RQIA Independent Review of The McDermott Brothers' Case

RQIA considers that, in general, WHSCT contributed appropriately to the
Public Protection Arrangements for Northern Ireland (PPANI) arrangements in
this case, through the work of the WHSCT's Principal Officer. An initial lack of
awareness of the role of the new PPANI arrangements across the
organisation did not adversely impact on the response of the organisation to
the PPANI process. A recognised need to ensure effective collaboration in
this case after the brothers were designated at Category 1 was subsequently
addressed by the WHSCT establishing a multiagency core group.
From the initial assessments of the brothers as having learning disabilities up
to 30 September 2010, it was evident that WHSCT had provided the full range
of care and treatment services to James Francis and Owen Roe McDermott,
in keeping with their assessed needs.
RQIA recognised that the many issues surrounding this complex case have
created significant difficulties in delivering care and treatment to the brothers
and their immediate family. RQIA commends the professionalism and
integrity of all staff involved in the care and treatment of the brothers, which
was evidenced during this review.
It was evident that, during the early period after the disposal hearing, there
was a lack of clarity within the WHSCT as to its duties and powers in relation
to the STOs which had been imposed by the court. This lack of clarity led to
actions which, in retrospect, were not fully appropriate. This led to the
WHSCT instigating daily supervision and the issuing of a direction to the
brothers to be admitted to hospital. RQIA considers that neither of these
actions were appropriate in the circumstances.
RQIA found that following the admission of the brothers to hospital on a
voluntary basis, the supervising officer continued to exercise her
responsibilities in relation to the STOs up to 30 September 2010, the endpoint
for this review. She maintained contact with the brothers in hospital and also
with family members in Donagh.
The WHSCT has a key responsibility for good governance, which includes
effective communication with a wide range of relevant stakeholders. The
management of the McDermott case has been complex for WHSCT and has
required sensitive handling and communication. The WHSCT has had to
ensure it upholds its duties under the Mental Health (Northern Ireland) Order
1986 and its obligations to protect children and vulnerable adults. It must be
recognised that the WHSCT in its communication with the community and in
other public forums must maintain its legal duty of confidentiality for those in
its care. RQIA considers that within the governance arrangements, risks were
managed at appropriate levels. Issues and concerns in relation to the case
were shared and discussed at the WHSCT's Senior Management team and
the WHSCT Board. The WHSCT maintained continuous and open lines of
communication with the Health and Social Care Board and DHSSPS.
In assessing the actions of the WHSCT in relation to communication with the
survivors, and the provision of services to support them, RQIA found that
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