Day 5 Jessie’s Inquest: Jason Brown, IMC Locums

The final witness to give evidence on Day 5 of Jessie’s was Jason Brown from IMC Locums.

The coroner asked him to come forward, he gave an affirmation and told the court that he is Associate Director of IMC Locums, a healthcare recruitment agency.

Coroner: Thank you. I’ll start by asking you to tell the jury a little of what IMC Locums are?

JB: We are a healthcare recruitment agency which supply staff of various specialities to the NHS and the private sector… we may be asked to supply a nurse for a night shift for example for a general hospital or a mental health hospital. We’ve also got a radiotherapy department and an allied health professionals department.

In effect filling in the gaps the NHS or private sector need filling due to sickness or whatever. [Fuller answer – didn’t catch]

Coroner: Does if cover the whole country or are you just local?

JB: We cover the whole country, although the nursing division is fairly new, 4 years old, and is the Midlands down… cover whole country and places like Channel Islands as well.

Coroner: Qualified nurses or HCAs, for example, will become temporary staff you deploy as and when needed?

JB: They contact us to register to be an agency nurse or HCA, to pick up additional shifts on top of their permanent position or become a career locum, their full time employment, albeit on an ad hoc basis.

Coroner: Who employs them?

JB: Depends who pays the individual, if we pay them as a PAYE employer then IMC Locums are their employer. If for example locums use an umbrella payment service, technically that umbrella company are their employer, we’re just [can’t hear] they’re working on site for IMC Locums but the umbrella company their employer is deducting tax etc at source

Coroner: We heard IMC Locums worked on Caburn Ward

JB: Correct

Coroner: Do you remain their employer or is it Sussex Partnership Trust?

JB: They’re working on behalf of IMC Locums, at Sussex Partnership.

Coroner: Ok, what about when East Sussex request a care package for someone they required.

JB: We weren’t providing a care package, we were providing locum staff… it wasn’t a care package, we’re not a care provider we’re a locum agency, there is a difference between the two.

Coroner: You were providing staff in Jessie’s case, supporting her in her accommodation, to provide the care East Sussex County Council were responsible for?

JB: Correct, to work off PBS documentation already made available to us by the LA and the NHS Trust, but not to enhance that or move on from that, purely to work to the documentation and clinical bits and pieces given to us by the local authority.

Coroner: I can simplify to say you hired and fired as far as that circumstances are concerned?

JB: Yes

Coroner: But you’re under contract with East Sussex County Council to provide the staff?

JB: We was asked to supply relevant locum staff to fulfil the two to one support Jessie required at Viaduct Road, yes. It was agency decision who went and worked and who didn’t work.

Coroner: Two more areas, first one is what training does IMC provide for its temporary staff?

JB: IMC Locums are an NHS Framework Approved Locum Agency. In layman’s terms have to be able to [can’t hear] through documentation and training for everyone we place in NHS before allow them to set foot inside any hospital or community setting in regards being able to work as medical professional, applies to HCAs as well

Coroner: So you provide it?

JB: No, it’s approved by the NHS, certain training providers to match what the NHS require us to provide them

Coroner: I’ll stop you, we’re short on time, want to stick to the key points, you as IMC Locums don’t provide training?

JB: No, training from Bild Approved, accreditation the NHS Framework stipulates we have to have

Coroner: So all staff you provide have undergone the necessary training?

JB: Yes, absolutely, don’t let anyone work without it

Coroner: Can I move forward to your specific dealings with Jessie, when asked provide support for her at Viaduct Road

JB: Yes

Coroner: What were the requirements for you as an organisation?

JB: As says in my statement, initially we were asked to provide additional support for Jessie under CAMHS at previous property in Lee Road in Lewes in Sussex. When transition to adult services, went under remit of East Sussex County Council who asked us provide two to one eyes on support for Jessie when in the property. Requires us find four individuals, two in the day, two at night, on 7 day period, up to 28 individuals, to make sure Jessie was safe in that property until they found suitable care for her.

Coroner: Was a time period discussed?

JB: Interim basis until suitable provider found for Jessie who could meet the various presentations Jessie had… we wasn’t ever the end goal… but was no definite time period.

Coroner: In preparation for providing support to someone, what work do you undertake to ensure the staff you place are suitable

JB: Only utilise people who’ve worked in mental health arena, autistic people are not classed as having a mental health disorder, but may have other difficulties, such as learning disability or things like that [missed section] tried to ensure had worked in arena with patients presented with those various diagnoses Jessie had.

We wouldn’t allow anyone who hadn’t worked in those settings before, as safeguarding for Jessie and safeguarding for that individual as well, not fair work in environment never worked in before. That’s how we’d ascertain who to put forward and who not.

Coroner: Will go into specifics of issues raised about staff. Did you understand was preference for Jessie to have male carers?

JB: Yes, when she was at Lee Road was more heavily female led, understand some instances with some of the female RMNs at the previous property. When she was moved to Viaduct Road under strict instruction to make male only, in theory find 28 males to provide that support, generally worked out 10 or 12.

Coroner: When did you start work with Jessie?

JB: November 2020

Coroner: At viaduct road?

JB: Have to check statement, believe early 2021 if my memory serves me right, I believe was when she turned 18 around about that period

Coroner: OK

JB: Can’t remember exactly the date Viaduct Road was sourced but from then onwards, maybe the council can confirm when that date was.

Coroner: Just answer questions if you don’t mind. Want to explore issues that arose during your provision of care to Jessie. Issues raised with East Sussex County Council, predominantly by the family.

I think the easiest way of dealing with this is to ask you when you became aware of the safeguarding concerns being raised?

JB: We were made aware by lady called Ruth Nathan, her social worker… or Lauren Bernard, or a gentleman called James, forget the surname.

Coroner: So as concerns arose, did one of those individuals contact you?

JB: What do you mean?

Coroner: You just said concerns got raised by Ruth, Lauren…

JB: When you say safeguarding do you mean by our staff with Jessie?

Coroner: Yes

JB: They were raised by Jessie’s family

Coroner: To you directly?

JB: Generally to me directly, but if I wasn’t in the office have colleagues who’d have taken messages on my behalf but would never have dealt with them direct.

Coroner: You became aware of individual concerns raised and you provided a response to the safeguarding enquiry is that correct?

JB: Yes

Coroner: I’ll go through each and ask you what you did or discovered

JB: Yes

Coroner: Do you have the safeguarding information available to you?

JB: I don’t, I wasn’t made aware to have that information

Coroner asked he be given G85. Discussion amongst counsel about which section he needs shown. The witness asked if he could move to the back of the room to turn off one of his phones whilst they discuss the documents.

Coroner: I appreciate that this isn’t one of your documents. It’s a summary of concerns raised and responses that IMC Locums provided.

JB: Yeh

Coroner: OK, I’ll go through each one and ask you what the response was from IMC Locums.

1) Concerns that only male workers were on the rota to work with Jessie between August and November 2021, which would have made providing personal care to Jessie problematic.

Coroner: Your response?

JB: We were strictly instructed by East Sussex County Council and her family to provide only male carers as requested by Jessie, plus also provided with Jessie latest risk assessment that stated she was able to look after her own personal care.

Was my idea to Lauren Bernard to start phasing back in female carers to assist with Jessie’s personal care. Started slowly book in those female carers, didn’t want switch female overnight for Jessie’s sake, started introducing them slowly.

Repeatedly told by East Sussex County Council Jessie had capacity for personal care, female carers only there to provide prompting to Jessie to undertake her own personal care for herself. Only assist if needed.

A lot of the time Mr Seares was with Jess, as informed by carers, so had no opportunity to assist. Mr Seares stated in an email to Ruth Nathan, Jessie’s Social Worker we weren’t CQC registered so shouldn’t be undertaking personal care in the first place.

Coroner: What’s your response to that?

JB: I agree with that, do agree with it. I want to labour the point we’d questioned and queried about Jessie’s ability to do personal care on more than one occasion. During time Jessie was at Viaduct Road she was admitted to Langley Green Hospital, had conversations, happy provide email, Jessie was able undertake own personal care on ward prompted by support workers. So we were under the impression she was capable of that.

2) Soiled incontinence pads were left on Jessie’s bedroom floor, commode not emptied [missed section]

Coroner: You were sent a photograph on 18 October, the jury have seen that.

Mr Brown told the court that IMC Locums saw the photo on 18 October 2021 but no other evidence was received concerning the above comment. He said that they sent a blanket email all staff about maintaining a clean environment whilst working with Jessie at Viaduct Road

He also told the court that various professionals not connected with IMC Locums had commented that the property was clean and tidy, directed to Mr Seares via an email to Ruth Nathan.

3) food, coffee, tea milk, toilet roll, bought by Jessie taken by staff, when staff member joined caught another carer taking eggs and bread which they refused to return. Also alleged box [medication – withheld] taken from room when Jessie was away from home.

Mr Brown told the court there was no evidence ever adduced of this happening, but an email was sent to staff that any substances in the property were that of Jessie, must bring their own food in.

Mr Brown said that they reimbursed Mr Seares when they were provided receipts by Ruth Nathan. In regards to the claims made by the carer, they had never informed us of the other carer taking egg and Mr Brown said he had never been informed of a box of medication being taken so couldn’t comment.

4) Carers spoke in their first language for much of the day, gave the impression of it being their house, didn’t reflect a person centred approach as Jessie felt excluded

Mr Brown told the court that IMC Locums informed staff they should only ever speak English, regardless of whether Jessie was close or not… was the staff’s view Jessie felt excluded due to Mr Seares being at the house constantly, and as such staff were not able to interact with her.

5) Carers did not understand autism, ADHD and physical needs, so could not work effectively with Jessie

Mr Brown told the court that all staff were provided with Jessie’s PBS Plan. He said that all staff were experienced in mental health “and various complexions around that”. Mr Brown said that IMC Locums were continually replacing staff, and that they emailed staff bullet points to assist them with communicating with Jessie.

6) Ruth Nathan asked carers to refrain from boiling fish as Jessie found the small overpowering, but that was not always respected.

Mr Brown told the court that IMC Locums were informed on [date – missed it] that staff were cooking fish. They informed all staff by email it was not acceptable and emails were sent to Ruth Nathan, asking her to inform them if it continued, but they were never told again.

7) IMC Locums staff were working elsewhere during the day and sleeping at night

Mr Brown told the court that IMC Locums have processes that ensure staff haven’t worked day or night shift for IMC Locums before their shift. On occasions where they were provided evidence, staff member was immediately removed and referred to our xxx [didn’t catch] department… the NMC were also informed, staff member was terminated with immediate effect.

8) One occasion Jessie left home at midnight, ended up several miles away in the sea, there were no records made of this incident

Mr Brown told the court that he could not comment as he was never informed of the incident.

9) Concern one carer was smoking cannabis in the house, the individual who gave the carer’s name to Mr Seares faced verbal hostility

Mr Brown told the court that he was never made aware of the incident. No carer had mentioned directly that a carer had been smoking cannabis, or had been hostile towards them.

10) Disagreement between carers could lead to shouting and sometimes physical fighting, including with Jessie [detail of incident – did not catch]

Mr Brown told the court that IMC Locums were never informed of any physical altercations, and he can not comment. He said that staff were reminded at all times of their expectations of behaviour towards colleagues.

Mr Brown told the court that the first IMC Locums heard of this was an email directly from Jessie on 25 January 2022, saying that a carer assaulted her in December 2021.

Mr Brown said that he contacted Ruth Nathan and East Sussex County Council and asked why he was not informed. He told the court that the carer had worked numerous times with Jessie since the incident.

Mr Brown told the court that on 31 January 2022, East Sussex County Council raised a Safeguarding Concern via Brighton and Hove City Council portal regarding the alleged assault. Lauren Bernard was in touch with IMC Locums around [can’t hear].

Mr Brown said that himself and Simon Hellyer, had been liaising with Jessie’s parents on 22 January 2022. He said that they had met with Kate and Andy, and made them aware at that time of concerns raised about the relationship between Jessie and Andy.

11) Male carers neglecting Jessie’s care needs, spending the day watching television and on their phones, not engaging with her

Mr Brown said as he’d informed earlier with regards to personal care, staff informed them it was due to Mr Seares being at Jessie’s home for long periods of time, they couldn’t interact with her.

Mr Brown told the court that he’d informed East Sussex County Council on numerous times. He said that all IMC Locums staff were reminded not to use their phones throughout the time they were supporting Jessie.

12) Only one carer would take Jessie out, some refused to attend A&E with her

Mr Brown told the court that he had addressed in previous points about staff interacting with Jessie. He said that IMC Locums were informed on 2 December 2021 that two RMNs refused to attend A&E. On confirmation of that information from the hospital, they immediately terminated their contract with IMC Locums.

Mr Brown said that Mr Seares had made allegations of other instances, which had proven to be false. Mr Brown said that Mr Seares had said a carer refused to attend A&E with Jessie on 15 December 2021. Mr Seares had stated Jessie was in an ambulance for two hours due to their refusal. Mr Brown told the court this was simply untrue, there was one RMN on shift that date, different to the one alleged by Mr Seares. It had been their third shift working with Jessie.

Mr Brown told the court that he had emails from East Sussex County Council re constant falsehoods from Mr Seares and allegations about staff.

13) Lack of recording in the home until a particular carer joined. This omission led to an ambulance team being given incorrect information or missing information when they arrived.

Mr Brown told the court that all staff were informed to complete care notes, that they were at the property and Mr Seares had access to them.

Mr Brown said that he had asked Mr Seares to get the paramedics to correlate, and to date that had not happened.

14) Staff would not wear badges and refused to give their names

Mr Brown told the court that all IMC Locums staff are given badges and asked that they be worn at all times. He said there were a number of examples of staff not giving their name, due to previous allegations against IMC Locums by Jessie and her family, and that he understood why staff might wish to protect themselves from any allegations.

The coroner asked Mr Brown what action had been taken by themselves and the NMC regarding a certain RMN. Mr Brown told the court that he had received an email from the NMC on 28 October 2021, and they had provided the details that they requested. He told the court to date no other communication has been received since. Mr Brown told the court in regards to comments that said RMN was smoking weed, it was the first time that he had been made aware of it, and so he could not comment further.

Mr Brown said that he had also liaised with East Sussex County Council about the RMN residing at the property.

The coroner asked Mr Brown to read the additional information provided by Mr Haselby [I have not seen the documentation that is being referred on in court, so I’m not sure where above was Mr Brown reading from documentation and where was him giving an answer on the day, apologies].

Mr Brown told the court Mr Hasleby responded as part of a complaint raised on 6 October 2021, was no reference to cannabis use at that time. Re the mental health nurse residing in the property… one nurse provides the majority of night shift cover during the week, is staying at the property during the day, due to the distance for him to travel to his property. He is able to stay at the property if he has a shift that night, will return to his own home when he has two consecutive days off. Agreed can be called on as an on-call nurse if needed support during the daytime. If he is doing washing he is responsible for providing his own washing powder.

15) Mr Seares believe IMC Locums are not CQC registered.

The coroner said that she thought he’d dealt with that. The second part of that complaint related to whether they are CQC registered and their complaints procedure.

Mr Brown told the court that IMC Locums are an NHS Approved Framework Agency, initially instructed by Sussex Partnership Trust, along with Wrixham Care in November 2022. Mr Brown told the court that SPFT were fully aware that they were not CQC registered, their key role is to provide temporary staff to the NHS and private sector.

Mr Brown told the court that IMC Locums were asked to provide on a two to one basis, due to Wrixham Care ceasing with immediate effect, remained in place until alternative provider found. He said that at all times they [East Sussex CC] were aware we were not CQC registered and as they were instructed by these organisations, whose client was Jessie, they had no reason to inform Mr Seares, as he was not our client.

16) IMC Locums workers were asked for more information by Ruth Nathan regarding inappropriate behaviour between Jessie and Mr Seares, but refused to comment, which could have caused her to be placed at risk. Are there reasons they were hesitant to answer questions?

Mr Brown told the court that they were informed by other staff of inappropriate behaviour between Jessie and Mr Seares, including extensive time in a locked bathroom where he was alleged to bathe Jessie, and Mr Seares spending time in Jessie’s bedroom which made staff uncomfortable.

The coroner then said that she did not need Mr Brown to read the detail as that was a discussion between James Hasleby and Lauren Bernard.

17) On the day allegations were made against Mr Seares by carers regarding possible sexually inappropriate behaviour, Mr Seares rang a carer to ask if the agency had concerns. She said no concerns. Gives mixed messages. Does the carer stand by the concerns she raised?

Mr Brown told the court that the carer did and she had been informed not to communicate with Mr Seares [can’t hear].

Mr Brown said that he had told Mr Seares to contact East Sussex County Council, which he frequently did, including being derogatory about carers and their ethnicity.

[Missed a section here].

Coroner reads: Please outline any action taken to date regards employees who worked with Jessie at any time. Have they been referred to DBS or People in Position of Trust referral, or referred to their relevant professional body.

I’m not asking you to name names, but there were 5 individuals there, were any of those individuals dismissed?

JB: I can say 4 out of those 5 no longer work for IMC

The coroner asked Mr Brown if he could confirm the vetting procedures that they have in place for employees. He responded listing procedures that are taken and training that candidates have to undergo.

There was then some discussion about the conclusion of the safeguarding enquiry and counsel for the family said that the jury had already heard it. The coroner said for completion it would be read out [I missed the details of the discussion, apologies].

The enquiry conclusion was that concerns regarding the care and support to Jessie by IMC Locums were initially raised by the commissioning authority, East Sussex County Council. They were received by Brighton and Hove City Council, who triaged and opened a Section 42 Safeguarding Enquiry.

Brighton and Hove made enquiries directly with Jessie and her father and mother, and required IMC Locums to make further investigations.

There is sufficient evidence that some care and support Jessie received from IMC Locums was of poor quality and some of the concerns amounted to abuse and neglect, and she suffered harm as a result. Therefore the safeguarding alert was partially substantiated.

The conclusion stated that it appeared IMC Locums had responded appropriately and actions had been taken to mitigate the risk to Jessie and others.

Jessie had requested another provider, and it was clear that East Sussex County Council had made extensive attempts to facilitate this.

Coroner: Two further questions, suggested in evidence before jury, that the reason Jessie ended up having to be admitted to hospital was due to the breakdown in care provided by your agency, to summarise it. Do you agree? Had there been a breakdown?

JB: Difficult to say what breakdown would be, was difficult to provide care required due to longevity Mr Seares spent at the property at the time… in very, very layman’s terms it was difficult for them to get close to support Jessie to full potential, may have contributed to that breakdown

Coroner: as an organisation, are you able to say whether you had appropriate staff to provide that care to Jessie?

JB: We was in effect being asked to find up to 28 individuals in a 7 day period, not only with experience working in the mental health field, but up to our fully compliant standards needed to work for us, full stop. As such it did present problems and sometimes quite strenuous difficulties in making sure we already had that 2 for 1 support day and night for Jessie, under constant treading of eggshells of what complaints would be raised to us by her family, constantly replenish that candidate pool of relevant people, that could take 6 weeks based on how long it takes to be fully compliant to work.

I’d say we did the best we could in that 16 month period. We were asked to provide that 2 for 1 support, under sometimes quite difficult conditions.

Coroner: As an organisation, had you up until Jessie’s case, ever dealt with such a prolonged period of care?

JB: Never. Had undertaken two to one or three to one observations under the instruction of a Trust, but done under short period of time to supplement their permanent staff members. We thought from late 2020 was a 6 week booking.

Coroner: Have you been asked since to provide that level of support?

JB: Not for that period of time, but for 4 or 5 other agencies off the back of the support we provided Jessie. As a result of it we’ve applied for CQC registration, our application went in 3 weeks ago

The coroner thanked Mr Brown and it was over to counsel for the family.

Counsel: You told us it was a temporary emergency arrangement, your witness statement said this wasn’t the correct support mechanism for Jessie, what you said today in your evidence?

JB: Yes. We made it clear from day one to anyone involved with Jessie’s care we were not the right people for her care and support.

Counsel: We heard evidence from Lauren Bernard that she first thought Jessie was independent for personal care… but support became necessary, is that in line with your understanding?

JB: Yes it is, which is why I suggested we provide some female support, as all male, which can present some problems given she was an 18 year old girl at the time

Counsel: And staff were aware Jessie was suffering seizures?

JB: Yes, would be if in documentation

Counsel: Reasonable concern Jessie might have seizures when having a bath, is that a reasonable concern?

JB: That is, yes

Counsel: We heard in respect of training in your witness statement you say autism specific training, unless specified by the client wouldn’t be carried out

JB: That’s right

Counsel: Who would the client be in this situation?

JB: If care home for autistic people in their remit. We provide staff to NHS and Private Sector, never been asked to provide someone with specific experience in autism, always other mental health disorders that people may have as well. Never really been a specific need for us to find that training.

Counsel: Who was client when Jessie was at Viaduct Road?

JB: Local authority and Sussex Partnership

Counsel asked which local authority, pointing out that there were two as Interested Person’s in the inquest.

JB: East Sussex County Council, my apologies

Counsel: Had evidence earlier in the week from Dr Simon Rowe who indicated he’d previously given training on autism to Wrixham Care carers. Was anything of that offered to IMC?

JB: No, training was offered about how to communicate with Jessie, but not specific to her autism.

Counsel: You read out earlier, one of your responses was staff were emailed bullet points to assist them with communicating with Jessie. Were you involved in putting that together?

JB: Bullet points were provided by the Speech and Language Therapist dealing with Jessie, advised to us, it wasn’t from my head, liaised out with staff

Counsel: February 2022, about one week before Jessie ends up at hospital, before being taken to Mill View, looks like that assistance came right at the end of your time with her?

JB: That’s correct

Counsel: At that point she’d been with IMC since August 2021, does that suggest the vast majority of time staff were working without the bullet point list?

JB: Would only be working with documentation provided by East Sussex, would be working under that because we weren’t given that before that date.

Counsel: In due course we’ll hear Ruth Nathan, she says she offered supervision to staff providing support to Jessie. It was taken up by two staff, on one occasion. Do you remember that offer?

JB: Truthfully I don’t recall it but I worked very closely with Ruth at that time, I’ll be brutally honest I don’t recall.

Counsel: Do you accept that was only taken up by two staff in 5 months, not a very high number of staff?

JB: No that’s not very high at all

Counsel: Any training on the impact of trauma on an individual?

JB: Unless listed in training I’ve listed wouldn’t answer… that’s what we have to get candidates to do via the NHS, anything else on top of that can’t comment. Wouldn’t know details and specifics behind it, have compliance department to deal with that.

Counsel: You don’t know if it covers trauma?

JB: I don’t. If you want me to find out I’m more than happy to do so.

Counsel: In terms of staffing the rota, we’ve gone through some of the responses already gave in light of safeguarding concerns. To summarise I think it’s fair, some allegations you say I don’t know about this or weren’t made aware of?

JB: Yeh, a lot we weren’t made aware of

Counsel: Others you say you don’t think allegations are truthful?

JB: Yes

Counsel: And others you’ve taken specific action with IMC employees?

JB: Yes

Counsel: You said four out of five on a list were names of people who don’t work there any more?

JB: That’s right

Counsel: If I can take you to that list again, G92, we won’t use any of their names, can you confirm their full names are there?

JB: Yes

Counsel: When allegations were made you were told who they were?

JB: With regards to those allegations were given specific names which is how we could act on it

Counsel: Second name in the list, you were sent video evidence of them sleeping?

JB: Yes

Counsel: You referred to clinical governance department?

JB: Yes, video evidence was sent to us by another carer

Counsel: So carers themselves were bringing those concerns to you?

JB: Yeh, rightly so. Sleeping is a no go, so then we took immediate action when we was told.

Counsel: In respect, one of the complaints, related to an occasion Jessie left home at midnight, ended up several miles away in the sea. No records made of this significant incident and it wasn’t discussed with you. Your response was cannot comment because you were not informed of incident, that’s part of the complaint isn’t it?

JB: Nobody mentioned it, not the carers, not the parents, not Jessie herself. We wasn’t informed by one individual about that incident.

Counsel: We have a police report relating to that incident in our bundle, 21 August 2021. Police received call from Jessie saying she was near the sea, feeling suicidal, wants to get into the sea. They found her wet and cold…. Said home life difficult, had carers living in home address who were difficult to live with and don’t offer the right support. It does appear it happened?

JB: Yes if police record that, it happened

Counsel: Would you not expect a significant event like that.. would it not alarm you, you weren’t notified by staff this happened?

JB: It dumbfounds me to be perfectly honest with you

Counsel: If you’re not informed, suggests you’re not able to look into incidents?

JB: The horse has bolted, so to speak, we was, if I was informed there and then on the day we’d have taken really serious action about it. Unfortunately couldn’t act because we found out quite considerable time after that happened, police, or no one informed us of it.

Frankly it’s disgusting none of our carers told us about it.

Counsel: In terms of why that also would have been important, was your understanding Jessie should be on two to one observations?

JB: Correct

Counsel: So shouldn’t be a way she could find herself at the sea?

JB: I suppose if made aware there and then, would have taken serious disciplinary actions against the two members of staff. Was it at night?

Counsel: Yes, at the sea at 23:20

JB: I don’t know who was working that night, but I’d absolutely state they failed at what they should have done that night.

No further questions from Jessie’s family. Over to counsel for Sussex Partnership Trust.

Counsel: Just one question, delicate question ma’am I’m mindful whilst we haven’t mentioned the carers in this list, quite rightly, we do have a name mentioned yesterday, feel it is only right to me to say whether the person mentioned yesterday is in this list, I don’t think this witness was in court yesterday.

Coroner: I don’t think he was

Counsel: think it has to be right. Can we go back to the list of individuals that were investigated through the process you’ve just been describing. Does the name at all Prince appear in that list?

JB: No it doesn’t

Counsel: Thank you, nothing further.

Counsel for Brighton and Hove: Does it not assist if we deal with the incident?

Counsel for Sussex Partnership: They haven’t got the right to reply and they haven’t been investigated

Counsel for Brighton and Hove: If you feel there’s a need to draw that out

Coroner: I think the allegation was before the jury

Counsel for Sussex Partnership: As far as you’re aware, within your own knowledge, and of this investigation, has anybody by the name of Prince come to your awareness of safeguarding concerns being raised about them?

JB: No

Counsel for Brighton and Hove: It isn’t actually a complaint against Prince in this list. If do it this way implication is secret evidence Prince has done something wrong, in fact he might be someone who’s helping out.

Counsel for Jessie’s family: Don’t think it’s accurate to say is no reference to Prince in this document, so perhaps that part can be read out. It related to transport to A&E.

Coroner: Question about Jessie not being taken to A&E and mention of him?

JB: He is mentioned in that

Coroner: Perhaps you could read that out putting his name back in

JB: No problem.

JB reads: Only one carer [missed] many carers refused to attend hospital with Jessie when she required treatment in A&E. Please confirm what action taken.

This addressed previous points about interacting with Jessie. Refused 2 RMNS refused to attend A&E, eventually attended 23:30. On basis of information and confirmation from the hospital, immediately removed them and terminated their employment with IMC Locums.

Mr Seares made allegations of other staff not attending A&E, proven to be false… one staff member Prince called Mr Seares directly given Jessie’s refusal to attend. Mr Seares told Prince not to attend [missed section].

Over to questions from counsel for Brighton and Hove.  

Counsel: Questions asked by the coroner were so extensive you’ll be pleased to know that reduces things. Some background things, first of all reference to Jessie and capacity, referring to her mental capacity to make decisions?

JB: No

Counsel: I‘ll separately deal with capability. Let’s start with capability. When you took over this package your understanding was she had the capability to provide her own personal care

JB: Yes

Counsel: And that was the known history as well?

JB: Yes

Counsel: As and when that may have changed can be explored. Her capacity is about her mental capacity to make decisions about that care as well, and other issues, is that fair?

JB: Yes that’s fair

Counsel: Understanding was she did have capacity, is that right?

JB: Yes my understanding is she did have capacity

Counsel: You’ve given detailed evidence about complaint and response, without going all over again, is quite obvious there’s quite a lot of dates in there when matters were raised with you, dates where you responded and dismissed people, that sort of things. Say about 12 or so headline complaints, were they raised on a rolling basis, is that right?

JB: Yes

Counsel: And was it fair to say you responded to them on a rolling basis?

JB: Majority of them on a rolling basis yes.

Counsel: By which I meant members of staff .. you then dismissed them?? [can’t hear]

JB: [Can’t hear]

Counsel: And referred to professional bodies?

JB: Absolutely

Counsel: Was one reference to being approached by the NMC for information. Nursing and Midwifery Council to try not use too much jargon, they’re the regulatory body for registered nurses, is that fair to say?

JB: Yes

Counsel: When contacted by them was that first you knew about the problem?

JB: Problem with regards to what?

Counsel: That particular individual?

JB: That nurse had been reported to the NMC by Mr Seares and we was contacted by NMC to confirm various details about that nurse, hadn’t heard anything since or further. That said nurse is still a practising RMN.

Counsel: When we think safeguarding, all sorts different meanings, legal responsibility to keep vulnerable people safe, there will be policies, some your own and some in Sussex?

JB: I think we need to differentiate between safeguarding and what we do as a business. We’re not a care provider. We don’t need to have safeguarding policies in place, we are a healthcare agency, we provide staff of various grades, not provide care, is a real distinct between the two.

Counsel: What’s been provided to the local authority is the sorts of things you required from staff before you’d even employ them. You would take care about that wouldn’t you?

JB: Yeh at the end of the day as I say to staff I employ, it could be their own parents in hospital, want to do due diligence, could be between 6 to 8 weeks from when they register to when we allow them to work.

Counsel: That’s for all the checks to be done?

JB: Yes, includes Enhanced DBS and all training as well. If they’re a nurse their NMC registration is checked on a monthly basis as well, regardless of whether they’re working with us at the time.

Counsel: There’s also formal safeguarding legal mechanism [can’t hear]

Are you aware that did happen as far as Jessie is concerned? So East Sussex in the end made a referral to Brighton and Hove towards the end of October about safeguarding issues about the care of Jessie.

JB: Umm to be brutally honest with you if that happened it happened, can’t recall. Was it about certain individuals?

Counsel: No, whole series of issues.

JB : Not sure I was made aware of that

Counsel: Ok, so not really your thing, your thing as and when complaints made you wanted to respond directly.

JB: Yes, if from East Sussed or others

Counsel: Your response was a response to Brighton and Hove City Council

JB: Yes, to a gentleman called Steve Lawton I think

Counsel: Yes, what they want to do is assure themselves these complaints made, and have been assured and acted on

JB: Yes

Counsel: Want go back to context. You explained you took on the care of Jessie in Viaduct Road because it wasn’t possible for her to stay at home, is that right?

JB: Yes I believe suggestion was made but Jessie’s parents said they couldn’t provide for her at home, so East Sussex found Viaduct Road and asked us to provide support

Counsel: Yes. Is it right East Sussex approached 30 agencies?

JB: Couldn’t tell you exact number, was raised every meeting. Couldn’t tell you how many they approached, but do know it was constantly raised.

Counsel: Is it right to say you have alluded to fact staff themselves raised concerns and complaints about Mr Seares. I’m not asking you to go into detail of that, that’s your evidence?

JB: Yes

Counsel: Is it fair to say Ruth Nathan rather took charge of that?

JB: She was I suppose the middle man between ourselves and the family, ultimately she was Jessie’s social worker, was raised to her directly and Lauren and James of East Sussex CC at the same time.

Counsel: She’s due to give evidence next week so don’t think need to raise that with you. Thank you very much.

Over to counsel for East Sussex County Council.

Counsel: Make sure the jury are aware of a few things, we heard of CQC regulated provision. Nurses and HCAs, both have training in providing personal care?

JB: That’s correct yes

Counsel: Can you help the jury, is it right if one of those working in home with Jessie was prompting with personal care, or in room with Jessie while undertaking personal care, you would not need to be a CQC registered organisation for that?

JB: Be truthful to you, I wouldn’t know the answer. CQC is relatively new to us, just put in application, our staff generally work in hospital environment and covered under that registration. Within the community is completely different set circumstances, if I gave you answer would literally just me be thinking something on spot, wouldn’t be comfortable doing that

Counsel: You said earlier was your suggestion to phase in female carers to support in personal care?

JB: To support in prompting of personal care absolutely

[Missed part]

Because as I said earlier was all males, presents problems itself, to enable Jessie to feel comfortable, so got female carers enabling her or prompting her to do personal care as opposed to just male individuals

Counsel: Were you informed by Jessie’s parents, or any professionals working with her, there came a time where Jessie was unable to wash herself?

JB: No

Counsel: Were you informed if she wasn’t under constant observation in bathroom was a risk of seizure?

JB: Was advised if Jessie was bathing herself door should be ajar so would be able to be heard… so observations still happening as opposed to left to her own devices behind a closed door

Counsel: So given that advice … but not needed personal care support?

JB: No ward manager said Jessie was able do her own personal care

Counsel: You said earlier as employment agency you weren’t right people to provide support?

JB: Yes

Counsel: Given search ongoing to find providers, was universally accepted by all?

JB: Yes. Said in every meeting we were at, we made clear we’re not the right people for Jessie, we are literally there to try ensure she’s safe until right provider is found.

Counsel: You were aware searches were underway?

JB: I have no doubt East Sussex were looking for the right people as opposed to continuing using us

Counsel: Given experience you and your staff had supporting Jessie, could you identify complexity of her needs?

JB: Absolutely Jessie needed two carers, one RMN and one carer, for level of support Jessie needed. She needed all manner of individuals to support her.

Counsel: You said you were offered training in ways to communicate with Jessie but weren’t offered specific autism training. From your experience, know you’re not a professional, would you say communication with someone with autism is one of the key aspects to support them?

JB: Absolutely, how to communicate with Jessie at time, I assume would have been in the documentation provided to us by East Sussex CC

Counsel: You agree communication difficulties are some of the difficulties come with someone with autism?

JB: Since Jessie we have been asked to provide support on similar care packages, provided PBS Plans and documentation, quite detailed how communicate with that individual.

Counsel: Want to ask briefly about safeguarding allegations about staff you deployed, you said in contact with Mr Seares, and James Haselby and Lauren Bernard and Ruth Nathan [can’t hear]

JB: Didn’t have direct contact with Mr Seares, was all via James, Lauren and Ruth Nathan. Mr Seares wouldn’t come to us directly, would raise concerns via those individuals

Counsel: In respect of the staff member stayed in property in daytime ahead of night time shift

JB: Yes

Counsel: Apart from consecutive night shift, that carer would be expected to return home but could sleep in day?

JB: That specific RMN was only about 4 weeks, if he had consecutive shifts where he wasn’t required to work, he was expected to leave the property and go to a hotel.

Counsel: Yes Lauren Bernard said East Sussex CC paid for a hotel. Were you ever asked for a different person to be allocated, that they come off rota?

JB: Yes, to be brutally honest we were asked that on numerous occasions about numerous individuals.

Rolling requests from mainly Mr Seares and also Jessie on occasions, were constantly asked to not provide certain individuals, who would then be requested back a few months down the line by which time they wouldn’t be available.

No further questions from East Sussex. One clarification question from Jessie’s family.

Counsel: Mr Brown, you answered questions earlier about a named individual

JB: Yes

Counsel: Ruth Nathan provided a full chronology to her witness statement, is entry 16 December 2021 I’d like to ask you about. Lauren Bernard, social worker. Email received from Jason Brown, that’s you?

JB: Yes

Counsel: Querying should carers go to hospital with Jessie even if she refuses. Jessie called ambulance yesterday but Jessie refused to go with her carer. Carer on shift called Andy who said Jessie did not want them there.

Lauren’s response, all involved my professional opinion, offer go to hospital with Jessie in the ambulance, if she refuses then follow to A&E, can be supported if required, carers can keep distance if needed.

JB: Yes

Counsel: Lauren says still go to hospital but if Jessie is agitated by presence of this individual, maintain distance. Is that fair?

JB: Yes

Counsel: No further questions.

Over to the jury for their questions.

Juror: Just to get clear, so many details, just want to be absolutely clear. The reference to Prince, can I confirm, no allegation of them assaulting Jessie was ever made?

JB: No

Juror: So the only reference we have for Prince is with this issue of him accompanying Jessie to the hospital?

JB: Yes

Juror: Ok

Then another juror had a question.

Juror: Can I just clarify again, you said, personal care given, and you said staff were prompting Jessie to do her own personal care. Which is it, was she prompted or given?

JB: Was never given, always prompted

Juror: Your staff worked 18 months

JB: [can’t hear]

Juror: [cant hear] you said your staff don’t get safeguarding training?

JB: No that would be part of training they undertake when they get registered with us, safeguarding training

Juror: 18 months they worked with Jessie, you place people with providers and in hospital, so they follow organisations they work with. Which policies were they following when working with Jessie?

JB: Care plan and PBS

Juror: Policies?

JB: As locum policies

Juror: Were your policies at the time compliant with CQC?

JB: No they didn’t, its why it’s taken us so long to apply for CQC registration, needed to make sure we were compliant

Coroner said that he can’t say what East Sussex CC knew but knew not CQC registered.

Juror: In 18 months [can’t hear, something about supervision]

JB: Clinical governance department, our own responsible officer and clinical lead, should they need additional support

Juror: [can’t hear]

JB: Not really, no, because all clinical aspects of Jessie’s care by East Sussex CC

Juror: [can’t hear]

JB: Clinical supervision from their lead practitrioner

Juror: I’m talking about employers [can’t hear]

JB: If Jessie’s case or in hospital, would be our own individual clinical governance responsible officer or clinical lead if needed, don’t recall [cant hear]

Juror: Were you yourself managing her medication?

JB: No, the nurses? That’s what told by nurses.

Juror: You’ve got to be registered with CQC

Coroner: We can’t get into a debate, got to be careful you can’t give evidence

Then back to the first juror again.

Juror: Fact you weren’t CQC registered, does that mean they needed to have training before they come to you or you’re responsible for training?

JB: To clarify, all our candidates undergo extensive training in line with NHS Frameworks, we’re a locum agency not a care provider. If care provider, what we’re looking at going forward, would need to, but we’re not a provider.

Coroner: so don’t go off on a red herring, was no requirement for you to be CQC registered at the time?

JB: There was a requirement, but let me explain

Coroner: No requirement for you to be CQC registered as a locum agency?

JB: not at all

Then another juror had a question.

Juror: When you take on HCAs, not nurses, what qualifications do they come with? NVQ Level 1, 2, 3?

JB: I’ll be perfectly honest I’m not the person [can’t hear]

Coroner: Stop, stop, stop, the jury don’t have the statement

JB: I’m happy to read out all the training they undergo

Coroner: Whether they need NVQ Level 1, 2 or 3?

JB: It’s not listed as a requirement, we’d have to check.

Counsel for Brighton and Hove City Council says that the jury have to be told.

Mr Brown listed the training provided to HCAs, at pace, I didn’t catch it all but it included basic, intermediate or advanced life support, prevention and management of violence, MAPPA training as required by the authority in agreement with the supplier, Mental Health Act, Mental Capacity Act, Communication, Consent, Dementia Awareness, Nutrition, Privacy and Dignity, Promoting person-centred care, Your healthcare career, Lone Worker Training, Equality Diversity and Human Rights, Radicalisation, Counter Fraud, Violence and Conflict Resolution, Information governance, Food hygiene, COSSH and Riddor, Infection prevention, Safe handling, Fire safety, Safeguarding Adults Level 3, Safeguarding Children Level 3, Moving and handling.

Juror: And that’s updated annually?

JB: Yes

Then another juror had a question.

Juror: Am I right that IMC Locums also provided staff at Mill View, where Jessie was after Viaduct Road?

JB: If our staff there purely by coincidence, rather than us providing staff. SPFT are one of our clients, we fill ad hoc shifts on a rota basis. If Jessie happened to be at Mill View at the time, staff may come across her, yes

Juror: You had no awareness Jessie was there?

JB: No, the last hospital we were aware of was Royal Sussex in February 2022. We weren’t aware of Jessie’s movements after that.

Juror: Were Mill View aware of the ongoing Safeguarding Investigation about IMC Locums?

JB: I’ve no idea.

No further questions. Mr Brown was released and the jury were given warnings again before being released at 13:20 on Day 5.

We’re back in court tomorrow 10am, so I’m off to bed. With thanks to those reading, sharing, commenting and funding my reporting.

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