The second witness on Day 2 gave her evidence before the court adjourned for lunch.
Michelle Cook / Social Worker East Sussex County Council
The coroner explained to her the format of proceedings and took her through her evidence.
Ms Cook told the court she was a social worker for East Sussex County Council and had been employed by them since 2018. The coroner said to assist the jury that Ms Cook would be picking up where Ms Bernard (who gave her evidence on Day 1) left off.
Ms Cook took over from Ms Bernard and she first met Jessie on a joint visit with Lauren Bernard on 22 March 2022. At the time Jessie was in Mill View Hospital, detained under the Mental Health Act. The coroner said that Ms Bernard’s evidence to the court was that the visit to Jessie on the 22 March was to introduce Ms Cook to Jessie and because a new social care assessment needed to be carried out under the Care Act in readiness for Jessie being discharged.
Ms Cook agreed but told the court that she had only started with the team on 21 March and did not recall them telling Jessie that she would be her social worker on that visit, as she was new and shadowing to learn from Ms Bernard at that stage.
In response to a question from the coroner about whether she knew much about Jessie before the visit, Ms Cook said that she would have spoken to her colleagues and her senior before the visit, and that there was “a lot of information on the system”.
Ms Cook told the court that she would be responsible for taking forward Jessie’s social care assessment, and that was the plan following the 22 March visit. A planned visit in April didn’t take place as Jessie had tested positive for covid.
The coroner took Ms Cook to her statement and asked her to tell the jury what happened on the 4 April 2022. Ms Cook said a professionals meeting was held on Teams. Asked to explain to the jury what that is, Ms Cook said it was an opportunity for professionals, the lead practitioner, hospital staff to get together to discuss how Jessie was doing.
C: Would you have been present at that?
MC: From my case notes it looks like I was present, I don’t totally recall it, but in Case Note we have to record… I’ve done a note to say I was present but I don’t recall it
Asked what she did the following day Ms Cook told the court on 5 April she introduced herself to the discharge coordinator Charlie X [didn’t catch]. She said that she requested an occupational therapy (OT) assessment, telling the court that Lauren had already requested one because the one Jessie had was quite out of date. Ms Cook said that she mentioned to the discharge coordinator that there was a meeting to be held on 27 May to discuss where Jessie needed to be supported in the community and the Trust were looking at placement as well.
Asked to tell the jury what happened on 7 April Ms Cook said that she wanted to introduce herself to Jessie so she joined a virtual meeting with herself and Ruth Nathan on the call. She told the court that when Jessie saw Ruth Nathan she became “very distressed and didn’t want to talk to her at all. When I tried to introduct myself she didn’t want to talk to me either”.
Asked by the coroner whether Jessie knew at that point Ms Cook was her new social worker she responded “I don’t think she did, no”. Asked what she did next she said given she was new she spoke to her senior who advised that she wait for the assessment, and the outcome of the Complex Case Review Meeting, and continue to chase for the occupational therapy assessment.
On the 11 April the discharge coordinator, Charlie, emailed Ms Cook to ask whether she had received the OT assessment and whether a possible placement for Jessie in Eastbourne was still ongoing. Ms Cook replied to say no and that they were waiting for the Complex Case Review.
Ms Cook told the court that on the 12 April Jessie wanted an advocate, and that person was G/Jemma Carr. She was asking Ms Cook whether Jessie had capacity, she asked Dr Cuthbert and she replied that she did.
The coroner asked about Ms Cook’s next activity on Jessie’s case on 20 April. She said that she had emailed the discharge coordinator, Charlie, again saying that her understanding was Jessie was not ready for discharge yet, that Dr Cuthbert was waiting for the Complex Case Meeting as she felt Jessie was not safe to join the community, as there had been some instances with staff members.
Asked by the coroner whether she had the OT assessment at that stage, Ms Cook responded no. She then had a text message with Jessie, and told the court that she was advised the best way of communicating with Jessie was by text. She messaged her on the 26 April, saying “I’m your social worker, I’ve taken over from Lauren” and she messaged again the following day, 27th, to say that she would like to visit Jessie on Tuesday for an informal chat. Asked whether Jessie responded to that message, Ms Cook said that she did not think so.
Ms Cook told the court that Lauren had advised, even though she had said she would be visiting, that she should confirm she was going up to the hospital which she did. Asked by the coroner who was present for the 3 May meeting, Ms Cook said Jessie, her father and Gemma the advocate. The coroner asked her about the meeting and Ms Cook said that when she arrived Jessie was making bracelets. She had already had her social care assessment and she wanted to go through the points in there with Ms Cook, as there were some that she disagreed with [couldn’t hear fuller answer].
The coroner Ms Cook if on 3 May she were aware of the ongoing safeguarding enquiry, she responded “I think I was, yes, there would have been notes on it”. The coroner asked Ms Cook if she would have spoken to Jessie about those matters.
C: Would you have expected to have a discussion about it?
MC: I mean it’s all case noted, so I may have read it. There was a lot of information going through a lot of professionals. There was a lot of professionals involved with Jessie’s care, and obviously it’s helpful to know what was happening, so knowing about it was important yes.
C: but you weren’t carrying out your own inquiry at all
MC: I didn’t mention it at all no
Asked by the coroner how Jessie appeared to be presenting on 3 May 2022, Ms Cook said “she was a bit agitated, I’d turned up and was interrupting her bracelet making. She had Gemma there … she was engaging”. She told the coroner, in response to a question, that Jessie did not express any suicidal ideation or give her any course for concern on that visit.
It was then over to counsel for the family for their questions to Ms Cook.
Counsel: In terms of your relationship with Jessie, did you at any point speak to Jessie’s mum, Kate?
MC: Ummm no
Counsel: Did you get any advice from Jessie’s parents about how best to build rapport with her?
MC: I think I spoke to Jessie’s dad about rapport.
Counsel: We heard evidence yesterday from Rob Higgins about the way he built a good rapport with Jessie. He took advice from Kate about getting down on her level, that helping him, did you take advice from Jessie’s parents about that?
MC: No I didn’t
Counsel: Did you speak to Rob Higgins, as Jessie’s personal advisor about what had worked for him?
MC: No I took advice from the previous social worker and my senior about how best to work with Jessie
Asked by counsel if she were aware that Jessie had a preference for face to face meetings, not online, Ms Cook said that it was “difficult at the time, was all about covid as well, we used Teams and things like that”.
Counsel: In terms of having a person centred approach and meeting an individual’s needs, especially someone like Jessie with autism, it’s really important to have an understanding of how best to communicate with them?
Counsel: You gave examples of sending text messages and Teams meeting which wasn’t successful, did you consider more face to face meetings to progress the work you were doing?
MC: I would have done. I was allocated to Jessie in April time, I was on annual leave, I was planning to do more face to face visits. I did 3 May, there would have been follow up visits face to face
Counsel: What was your impression of how Jessie was coping on the ward?
MC: She’d had difficulty with staff but she was improving because they’d introduced a star chart and she was pleased stars were going up on this chart
Counsel for the family said that you could see in Jessie’s records, from as early as 7 March, when she first went onto the ward that she was finding the environment difficult and she appeared anxious at times. She was feeling over stimulated as a significant cause of her anxiety. Asked by counsel if she was aware the ward was having that impact on Jessie, Ms Cook told the court “I knew she was finding it difficult through her actions, she was attacking staff” [fuller answer – can’t hear].
Asked by counsel if she were aware that Jessie was of the opinion that admissions to mental health units had been more traumatic than supportive for her, as reflected in her Autism Crisis Plan, Ms Cook said that she knew that through her co-workers.
Counsel took Ms Cook to the note of the assessment of Jessie she had conducted in March 2022 that listed a risk factor as Jessie currently having a “lack of meaningful activities, exacerbated by the pandemic and interim care arrangements”. Asked if she recalled the risk of Jessie being bored and under stimulated, Ms Cook said that she knew Jessie liked to be active “she was very into her bracelet making and her business and dying her hair, things like that”.
Asked again by counsel if her assessment was that Jessie was bored and it was having an impact on her mental health and wellbeing, she agreed that it was, and that it had been the assessment of the previous worker, she had fed into that.
Counsel: So it’s important Jessie is in an environment where she had access to meaningful activities that can help her with her wellbeing?
Counsel: Were you aware of Jessie’s parents views on her being on a mental health ward?
MC: I don’t recall that. I don’t remember making any notes about it
Counsel: Did you speak to them about it?
MC: I spoke to Jessie’s dad, but I can’t recall
Counsel: We have in records comments made by Jessie’s parents, communicated to Ruth Nathan, on 16 May. The day before Jessie’s death. Recorded at eight twenty, it says “our view is Jessie should not be in Mill View, she should be supported in the community with appropriate care” …. said staff are not familiar with Jessie’s needs
Do you recall their concerns about the way Jessie was being cared for on the ward?
MC: I don’t recall that
Ms Cook told the court that there was going to be a Complex Case Meeting on the 17 May to discuss “all the placements and how to keep Jessie safe, whether in a [Sussex Partnership] Trust placement, or how she’d be supported in the community”.
Counsel for the family said Jessie had been on the ward since March 2022 and asked whether it was a significant period of time to wait for a case review and Ms Cook responded that she did not know and she had not organised it. The coroner said she was not sure it was a fair question for this witness. Counsel suggested it was relevant, with regards to whether Ms Cook had indicated discussions needed to happen any earlier. She responded there were “ward meetings being had to discuss Jessie, it wasn’t she was in the ward and nothing happened until May”.
The discussion continued and Ms Cook said that work was ongoing to get things ready for Jessie’s discharge.
Counsel: You said May 2022 was going to be a significant meeting, was complex care meeting, where people would put their minds together to consider where Jessie would be best placed when she was discharged from Mill View?
MC: Uh hum
Counsel: Did you have any observations about the length of time it took to get that meeting organised? Did you think it was appropriate to wait until the 21 May to have those conversations?
MC: Yes. I only started in the team in March… was carrying out my social care assessment and liaising with other professionals, that was the date that was set, I didn’t think to question it or anything
There were no further questions from the family. No questions from counsel for Sussex Partnership NHS Trust or from Brighton and Hove City Council. Next it was over to her counsel, for East Sussex County Council.
Counsel asked Ms Cook to explain how the occupational therapy assessment would feed into decisions about care in the community. She did [I didn’t catch it].
Counsel: You’d taken steps to get that occupational therapy assessment early in April?
Counsel: I think you also answered already, but to clarify, in terms of identifying a suitable placement in the community where Jessie could be supported with a package of care … you needed to complete the social care assessment?
Counsel: And part of that is making sure you have Jessie’s voice in the assessment?
MC: Yes, very person centred which is why she had the assessment and I went to see her so she could put her views across
Counsel: To be absolutely clear the local authority wouldn’t have any say on when she’d be fit for discharge?
MC: Oh no
Then it was over to the jury for their questions. A juror wanted to check the timeline of Ms Cook’s visits to Jessie. She told them that she went to see Jessie on 3 May and then she was on annual leave until 16 May. Asked by the juror if Jessie was aware of this big meeting she said “I think she was, but I can’t totally recall, I think she was”.
Another juror asked about the advice to communicate with Jessie by text message, and she asked Ms Cook whether Jessie had made it explicit that was the way she wanted to be contacted. Ms Cook said that was what the previous social worker had advised, that it was the best way to communicate with Jessie.
No further jury questions. Ms Cook was thanked and released. The jury were reminded of the warnings given to them and retired for lunch.