NHS Oxleas Foundation Trust has today been fined £300,000 after two members of staff suffered life-changing injuries when they were repeatedly stabbed by a service user. The Trust pleaded guilty to breaching Section 2(1) and 3(1) of the Health and Safety at Work etc. Act and was also ordered to pay costs of £28,000.
The Old Bailey heard how, on July 17, 2016 a healthcare assistant, Francis Barrett was preparing toasted sandwiches for the staff and some of the patients in the kitchen on the Burgess Ward of the Bracton Centre, which is a medium secure forensic unit in Kent. He went to leave the kitchen to speak to a service user, leaving the knives on the work surface.
As he opened the door, which had been locked from the inside, one of the service users who had been seen nearby pushed him back into the kitchen, forcing him onto the floor. The service user then grabbed a kitchen knife from the side and stabbed Francis Barrett multiple times in the chest and stomach. In his victim impact statement Francis described feeling like a piece of meat being prepared for cooking.
Julius Falomo, a psychiatric nurse, also working on the ward, saw what was happening and shouted for the attack to stop. The service user attacked him as well in the corridor, allowing Francis Barrett to lock the kitchen door. Julius Falomo was then stabbed multiple times.
Armed police arrested the service user. Both employees were treated for multiple stab wounds and were air lifted to Kings Hospital, where they received blood transfusions and surgery to repair the damage caused by the attack.
Both nurses still suffer pain, medical problems and psychological damage from the attacks. Two other members of staff who, for their own safety, had to hide on the ward and witness the attacks on their colleagues have suffered both emotional and psychological damage. Both described in their victim impact statements feeling helpless and that they feared they would be next to be attacked. Both took time off work and have received counselling from the Trust.
An investigation by the Health and Safety Executive (HSE) found that although the Bracton Centre routinely received high-risk patients, at the time of this incident there was no patient specific risk assessment identifying the risks posed by a patient and the measures required to control those risks prior to admission to the ward.
The investigation also found that the use of knives on an acute ward was fundamentally unsafe. Staff were entering and exiting the kitchen area several times whilst knives were in use and there were no instructions or control measures in place regarding kitchen knives. Following the incident all knives were removed from the acute wards.
Speaking after the hearing, HSE inspector Joanne Williams said: “This incident has had a profound impact not only on the two nurses who nearly died because of their injuries, but also their colleagues who witnessed the attacks. These NHS workers dedicated themselves to a public duty that came with daily challenges and the Trust had a responsibility to keep them safe.
“The treatment of patients in medium secure psychiatric units involves an inherent risk of violence and aggression. The needs of patients can be complex. However, the Trust nevertheless had a duty to ensure the safety of its staff and its patients so far as was reasonably practicable.
“In this case there were relatively straightforward steps that could have been taken prior to the incident to prevent it happening. These included carrying out a patient specific risk assessment prior to admission to the ward; the removal of knives from acute admission wards, including Burgess Ward where patients do not routinely require occupational therapy; and proper training in search techniques.
“The risk of violence posed by patients was entirely foreseeable. Had these steps been taken Francis Barrett and Julius Falomo would not have suffered the serious injuries that they did.”
