Lousia Ovington independent investigation report ... - NHS North East

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CHAPTER 1 - NARRATIVE OF KEY DATES AND EVENTS 24 Cuthbert Ward, St Nicholas’ Hospital, Newcastle: 13 January 1999 to 16 August 1999 61. On 13 January 1999 Louisa Ovington appeared in court in relation to her assault on one of the nurses at the Tony White Unit. The Section 37 under which she had been detained was discharged and the court ordered that she be subject to an assessment under Section 38 of the Mental Health Act at St Nicholas’ Hospital in order to determine whether her personality disorder was treatable and whether it would be appropriate to recommend that she be detained under Section 37 or Section 37/41. Section 38 has a maximum duration of one year and needs to be renewed every 28 days by the court. 33 (Louisa Ovington was apparently hopeful that the order would be rescinded; in May 1999 however she appears to have accepted that it would not and the records show that she was becoming more realistic and prepared to accept some responsibility for her actions.) After the hearing she was admitted to Cuthbert Ward (medium secure forensic ward) at St Nicholas’ Hospital under the care of Consultant 9 .34 62. In view of her history of aggression and of making false allegations whilst at the Tony White Unit, Louisa Ovington was very carefully supervised. Initially she had two members of staff with her at all times, one of whom was always female. She was segregated for the first two months. During the following two months the observation levels were gradually reduced. She was first allowed ground leave, escorted by three members of staff, on 23 April 1999. She was regarded as being at risk of suicide and of serious violence and self neglect both on admission and at meetings held in March and May 1999. 63. In March 1999 the minutes of a meeting record that Louisa Ovington had been vocal, aggressive and threatening on admission, but that since then although her mood had been changeable and she was verbally hostile and abusive at times, there had been no physical attacks. She became hostile when challenged about her present and past behaviours and particularly guarded when discussing assaults upon others, feeling that staff were “trying to goad her” and “judge” her. The staff also noted that Louisa Ovington tried to “split” staff in attempts to manipulate situations by claiming that other staff had verbally backed up her cause. There was a consensus that assessment of whether Louisa Ovington had a mental disorder that was treatable should take place in conditions of at least medium security and work was started to find an appropriate placement. 64. On admission to St Nicholas’ Hospital Louisa Ovington was being treated with an anti-depressant, a mood stabiliser and antipsychotic depot medication. In April 1999 however, the depot medication was stopped because her psychotic symptoms appeared to be in remission. In addition Louisa Ovington had stated that she had been feigning these symptoms. However Consultant 9 told the panel that he thought that she had a genuine psychotic illness and that he did not think she was astute enough or a good enough actor to have feigned all symptoms. 33 See Chapter 8 34 7th admission to hospital
CHAPTER 1 - NARRATIVE OF KEY DATES AND EVENTS 65. Louisa Ovington had multidisciplinary assessments and treatment whilst at St Nicholas’ Hospital. This included working with occupational therapists, nursing staff and psychologists. She attended numerous groups: social skills, social activities, expressive art, baking, cookery, thinking skills and healthy living groups. Initially she had individual sessions with the occupational therapist and later group sessions to assess her interactions with others. She was noted to be able to concentrate for long periods on activities in which she was interested. Her behaviour in group sessions varied from appropriate to subtly disruptive. She was described as exercising self control when she chose to but also seen to wind herself up to anger. 66. Anger management sessions were carried out. The staff and Louisa Ovington looked at her past assaultive behaviour in order to help her to identify and divulge feelings that may precede behaviour, control feelings, not harm herself or others and accept her own responsibility. In March 1999 Louisa Ovington stated that they were a waste of time and that she didn’t have a problem with managing anger, though she said she would continue with the sessions ‘because of the courts’. She took part in eight planned sessions but found them very difficult and so eventually the sessions were suspended whilst she continued her work with the forensic psychologist. 67. A thorough psychological assessment was carried out by Psychologist 1, a consultant forensic clinical psychologist and Assistant Psychologist 1. This process consisted of clinical interview, completion of established psychometric inventories relating to personality and interpersonal behaviour and an interview with Louisa Ovington’s great aunt and uncle to get a corroborative history. Louisa Ovington’s great uncle also provided a brief written summary of Louisa Ovington’s life in which he commented “Even now I think she could kill – we love her but are apprehensive as regards the future – she is capable of anything”. 68. Psychologist 1 noted that Louisa Ovington minimised her problems with anger and aggression, stating they were in the past. She related all her past difficulties to abuse of illegal drugs. She reported a promiscuous period in her life when she was ill. She described an erratic mood, changeable emotional state and general impulsivity. Psychologist 1 felt that Louisa Ovington had been “much more disturbed and affected by the trauma of seeing her mother being murdered than was first understood”. 69. In her evidence to the panel Psychologist 1 said:“There were certainly always issues that remained essentially off her agenda and they included the murder of her mother” and also commented that she was very ‘‘closed off” (a comment repeated in the notes from Kneesworth). 25
Page 1: REPORT TO THE NORTH EAST STRATEGIC
Page 5 and 6: Contents CONTENTS Page Preamble 6 I
Page 7 and 8: Introduction and terms of reference
Page 9 and 10: The panel met on 14 occasions, tota
Page 11 and 12: CHAPTER 1 - NARRATIVE OF KEY DATES
Page 13 and 14: This opinion was referred to by man
Page 17 and 18: 20 May 1998 to 12 January 1999 CHAP
Page 23: 60. As was common in 1998, there we
Page 27 and 28: women. Registrar 1 prepared a very
Page 29 and 30: 77. One of the major components of
Page 31 and 32: visit to see him. A little later, o
Page 33 and 34: 93. The final report from the psych
Page 37 and 38: surprised and told the panel that h
Page 39 and 40: • Consultant 9,in his evidence to
Page 43 and 44: 129. Although Louisa Ovington conti
Page 51 and 52: there was “some latitude” in th
Page 53 and 54: 61 14th offence 62 15th offence 63
Page 55 and 56: 176. Social Service staff did respo
Page 61 and 62: 78 21st offence 204. However Louisa
Page 63 and 64: hours. They did not have access to
Page 65 and 66: 210. CPN 2 also completed a risk as
Page 67 and 68: Chapter 2 - Evaluation of the healt
Page 69 and 70: CHAPTER 2 - EVALUATION OF THE HEALT
Page 71 and 72: During Louisa Ovington’s first ad
Page 73 and 74: Kneesworth House Louisa Ovington co
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The conclusion drawn by the psychol
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On 10 July 2001 Louisa Ovington att
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take part in several sessions of a
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COMMENT CHAPTER 2 - EVALUATION OF T
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CHAPTER 2 - EVALUATION OF THE HEALT
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CHAPTER 3 - OUTLINE OF MENTAL ILLNE
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CHAPTER 3 - OUTLINE OF MENTAL ILLNE
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CHAPTER 4 - THE CARE PROGRAMME APPR
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The essence of CPA is to ensure car
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Chapter 5 - Involvement with police
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89 ibid The guidance states that th
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DS1 told the panel bluntly that, in
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and social care agencies. The panel
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CRO with a condition of psychiatric
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COMMENT The probation officer estab
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CHAPTER 5 - INVOLVEMENT WITH POLICE
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COMMENT CHAPTER 5 - INVOLVEMENT WIT
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CHAPTER 6 - RISK ASSESSMENT AND MAN
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CHAPTER 6 - RISK ASSESSMENT AND MAN
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• South West Durham Mental Health
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CHAPTER 7 - PROVISION OF MENTAL HEA
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The policy changes were driven by t
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• Past psychiatric history; • S
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CHAPTER 8 - USE OF THE MENTAL HEALT
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Given the multiplicity of agencies
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CHAPTER 9 - CONCLUSIONS AND RECOMME
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Some of the risk assessments from a
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• Recommendation 16. Trusts shoul
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f) Use of “talking therapies” C
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professional who had seen her withi
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i) Joint working CHAPTER 9 - CONCLU
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their procedures for formal contact
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LIST OF RECOMMENDATIONS • Recomme
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LIST OF RECOMMENDATIONS • Recomme
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LIST OF RECOMMENDATIONS • The pol
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Bibliography 1. Effective Care Coor
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INTRODUCTION 28 North East Strategi
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Lousia Ovington independent investigation report ... - NHS North East

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