Prison staff failed to investigate dementia of inmate who died awaiting trial for sexual assault

Anthony Noble was facing multiple charges of sexual assault

HMP Preston (Image: Thomas Temple / Newsteam)

Bosses at HMP Preston have agreed to make changes after the death of a 76-year-old man with dementia who was being held on remand, according to a report.

Anthony Noble died at the Lancashire prison in May 2022, less than two weeks after he was taken to the prison. Noble, formerly of Broadgate Foot Caravan Park, Morecambe, was facing multiple charges of sexual assault at the time of his death.

He was taken into custody on April 30 ahead of an appearance at Preston Magistrates Court on May 4. That hearing was pushed back to May 25 but Noble died due to a medical cause of death of coronary artery disease on May 8.

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An investigation was subsequently launched by the Prisons and Probation Ombudsman (PPO) which has now published its findings. It said that when Noble arrived at Preston, the reception nurse carried out a reception health screen and the prisoner said he had no health concerns and was not taking any medication.

Noble appeared confused but the nurse did not assess his mental capacity. The next day, a seconding screening was carried out which led to a social referral over incontinence but there was no evidence that falls risk assessment was carried out as would be expected.

The report says: “The same day, staff referred Mr Noble for a cognitive assessment because of his confusion. He was assessed on May 2 and this showed significant cognitive impairment. A subsequent assessment showed that he had dementia. He was referred to the memory clinic but died before he was given an appointment.

“On May 3, Mr Noble was moved to the prison’s inpatient unit after staff identified that he was unable to care for himself. Healthcare staff took his clinical observations daily. These were normal up to May 8. At around 11.45am on May 8, a healthcare support worker took Mr Noble’s clinical observations and calculated a National Early Warning Score (NEWS2) score of 2.”

This score is one which indicates further assessment should be carried out to identify the level of monitoring needed. A member of healthcare staff took Mr Noble’s clinical observations shortly after 5pm and calculated a new score of zero, noting that there were no concerns.

A roll check was completed half an hour later with no issues found but shortly before 7pm, a nurse went to visit Noble and found unresponsive on the floor. Two members of healthcare staff arrived with emergency equipment and administered oxygen and used a defibrillator. These efforts continued until paramedics arrived to take over at 7.10pm and Noble was pronounced dead 20 minutes later.

The PPO said that Noble is the fourth HMP Preston inmate to die in the space of four years but there are no similarities between his death and the others. It also noted that his care was not different to that which would have been experienced in the community.

However, it issued three recommendations to improve future care at the facility, all of which were accepted by bosses at HMP Preston. These were that the Head of Healthcare should:

  • ensure that staff carry out a mental capacity assessment during the reception screening process if a prisoner arrives with signs of dementia or confusion;
  • ensure that staff assess older prisoners’ risk of falls during the reception screening process
  • complete an audit on the use of care plans within HMP Preston
    • 10:56, 10 JAN 2023

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