Source · Investigations in the NHS

Independent investigation: Vera Croghan, Norwich (2020)

East of England Incident 11 Dec 2020 Subject Vera Croghan

Index summary

Man with schizophrenia starts fatal fire at his grandmother’s house. Recent inpatient – Diminished responsibility Sec 37/41

Recommendations

4 total
1 Addressed to: Norfolk and Suffolk Mental Health NHS Foundation Trust No Response Published

Link to recommendation 1

Recommendation · source text
The trust will explore the possibility of additional scenario-based training in respect of mental capacity and application of the Mental Capacity Act (this recommendation was made in the IMR and has been included here for completion).
2 Addressed to: Norfolk and Suffolk Mental Health NHS Foundation Trust No Response Published

Link to recommendation 2

Recommendation · source text
The trust will ensure that mandatory domestic abuse and safety planning/risk assessment training addresses assessment of risk and is relevant to all parties living or staying within a household.
3 Addressed to: Norfolk and Suffolk Mental Health NHS Foundation Trust No Response Published

Link to recommendation 3

Recommendation · source text
The Trust will strengthen arrangements for assessments of safeguarding and teams (in team meetings and in supervision) should strengthen the way that they engage with families to maintain their professional curiosity about the wider impact in families. The clinical team should reinforce their policy for `Think Family14.
4 Addressed to: Norfolk and Suffolk Mental Health NHS Foundation Trust No Response Published

Link to recommendation 4

Recommendation · source text
Development and roll-out of DIALOG and DIALOG + must be maintained and reviewed and audited to ensure that social, cultural, familial, and other patient-based information can be built into care more effectively.

Acceptance status

Per recommendation
No Response Published
4

Total recommendations
4
About this data

Acceptance status records the published response to each recommendation. Acceptance does not establish that an action has been completed.

Independent health investigation reports and reviews commissioned by government or NHS England.

About this investigation

Source & metadata

Independent investigation report. Recommendations and any published response are extracted below.