychology, not in a possession of a degree of any sort, not being rude about him.
Mr Knox told the jury that we talk about a lack of professionalism, but the reality was that Ryan Fuller was “a young man who was really thrown in to try to be able to deal with it” and that he tried to deal with it kindly and pleasantly “with people who were very, very difficult”.
Mr Knox told the jury that they’d probably also worry that patients were being detained under the Mental Health Act for treatment for their mental disorder. He said he made no apology for saying that reference to such things as outings were “rare it seems”, there was reference to occupational therapy yet “no real sign of it”. Mr Knox told the jury that we know a number of patients had to be provided with plastic cutlery and that they couldn’t have ordinary knives and forks because they’d weaponise them. He told the jury that the reality was that these people “were dangerous to themselves and to other people”.
Mr Knox reminded the jury of an entry he’d read to them where his client was headbutted by Patient 8 “in the course of his duties” and that he was sufficiently injured to require a report to be made to the police “not because the police were going to do anything because clearly the person wouldn’t be prosecuted”, describing Patient 8 as being “clearly a man under a very substantial disability”.
Reality is this, members of staff were regularly injured in the course of this.
Mr Knox told the jury that was an important thing to remember and that Ryan Fuller had been in this job for three years and he’d been assaulted and that it should be absolutely obvious that he’d never seek to wind up a person.
Mr Knox told the jury that Ryan Fuller knew the patients far better than Olivia Davies, he knew how to talk to them and “get some sort of response from them”, he said he was thinking about Patient 2. He told the jury that Ryan Fuller understood “how they could be able to pass the day”. He stressed to the jury that there was “frankly very little activity they could safely be allowed to undertake, because of the question of safety”.
Everything he did and said was part of trying to maintain a reasonable, sensible life for those people, and for the people who were caring.
Mr Knox apologised for the stuffy court and said he’d attempt to be as brief as he could, and that he’d turn to the individual patients. He took the jury to the agreed facts document and told the jury that it wouldn’t have escaped their notice that the police have vast quantities of documents “from the authorities, from the owners of the home”.
Mr Knox said what they were very clear about was that Patient 1 was diagnosed with schizoaffective and autistic spectrum disorder, and that she had a “history of behaviour management issues such as being aggressive towards others”. He read from a document which stated that Patient 1 may assault staff if she perceives her needs are not being met immediately. He invited the jury to remember that Patient 1 could move from settled to unsettled very quickly, and he said the picture appears to be a young woman who has got a degree, probably a high degree of intelligence, but an inability to control herself at all times.
[The sound started to drop in and out really badly here whist Mr Knox continued to tell the jury about Patient 1].
Mr Knox told the jury that the allegation in Count 9 against Ryan Fuller “arises it seems from his being said to have been a party to a suggestion that male carers would be brought in, in the context of his actually having to restrain her”.
Mr Knox told the jury members that he imagined they’d live for some time with the hearing of “that noise, the screaming she made” and that whilst Ryan Fuller was trying to restrain Patient 1, she was trying to scratch his arm “not a little bit, this is serious stuff”.
Mr Knox said that the jury would look at the videos when they retire and he invited them to look at the initial video of Patient 1 where there is no charge against his client, but where Mr Fuller comes in “with his hands in his pockets”, which he said goes without saying is “one of the least threatening ways in which a man can walk into a context like this, with his hands in his pockets”.
Is obviously unthreatening. He is obviously making himself less of a threat, if he ever were a threat.
Mr Knox told the jury that Ryan Fuller was “simply restraining when she needs to be restrained” and he was by being party to what others were saying, charged with Count 9. Mr Knox accepted was for the jury to decide, however he suggested that the prosecution suggesting it was ill-treatment was unfair and unreasonable, all that was happening were Patient 1’s carers were trying to get her to understand what she was doing is unreasonable and was going to lead to trouble.
Mr Knox directed the jury to a document in their bundle, relating to Counts 11 and 12. He told the jury they could look at the video. He told the jury that Patient 2 was apparently averbal and directed them to further documents. He then described Patient 2. He told the jury that Ryan Fuller was her keyworker and he suggested that she had a degree of comprehension and that Ryan Fuller “had some sort of rapport, understanding, relationship with her [Patient 2] because he’d been there, as she had, for some years”.
Mr Knox then discussed the second count where he said that Ryan Fuller was talking to Olivia Davies, he told the jury they’d have to make their own mind up whether he was showing off to Ms Davies. He said Ryan Fuller was talking to Patient 2.
He’s having a chat with her. Ill-treatment? Cruelty? Why would this amount to cruelty? Is this giving her an unpleasant way of dealing with people that will harm her future?
[Couldn’t hear next part]
Mr Knox then moved to Count 14, with Patient 3, telling the jury that the prosecution say that Ryan Fuller knows its wrong because he tells his colleague to delete the photograph. Mr Knox told the jury that they may think it’s silly, and told them he’d provided additional documentation about Patient 3 “the purpose is not to suggest he’s an unpleasant person, but gives a more vigorous interpretation of what he’s capable of doing”.
Ryan Fuller is not going to wind up someone capable of significant violence.
You’ll remember although small and wiry, he was very, very strong. One part of the evidence suggested it took eight people to subdue him.
[Couldn’t hear the next part]
Mr Knox asked the jury whether Ryan Fuller had engaged in a serious criminal offence, and were they sure it amounted to cruelty.
Mr Knox then told the jury he’d address Count 15, in relation to Patient 4. He invited the jury to look at the document he’d supplied them with, which he respectfully suggested was important.
Now I make this comment to you. When you see these allegations you realise just how dangerous young Patient 4, not so young Patient 4, actually was.
Mr Knox asked the jury to look at the previous two to three days before considering Count 15 incident on 25 January 2019. Mr Knox told the jury that Ryan Fuller comes upon the restraint and takes the head, he also told them that Patient 4 clearly has a habit “even that day of completely losing control and he’s got to be restrained”.
Mr Knox told the jury that the prosecution do not suggest that the restraint was unreasonable, but the allegation is in relation to Mr Fuller taking Patient 4’s spectacles off and putting them on his own head. Mr Knox said that Ryan Fuller’s account is that he took the spectacles to avoid them being damaged. Mr Knox said that he was asked for chewing gum, he has gum and shares it amongst themselves, he said that was taking the temperature down, it’s not abusing Patient 4, who Mr Knox told the jury was in an internal frenzy, that was “want to pass”.
[Couldn’t hear the next part]
You have to be satisfied that he did what they say, for sure, on basis this wasn’t reasonable, was just done to be cruel.
Mr Knox said he’d next address Count 16, a very short account. He said Patient 4 is diabetic and doesn’t like his medication and that it was said that Ryan Fuller was teasing him about his required medication.
You may think is difficult to see where he is, what he’s participating in that discussion amounts to cruelty or he’s simply pointing out yet again to Patient 4 he has to take his medication, important for his physical health and his stability.
Mr Knox then took the jury to documents from Cygnet records, telling them there is agreed evidence that removing items from Patient 4’s room is not a new idea, or torturing him, but is common sense and a reasonable action of protection for him and those around him.
Mr Knox said the next allegation is in relation to Count 23 which related to Patient 5, which he told the jury they may remember as 1-2-3-MAYBO. He asked the jury to please remember when watching the video that the TV is on in Patient 5’s sitting room and Patient 5 was apparently watching on the TV a football results programme. He said there was a transcript but that the jury may not find it 100% clear.
What I respectfully submit is this, whilst you could say this is poor taste, questions is this isn’t very professional as well, we’re not talking whether professional, we’re talking about is this cruel.
It may be in poor taste, it may be a bit silly, I’d invite you to think silly is the right adjective.
It’s not malicious, it’s not unpleasant, it’s treated as a joke.
Mr Knox told the jury they will not see “the slightest sign” of Patient 5 being upset, irritated or in any way put out.
Mr Knox said the final three counts against Ryan Fuller are Counts 24, 25 and 26 and that they relate to Patient 6. Mr Knox said there was information about Patient 6 in the agreed facts, and he had given the jury further material about him.
Mr Knox said the observation record from that date shows that Patient 6 was described as having good behaviour, settled, good and good “in other words whatever had gone on in the garden clearly hadn’t impacted”.
Mr Knox took the jury to a police report prepared by an officer who had viewed the CCTV footage from Patient 6’s flat.
This gives you I suggest a chilling example of what goes on in his life on a day to day basis between 27 December and 11 January.
Mr Knox said that it showed Patient 6 had grabbed clothing of staff members, tried to bite them, throws cushions around [he proceeded to read more examples, I didn’t catch].
Ladies and gentlemen you know also this is the man with 25 placements in 24 years.
Mr Knox took the jury to Patient 6’s segregation reduction careplan, telling them that this is “a dangerous, dangerous man, 4 to 1”. Mr Knox said he wouldn’t try to tell the jury what was in the videos, adding “it’s a pretty chaotic picture”.
It’s a good deal of swearing and bad language but reality of it is this, I say it’s quite impossible for you to say, my submission, that there is here ill-treatment by him.
Mr Knox told the jury that the prosecution say there are three counts of ill-treatment including masturbation gestures. Mr Knox told the court that Ryan Fuller had told them Patient 6 was the one person who he had “at some stage a bad relationship” with. He said that they’d known each other for three years and Mr Fuller had described that to the jury.
This is the man who was very difficult …
Ryan Fuller is said, by himself and others, he was trying to get some sort of rapport, would be difficult to describe as a relationship, some sort of rapport, some method by which they’d communicate on a reasonable basis.
Those are the competing tensions in relation to those.
Mr Knox asked the jury to look at the documentation he had supplied so they can see whether Mr Fuller responds and whether this is three counts of abuse and cruelty.
[Couldn’t hear next bit]
Mr Knox said he invited the jury to see that they have a young man, between 20 and 23. “You will not have heard him raise his voice”, he says he’ll leave the garden episode “I don’t actually say he was shouting but if I’m wrong it’s up to you to say”.
Mr Knox told the jury that Ryan Fuller “was exposed to Olivia Davies a lot … the prosecution say this is a cruel man abusing people in his care”. Mr Knox told the jury that Mr Fuller was a young man, doing his best, he was amiable.
On the whole you can see is simply sometimes silly, I accept that. I don’t resile from what I say about MAYBO 1-2-3.
Is this cruel?
Is this an abuser?
I say not, I say this is a young man over three years who tried hard to do what he had to do. An extremely difficult exercise in trying to provide some sort of life for these people, who didn’t have anything constructive or useful to do. That wasn’t his fault, he was simply there, dropped in with minimal training to try look after the most difficult people.
Mr Knox told the jury that they may find the evidence suggests that Mr Fuller did a good job.
[Couldn’t hear his final closing statement].