Day 1 afternoon evidence: Jessie’s inquest

In this post I’ll recap the evidence that the court heard when they reconvened after lunch on Day 1 of Jessie’s inquest. You can read my report on Jessie’s mother’s evidence to the jury here, and her father’s evidence and account of Jessie’s last five and a half years here.

When we returned to court for the afternoon session (I’m attending remotely, for which I’m very grateful) the placement of the microphone and camera had moved, and whilst I could see the coroner, I could not hear the witnesses as well as I could in the morning, so my notes are much less detailed.

Post Mortem and Toxicology Report/ Dr Mark Taylor

The afternoon’s evidence started with the Coroner’s Officer reading onto the record the report of Dr Mark Taylor who conducted Jessie’s post mortem. He found Jessie’s cause of death to be compression of the neck by a ligature [I’ll not share more details in line with Samaritans guidance]. The toxicology report showed that toxicology was not contributory, the only drugs detected in Jessie’s body were her prescribed medication which was not presence in excess.

Isobel Clarke / Senior Social Worker, East Sussex County Council Children’s Services

Next the Coroner’s Officer read onto the record the statement of Isobel Clarke, a Senior Social Worker in the Through Care Team in East Sussex County Council Children’s Services. She told the court that she’d worked for the team since March 2018 and was supporting young people aged between 13 and 18. She had qualified as a social worker in 2010 and had “extensive experience working with children, young people and families”.

She was allocated as Jessie’s social worker on 5 August 2019. Jessie had been supported by the Youth Support Team prior to entering care. Ms Clarke told the court that on 6 June 2019 it was agreed that a residential placement would best meet Jessie’s needs, and Jessie’s parents signed a voluntary agreement for the local authority to take over her care (I think it was a Section 20, I’ll check).

She described this arrangement as being a voluntary section where parents consent to their child becoming a looked after child. They retain parental responsibility and continue to be part of discussions.

Ms Clarke told the court prior to 2016 Jessie was “not known to children’s services”. She had an EHCP for social and emotional difficulties and had received some specialist educational provision due to her behaviours. Jessie came to the Through Care Team when she was 16.5 years old, which Ms Clarke described as a “relatively late age to become a looked after child”.

Ms Clarke’s statement described her role as helping to prepare children for independence when they reached adulthood, she said that may involve supporting their independence, helping find accommodation, and helping them to access health and mental health support.

She said that Jessie was generally happy for information to be shared with her parents and she maintained a good relationship with them both.

Ms Clarke said that she was allocated Jessie on the day she was taken to Poole Hospital after an incident of self harm at Southlands School. She said that she attended multiple meetings that week and met Jessie again the following week at Poole Hospital. She told the court that Jessie really enjoyed her time at Southlands School and wanted to return there, but that was no longer possible.

She said Jessie spent four weeks in Poole Hospital, initially supported by staff from the school, and then supported by Wrixham Care staff. She told the court that Wrixham Care were a private, unregulated organisation who offer support to young people with behavioural or emotional needs.

She said that Fairways, a children’s service charity, were identified as a residential provider for Jessie but they were not able to provide her with a place for 5 weeks. Ms Clarke told the court that the plan was for Jessie and her father to go to Centre Parcs for 2 weeks, with support during the day so she didn’t have to stay in hospital.

Ms Clarke said that following those 2 weeks, Jessie’s proposed placement was still not available so Fairways agreed for her to move to their emergency accommodation in Wales. Ms Clarke said there was a strict regime in place and Jessie did have challenges there and multiple A&E attendances, although she said at a later date she had felt safe in Wales.

Ms Clarke continued, that at the beginning of November 2019 Jessie was moved to Fairways in Gosport. She told the court that Jessie generally got on well in the placement, and she helped to decorate the property, however she was not getting any mental health support from CAMHS and her self harming continued.

It was decided that Fairways could no longer support Jessie on a one to one basis and so she was moved to a group placement in Southampton, Ms Clarke said. She said that Jessie was not able to cope with the other residents and the staff and she took herself to Southampton Hospital. Staff there said that Jessie was “not detainable”. Ms Clarke said that Fairways gave notice and Jessie was taken to Netpex in London.

Ms Clarke told the court that on arrival at the Netpex property it was not deemed by her parents, or Wrixham Care, to be appropriate and they supported Jessie to return home while a “bespoke package of care was discussed and agreed”.

Ms Clarke said that there were no placements found nationally that could meet Jessie’s needs and it was decided that a “bespoke package” would be considered.

This package was accommodation, with Jessie to be supported by two Wrixham Care Support Workers, who would live with Jessie. Also included was weekly CAMHS intervention, social work involvement and education provision to be provided.

Ms Clarke told the court that during the initial covid lockdown Jessie remained at home with her parents and Wrixham care staff and in July 2020 she moved out of home and into a property in Lee Road in Lewes, with Wrixham Care support. She said this property was rented out by Lewes District Council and this was where Jessie remained for the remainder of the time that she was involved with her.

She said that Jessie continued to self harm and present at A&E although there were “more periods of stability” during this time. Ms Clarke told the court that Jessie had wanted to get a therapy dog, or talked about getting a puppy that she could train as a therapy dog herself. Ms Clarke said that she had discussions about who would look after the dog when Jessie went to A&E after self harm incidents and it was agreed they would revisit in 6 months. She told the court that “we agreed” to look into Jessie volunteering in an animal welfare placement but Jessie was not interested in this idea and was “very fixed on purchasing a dog herself”.

Ms Clarke told the court that at Lee Road Children’s Services began regular meetings to look at a plan for moving forward post 18 for Jessie. She told the court on 30 October 2019 Jessie met her personal advisor, Rob Higgins, for the first time. He had attended previous meetings but due to multiple changes for her at 18, it was not deemed appropriate for Jessie to meet Rob before that.

Ms Clarke told the court that Jessie started back in Education in November, attending a placement for young people not able to attend education due to health issues. She said that Jessie was reluctant to attend any education that was not mainstream but she did agree to start attending, and it was appealing to Jessie because it was face to face.

Ms Clarke said that Jessie attended the educational setting with Wrixham Care Staff three times a week, initially for one to one sessions. She told the court that Jessie was very motivated to attend mainstream college in November 2021.

She said when she stopped working with Jessie she was still living at Lee Road and Adult Social Services were trying to identify suitable accommodation for her.

Rob Higgins / Personal Advisor East Sussex County Council

The next witness was Rob Higgins. I struggled to hear many of his answers but will report what I could hear.

Mr Higgins was asked by the coroner to tell the court about his role and he said once a young person reaches 17.5 years of age a personal advisor comes on board for all looked after children and care leavers. They are based in the Through Care Team at the council, and once allocated they meet a young person every 4 to 8 weeks.

He told the court that they can provide advice on benefits [more that I couldn’t hear] and their role is to provide stability and work long term with care leavers. In response to a question from the coroner Mr Higgins said that the large majority of his cases were individuals with mental health difficulties.

Mr Higgins told the court that there were so many professionals involved with Jessie, he just wanted to get to know Jessie as a person and build a relationship. He said that professionals “come and go with Jessie’ and he would be with her for 5 or 6 years, to provide stability.

The coroner said that the previous witness had told the court Mr Higgins was allocated to Jessie “quite a period of time” before he saw her. He told the court it was felt by the social workers at the time, because of how many professionals were involved, it was sensible to wait until Jessie was closer to 18 before he met with her. Jessie turned 18 in December and Mr Higgins had his first meeting with her in October.

Mr Higgins told the court he had spoken with Jessie’s mother, Kate, about her likes and dislikes, to get an idea of what her interests were, before he first met Jessie. He said it was during covid when he first met Jessie and the social worker was unable to attend because she was shielding, but he met Jessie and introduced himself [couldn’t then hear].

The coroner asked what happens to social workers when someone transitions from being a young person, and Mr Higgins said that the social worker does not always stay involved and that people are handed over to a new social worker in adult services. Mr Higgins explained his role was to provide stability and be consistent, even when social workers change.

The coroner asked Mr Higgins what his plan was in October 2020 and he told the court that he spoke to Jessie about what she loved doing. He said she was an artist [and more couldn’t hear]. He told the court that Jessie spoke about what she wanted to do, “she had many dreams and aspirations” and was quite excited about [can’t hear].

Mr Higgins said Jessie was emailing him throughout November about having her own cat, which he thought was very sweet. He met with Jessie in November when she met her new Adult Social Worker, he went along to support Jessie and the social worker in that as he’d met Jessie before. He then saw Jessie again in December and had contact with her mainly over the phone at that time.

Asked by the coroner what Jessie was raising with him at that time, Mr Higgins said in December she was thinking about Wrixon Care and that she’d built relationships with some of the staff working for them. Mr Higgins said that he was made aware in January that Jessie had self harmed and asked if that raised concerns for him he replied “of course, I’d built up quite a strong relationship with Jessie early on” [can’t hear].

Mr Higgins told the court he had received a text message from Jessie on 20 January, sent the night before, which read:

Hey Rob, know you won’t get this before the morning, just wanted to let you know you’re a really good PA, thank you and goodbye.

Mr Higgins told the court he immediately phoned to check on Jessie and was informed she was safe in bed. He agreed with the coroner that in January, Jessie had decided she wanted to resume education and go to university. He said that he had discussions with Jessie about politics and the ways of the world [can’t hear].

There was then a series of questions and answers from Mr Higgins about contact he had with Jessie in February that I could not hear. He told the court he was dropping Jessie’s living allowance off at Lee Road and found out that she was back in hospital on 29 January 2021. On the 2 February he spoke to Jessie to remind her about a Universal Credit Appointment she had, saying it was important that she attended, he told the court later that day he found out she was back in hospital again.

Mr Higgins told the court when he spoke to Jessie in the middle of February she was upset as one of her grandparents had passed away and she loved him very much. That had upset her. She was still in hospital at that time.

The coroner took Mr Higgins through further contact and discussions he had with Jessie and he told the court what his involvement was and how he found Jessie. He said in May that Jessie was really looking forward to her placement with Sussex Empowered Living and the coroner told the court that “we know that didn’t happen”.

The coroner asked Mr Higgins about when he saw Jessie in August and he said that he went to see her in hospital in Hastings. He said that Jessie was frustrated by the lack of anyone finding her a placement. He said towards the end of his visit, himself, Jessie and her father were talking in the corridor and Jessie complained of a headache and feeling dizzy. She then had a seizure and Mr Higgins told the court it was the first time he’d seen Jessie have a fit and it was “quite distressing to see”.

Mr Higgins told the court when he visited Jessie on 21 September she was relieved to be out of Conquest Hospital “she hated it there” and Jessie was pleased to be back in the Brighton area and close to her family.

The coroner continued to take Mr Higgins through his contacts with Jessie. He described her as tearful and fed up in early November. On 12 November he described a visit as “quite nice”, he went to Jessie’s house and met with her dad and then Mr Higgins took Jessie to Costa “she loved going to Costa for coffee and a chat”. He told the court that Jessie mentioned that the Red Cross were supporting her with a befriending service at that point as well.

He told the court when he returned in December the house was cosier, and cleaner. Jessie now had female carers on her team and he said she had a good relationship with the female care.

The coroner said that Jessie was in and out of hospital over the Christmas and New Year period and asked Mr Higgins when he saw her on January 21st, whether he saw a decline in Jessie’s mental health and how she was appearing then. Mr Higgins told the court that Jessie was in quite good spirits at that point, that she spoke about her future and “she spoke about the relationship she had with her mum and dad at that point, which was really positive”.

Asked by the coroner if he saw a fluctuation in Jessie’s mood from time to time, Mr Higgins agreed. He also agreed that Jessie’s mood was unpredictable. The coroner asked Mr Higgins if he’d seen Jessie’s physical condition worsening and he said he had, and that by January Jessie needed a wheelchair, he said that it was “distressing to see her deteriorate”.

Mr Higgins told the court that he visited Jessie when she was detained under the Mental Health Act at Mill View Hospital. Asked by the coroner if he could see the deterioration in her mental health, he replied “yes, when I first met Jessie in November the previous year she was very smiley and bubbly, but had deteriorated”.

The coroner said Mr Higgins clearly had a good relationship with Jessie over a period of time, asked if when he reflected back there was anything else he could have done to support her, Mr Higgins said he didn’t think so. He said that they had a good relationship and he wouldn’t have changed anything in their personal relationship.

The coroner asked him about the search for accommodation suitable for Jessie but I couldn’t hear his response to that question.

Asked by counsel for the family how he had developed a good relationship and rapport with Jessie he replied:

With Jessie, one thing that always stuck in my mind when I spoke to her, was getting on her level … getting to know the real Jessie.

He told the court Jessie had many hopes and aspirations. He also said he’d had discussions with both of Jessie’s parents and that had allowed him to get a picture of what Jessie was going through before speaking with her.

Asked what he thought the impact on Jessie was of the lack of a placement he told the court “in her mind that was exactly what needed to happen”. Asked about how Jessie experienced the uncertainty of not knowing where she’d be placed next he responded “How can any young person not know where they’re going to end up?”.

Counsel for the family asked Mr Higgins about the AMC Locums member of staff staying in Jessie’s home at Viaduct Road and he said 4 weeks sounded about the right time period. Asked about his meeting with Jessie when she was at Mill View Mr Higgins told the court:

Having someone to talk to in dark times is what she needed.

In response to a question, Mr Higgins confirmed Jessie talked to him about her Etsy jewellery making business. There were then some questions about AMC Locums staff which I didn’t catch.

No other counsel had questions for Mr Higgins, and there were no jury questions.

Lauren Bernard / Senior Practitioner Social Worker East Sussex County Council

The final witness on Day 1 of Jessie’s inquest was Lauren Bernard. She told the coroner that she had started working with Jessie in February 2021, alongside Helen Boyle as Helen was leaving her role. She agreed with the coroner’s suggestion that Jessie had built up a relationship with Helen and when asked how they prepare for change when a social worker is moving on, Ms Bernard replied:

There wasn’t much transition time due to the end of Helen’s role coming very quickly. I became involved in the professional’s meetings, then the next meeting Helen had with Jessie I went with Helen to meet Jessie in hospital.

She told the court she’d been given an overview of Jessie’s interactions with the social work team but she would not have access to the Children’s Services system to read through their notes. In response to a question from the coroner she said that she felt her first meeting with Jessie “went ok”. Helen had taken the lead and she introduced herself to Jessie, and there were “a number of things to discuss”.

Ms Bernard told the court that by the time she got involved “sourcing was well underway” to try and find Jessie a placement and Jessie had an interview with Sussex Empowered Living. In response to the coroner’s questions about that Ms Bernard said an independent person had deemed that Jessie had capacity to make decisions about her care and support “however during times when she was dysregulated she might not have had capacity”. She told the court that the local authority were going through the Court of Protection with regards to Jessie, which did have an impact on the number of settings available to Jessie.

There was some discussion between the coroner and Ms Bernard about what that meant, I didn’t catch all of it, but Ms Bernard agreed with the coroner’s summary that the High Court had agreed should Jessie lose capacity, it was ok for the provider to work in her best interests. She also agreed providers felt uncomfortable with dealing with Jessie at the point at which she lost capacity, and because of that the number of providers and accommodation options available to her was reduced.

Ms Bernard said that providers wanted to support Jessie using Positive Behaviour Support, which she described as specialist plans, working with the team and Jessie to work out ways to support her without going down an overly restrictive route “managing behaviour and supporting Jessie to make positive choices”.

The coroner asked Ms Bernard about what happened with Sussex Empowered Living and she told the court that they had accommodation available for Jessie in the Brighton area and to support Jessie with the big transition from hospital to independent living with 2 to 1 carers, it was agreed she would have a transition period. Ms Bernard told the court that during that transition period with Sussex Empowered Living, when Jessie was getting to know them, there was an incident at their head office on 5 July 2021. The staff mentioned that IMC Locums would be involved in supporting Jessie and she became “very, very upset an dysregulated, she could not be supported by the team to calm down”. Ms Bernard said that Jessie started screaming and threatening to hurt herself and she self harmed. Ms Bernard said that Jessie became so distressed she wet herself on the floor and there were “discussions about whether she had had a seizure” but she did not know if she had.

Ms Bernard agreed with the coroner’s summary that the Sussex Empowered Living team felt that they could no longer support Jessie and she therefore remained in hospital at that point. There was then discussion which I didn’t catch in detail about how distressing this was for Jessie and some incidents of self harm she engaged with whilst in hospital and on home leave.

Ms Bernard told the court in August 2021 she was travelling into the office to meet with Jessie after she presented at the council offices in Eastbourne with her father. She said due to covid she wasn’t working in the offices and when she arrived in “Jessie was unresponsive on the floor in reception, being attended to by community nurses, an ambulance was called and she was taken to hospital”.

The coroner took Ms Bernard through her statement of what happened next, Jessie was in A&E, she was then medically fit for care in the community but it was “not viable” for her to return home and she could not return to hospital so she was placed in emergency support at Viaduct Road in Brighton with two to one support. Ms Bernard told the court this was “the only option available to Jessie” and that they were looking for care providers but they would not be able to pick up on an emergency basis.

There was then a section I didn’t catch.

The coroner visited some of Jessie’s and her parent’s concerns about IMC Locums support and Ms Bernard gave the example of a carer moving into Jessie’s home. She said that she raised it with IMC Locums and asked that he not support Jessie any further. Ms Bernard told the court that Jessie had alleged a carer had been touching her feet while she was asleep. Ms Bernard said she raised this with the care agency and as a safeguarding concern in Brighton and Hove City Council.

The coroner asked if IMC Locums also raised concerns and Ms Bernard said that they raised allegations regarding Jessie’s father which had been discussed already. She said as the placement started to deteriorate, there were further complaints about the relationship between Jessie and the carers.

Asked by the coroner if those complaints and concerns were investigated Ms Bernard said that individual concerns and complaints were received at different times e.g. smell of cooking in the property, Ms Bernard said they can not stop staff eating if they were on a 12 hour shift, but they asked them to be considerate of what they are cooking. In response to a question from the coroner, Ms Bernard told the court that safeguarding matters were investigated by Brighton and Hove City Council because Jessie was living in Brighton at the time.

The Coroner discussed the referral for an occupational therapy assessment for Jessie as her physical health was deteriorating. Asked what she was seeking to achieve by that referral, Ms Bernard told the court that it was to make the accommodation as suitable as possible for Jessie and identify whether she needed mobility recommendations to promote safe independent living for Jessie.

Ms Bernard told the court that when the first safeguarding allegations were made she was on annual leave, but at the time of the initial planning meetings there was a discussion about introducing a female carer onto the rota to reduce the further risk of allegations being made.

In response to a question from the coroner about whether she was trying to source alternative accommodation for Jessie, Ms Bernard told the court:

LB: Yes there were limited options, bed and breakfast would not have been suitable for Jessie. We approached a number of care providers, unfortunately they were unable to support, they did not have capacity or did not have accommodation themselves.

C: I’ve added up the list. There are 28 providers on the list, 29 including IMC Locums. Are you saying of all those you approached you could not find anyone?

LB: Yes. The team approached them all.

The coroner asked Ms Bernard what happened in the latter part of 2021 and she told the court that there was continued involvement of IMC Locums, that she was trying to get Jessie support with occupational therapy as “unfortunately when she left Langley Green her sensory work had stopped” and she told the court that she was on a waiting list for it to be re-started.

LB: Jessie was very much struggling with the situation she was living in. She was facing an unknown future in care and support…. Sadly I wasn’t able to give any viable answers at the time.

C: Was there anything else you could have done at that point?

LB: Potentially. Potentially, when you reflect back on your own work, potentially could have been something else we could do. We could have re-approached providers, we did continue to approach alternative providers, but we could have looked at bringing new alternative carers but we couldn’t source it.

The coroner detailed what happened to Jessie in early 2022 and asked Ms Bernard what her role was when Jessie was detained under the Mental Health Act and placed in Mill View Hospital. Ms Bernard told the court that she had no involvement in the Mental Health Act assessment and that Jessie was being supported by mental health services. She said once Jessie was transferred to Mill View she was looking at a social care assessment for her and she was aware that there had been changes to Jessie’s physical and mental health. A new assessment was started whilst Jessie was in hospital so that it reflected her most up to date needs, she told the court. She said that she had started the assessment but it was too much for Jessie and they needed more information so she handed it over to someone else.

C: As a social worker, what were you hoping for Jessie?

LB: Overall aspiration was that she could live safely in the community, would have been high level of care that could be seen as quite restrictive, but idea was we would support her move from hospital to the community safely… so she had her independence and freedom that she craved. She was an intelligent young woman, she had her own aspirations as well, she wanted to have a job and work. Idea was she would transition to the community with support.

C: That was your aspiration, what stopped you achieving that?

LB: We were unable to find a suitable source of care and support for Jessie to ensure she had those opportunities to make those decisions, to start making those transitions into the community.

Asked by the coroner whether Jessie’s mental health fitted into that, Ms Bernard said that her mental health had an impact, but her physical health needs were also changing and progressing. She told the court that she was aware Jessie was undergoing further neurological testing for her epilepsy.

Asked by the coroner how Jessie’s mental health needs featured in relationship to other cases that Ms Bernard held she responded that sadly Jessie had very complex needs:

It wasn’t just her mental health needs, it wasn’t just autism, it wasn’t just physical health needs, unfortunately she had a combination of all three… trying to find support for all three areas of her support, which was very complex.

Asked by the coroner how many of the individuals Ms Bernard was supporting required accommodation with two to one care, she responded at the time 2 or 3 people on her caseload of about 17 or 18.

Counsel for Jessie’s family had a number of questions for Ms Bernard.

Ms Bernard told the court that she was aware Jessie had autism, she couldn’t recall if she was aware of her diagnosis of sensory processing disorder and she was aware Jessie was undergoing testing, she thought for Ehlers Danlos Syndrome, but she wasn’t aware that she had it.

In response to questions from counsel Ms Bernard told the court at the point she was approaching providers she had an understanding of Jessie’s autism, her joint problems and of Jessie’s seizures. She said that providers were all made aware of Jessie’s needs and they said that they would be able to support with seizures but that they would require a care plan from a health professional about whether they should administer medication.

Counsel shared a number of extracts from an autism assessment of Jessie that Dr Rowe of the TCAT service had conducted. Ms Bernard said she was aware that Jessie could struggle to manage day to day tasks.

She told the court that when they first did an assessment they were told Jessie was independent in personal care, but as time went on she was struggling. Ms Bernard said that Jessie made it clear her preference was for all male carers but they were not comfortable providing her with intimate care so a change had to be made to introduce a female carer on shift with Jessie.

Counsel read another extract from Dr Rowe’s report relating to post traumatic stress disorder and Jessie’s experience of flashbacks, and the suggestion of a grounding technique that might help with a male voice. Ms Bernard agreed with counsel’s suggest that an approach that takes into account Jessie’s history of trauma would help her to feel safe. Asked what steps were taken to ensure staff dealing with Jessie were able to do that, Ms Bernard said that it was an emergency situation so they used IMC Locums. Ms Bernard also told the court it would be “extremely important” that the provider read the TCAT reports so they were aware of recommendations relating to Jessie and that she shared information with IMC Locums about supporting Jessie in the community.

Counsel said that the report made it clear that Jessie had experience of settings not being able to meet her needs and as such Jessie would understandably be anxious and question whether places could meet her needs. Ms Bernard agreed with that and said they had to make sure that Jessie had interim care but the plan was “as soon as we could we’d be moving her onto a permanent care team where they could meet her needs”.

Asked how urgently this was addressed over the five month period Ms Bernard said it was very urgent and was investigated by her service manager, operations manager, practice managers and senior managers.

Counsel: In the meantime you were also aware that coming and going, placements breaking down, also had a detrimental affect? Might be making Jessie’s needs even bigger for her next placement. Do you agree with that?

LB: Yes, unfortunately Sussex Empowered Living withdrew their offer of support 48 hours before, which had a detrimental impact on Jessie trusting.

Ms Bernard told the court that she had tried to work with Sussex Empowered living to develop plans and additional support for them to support Jessie but they felt “based on incidents they experienced and witnessed they weren’t the correct provider for her”.

Counsel: Given what you know about Jessie’s presentation, do you agree the unpredictability of this placement falling apart would have had a profound impact on her?

LB: Yes, it did

Asked by counsel what her understanding was of whether IMC Locums staff had training in PBS, Ms Bernard said at the time she didn’t know and their support was put in place on an emergency basis.

Counsel: So, in the entire 5.5 month period, did you come to know at a later stage whether they had the adequate training in PBS?

LB: I can’t remember, I’m sorry.

Counsel: Does that apply to them completing the functional analysis of behaviour? Was that something you’re aware they had the ability to do?

LB: No I wasn’t aware. We’d been working with TCAT to get them to do those functional analyses as well.

Ms Bernard told the court that IMC Locums were very aware that autism was the main need for Jessie, and they said that they could meet Jessie’s needs.

Counsel: Let’s get this evidence straight, you made IMC aware of Jessie’s autism?

LB: Yes

Counsel: Did you ever requests that the IMC staff who provided support to Jessie were formally trained in autism?

LB: No, I don’t think I did

Counsel: Jason Brown also say’s when IMC Locums were instructed, East Sussex County Council were fully aware they are a healthcare support agency and not appropriate support for Jessie

LB: I agree with that… I spoke to the previous social worker about how they supported previously, spoke to the recruitment provider about how they managed it.

Counsel read an extract from Jessie’s September 2020 Support Plan, which she said, set out the view of Jessie’s parents about the places she was being placed.

After 5 years of trauma, sectioning, restraint … we just want our child to receive the right, compassionate, skilled care in line with the TCAT recommendations.

Ms Bernard said she was aware of their concerns, and was doing her best to support Jessie, but this was unfortunately emergency care provision. Counsel said that Jessie’s family wanted financial investment in the right standard of care, not staff on minimum wage without the adequate level of care that Jessie needed and Ms Bernard said her understanding was funding was not an issue.

Ms Bernard told the court that the local authority had already funded a high cost placement for Jessie with Sussex Empowered Living. Ms Bernard said that it was the council’s brokerage team that were looking for placements for Jessie.

Asked by counsel what her view was on the suitability of Jessie being on an acute mental health ward, Ms Bernard told the court that she did not think they’d be appropriate long term, especially for someone with autism and Jessie’s sensory needs.

Ms Bernard responded to a question from counsel that she was aware IMC Locums were not registered with CQC. Asked how she had satisfied herself that personal care could be adequately provided to Jessie by services not registered, Ms Bernard said she spoke to her manager and they said they were healthcare assistants and able to provide her care.

Counsel for East Sussex County Council asked if she could list the names of placements that were listed in the witnesses’ statement for the jury. The coroner agreed and she listed them. Ms Bernard said that she couldn’t say how many times those providers were approached but she knew if the brokerage team said that the response had been due to lack of capacity, that they did re-approach the provider on a number of occasions.

Asked what reasons were given for providers not being able to provide care, Ms Bernard said they were due to having no space, due to a lack of capacity, or due to providers feeling that they were not able to meet Jessie’s needs safely. Some providers said that it was due to the mix of other people they were already supporting, they did not feel Jessie would be a good mix.

Counsel: Just to go back to Sussex Empowered Living, the local authority can’t force a provider to take a young person?

LB: No. We tried to work with them, when they said they were withdrawing we tried to work with them to understand what their concerns were, work with them to provide additional support.

Counsel: Are you satisfied that they knew everything in advance you were able to give them about Jessie?

LB: Yes

Asked how many times Ms Bernard visited Jessie when she was in Viaduct Road with temporary support from IMC Locums, she said possibly 3 or 4. Asked what conversations she was having with Jessie about steps being taken to secure her a permanent placement, Ms Bernard said she explained to Jessie they were looking:

Unfortunately it was a disappointing conversation for Jessie each time. All I could say was we are approaching, and still waiting.

There were a couple of clarifying questions from her counsel, who ended by asking Ms Bernard if she had ever been given any explanation from a medical perspective as to why Jessie’s physical deterioration might be happening.

Counsel: Were you ever given any explanation from a medical perspective as to why that deterioration might have been happening?

LB: No, no. We were given some information, I believe it may have been forwarded on by Andy, with regard to her epilepsy… we were asking for a full udnerstanding.

Counsel: Were you ever given any indication that might have been because there was a lack of care she was receiving physical signs?

LB: Not from any professionals, no.

There were no questions for Ms Bernard from the jury and she was released at 4:30pm.

[That is the end of Day 1 evidence. Day 2 finished an hour or so ago, I’ll try to report at least some of that shortly, just need to stretch].

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