'Notes were missing' before Cheltenham woman took own life

A young woman took her own life in a secure psychiatric unit using a method she had previously attempted at another facility, an inquest has heard.

Laura Davis, 22, from Cheltenham in Gloucestershire, died at Arbury Court in Warrington on 20 February, 2017.

Prior to entering Arbury Court, Ms Davis was at Wotton Lawn psychiatric hospital in Gloucester.

Cheshire Coroner's Court was told information about her previous suicide attempt was missing from her notes.

On the first day of her inquest on Monday, the court heard Ms Davis had been admitted to Wotton Lawn, which is now run by Gloucestershire Health and Care NHS Foundation Trust, in June 2016.

She had suffered from poor mental health after being sexually assaulted at the age of 14, and suffering a second serious sex attack at the age of 16, the jury heard.

Ms Davis' mother Joanna Davis said her daughter had a long history of severe self-harm and a diagnosis of emotionally unstable personality disorder.

She said while at Wotton Lawn, her daughter had been admitted to A&E 48 times due to self-harm, and she had easy access to dangerous items.

Her medical records stated she had absconded from the facility 29 times, although Ms Davis' family believe the true figure is significantly higher.

"Sometimes we would find [dangerous items] on the floor of her room, she had harmed herself and the [items] would still be there," her mother said.

She added that on a couple of occasions she had removed the items herself and placed them in the sharps bin when staff at Wotton Lawn failed to do so.

In October 2016, another woman took her life at Wotton Lawn using the same method Ms Davis would later use.

Just two days after this patient passed away, Ms Davis made a serious attempt on her life using this method.

Her mother told the inquest: "She expressed a wish that this was the way she wanted to die."

In November 2016, Ms Davis was moved to Arbury Court in Warrington, a psychiatric intensive care unit (PICU) run by private provider Elysium Healthcare.

Ms Davis was only the third patient to be admitted to the newly-opened facility, the inquest heard.

"One really important part that hadn't been passed on was the fact Laura had tried to end her life [with a housekeeping item] and that she had told me, her step-father and her doctors that was her preferred method of suicide," Joanna Davis said.

Said she and Ms Davis's step-father had told Arbury Court on three occasions this item was a serious risk, but this was not communicated to the team caring for Laura.

Ms Davis' step-father Darren Watts told the inquest he had urged staff at Arbury Court to liaise with Wotton Lawn to fill in gaps in information about her care.

"I don't believe it was ever followed up, if it was followed up it was not conveyed to us," Mr Watts said.

The inquest into Ms Davis death, which is due to last between three and five weeks, continues.

Staff from NHS Gloucestershire and Elysium Healthcare are expected to give evidence.

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