Matthew Leahy died, aged 20, in November 2012. He was found hanging in his room at the Linden Centre, a mental health unit in Essex. Today his mother Melanie is awaiting a report to be published by the Parliamentary Health Service Ombudsman.
Since his death, his mother Melanie whose family are from Collier Row, has been trying to get justice for her son, whom she says was let down by the Trust.
She says his death wasn’t investigated properly, his care plan wasn’t written until after his death, his claim of rape wasn’t taken seriously, he was badly treated and his safety was at risk.
The Parliamentary and Health Service Ombudsman had already been looking into the deaths of two young men at the Linden Centre in 2008 and 2012.
The findings are damning and pretty shocking. It found there was “systemic failure to tackle repeated and critical failings over an unacceptable period of time”, that there were ‘missed opportunities’ to ensure the safety of the men and that “the lack of timely safety improvements following their deaths is completely unacceptable and it’s important the NHS understands why this happened and what lessons can be learned to prevent the same mistakes happening again”.
When investigating the death of Matthew it found his management of risk ‘was not rigorous enough’, that his care wasn’t adequately planned, the Trust didn’t take adequate care of his physical health, they weren’t open and honest with his family and the list goes on.
The Ombudsman, Rob Behrens, is equally critical of the Trust.
He told Melanie that it was an extremely concerning report, that there was a catalogue of failings that were entirely unacceptable.
He said it was deeply worrying that changes hadn’t been made at the Trust despite recommendations made by the Care Quality Commission and perhaps most telling was that he was “deeply disturbed but not surprised.”
Mr Behrens says he would fully support a public inquiry if NHS Improvement recommends one, and in fact would like to have it investigated further himself, had he had the powers.