Sam Molyneux
13 Sept 2017 · Coroner Andre Rebello · Liverpool & Wirral
This report repeats 1 earlier warning. See the linked reports.
The coroner's concerns
1. barricaded door delaying staff access
“in old prisons not all wings have been adapted to have anti-barricade doors.”
2. lack of ACCT consideration for self-harm risk
“perhaps should have been given his threats of suicide and self-harm articulated by him in a letter to a Governor on an adjudication the day before his death”
3. locating prisoners behind barricadable doors
“amending "Management of Prisoners at risk of harm to self, to others and from others (Safer Custody)" to include consideration of where reasonably practicable avoiding locating prisoners behind a door which is not designed to circumvent barricading”
Linked reports
Closely relatedConfidence 0.90 · high
Earlier report
“Admission staff must raise an ACCT Plan when a prisoner is identified at risk of suicide or self harm”
This report
“He was not on an ACCT but perhaps should have been given his threats of suicide and self-harm articulated by him in a letter to a Governor on an adjudication the day before his death.”