Family Speaks of Heartache following Tragic and Preventable Death

Potential Risks Were Ignored

Diagnosed with a range of medical and mental health issues, Kay Shepherd, 50 years old, was provided housing in Uxbridge by Hillingdon Accommodation and Floating Support Panel (Adult Mental Health) in October 2014. Ms Shepherd was assessed as requiring floating support from a support worker at charity Hestia, who were meant to meet with her weekly.

Emmanuel Willems, who also suffered with mental health concerns and had a history of drug abuse, moved into the flat several months later.

In the months that followed, there were significant and recurrent issues between the housemates, including rising tension about problems with the boiler in the property which resulted in the lack of heating and hot water.

This led to Mr Willems expressing delusionary thoughts about Ms Shepherd, and in July 2015, Mr Willems stabbed himself due to a significant deterioration in his mental health. While in hospital receiving treatment, he disclosed to professionals that he could have stabbed Ms Shepherd instead.

Despite this, and growing evidence that the two were not getting along in the flat, Mr Willems was discharged back to their shared flat where the relationship remained strained.

Over the coming months during visits from his care coordinator to his flat he was found to be in possession of a large kitchen knife which he kept in his bedroom. No adequate action was taken relating to this.

On November 11th, 2015, he fatally stabbed Kay in the chest.

Conviction and Inquest Outcome

The findings, handed down by HM Assistant Coroner Dr Séan Cummings, follows the conviction of Emmanuel Willems who was found guilty of manslaughter on the grounds of diminished responsibility on January 13th, 2017.

Speaking of the family’s heartache Mr Robert Adams, Kay’s Son said, “This loss under such tragic and preventable circumstances continues to have a profound effect on our family even now, almost five years after her death.

“While we welcome the findings of the earlier serious incident investigation, we still had many unanswered questions about the circumstances which led to what happened.

“The inquest has provided some of those answers, and we thank the Coroner for his time in producing the subsequent narrative verdict and report for change.

“It is our hope that any lessons learnt and changes that are put in place are shared widely across the NHS, and that no one should suffer as we have in the future.

“We would like to thank everyone who has supported us during this difficult time.”

The family was represented at the inquest by Claire Macmaster and Aimee Brackfield of Simpson Millar Solicitors, and Sarah Hemingway of Garden Court Chambers. The family was supported by the charity, Inquest.

What Happens at an Inquest?

An inquest is a formal investigation into a death that is overseen by the Coroner. An inquest is done in the event of someone’s death being unknown or unnatural. The investigation is designed to determine what and how the death happened.

The Coroner will look into medical reports, evidence, and any witnesses that were present at key moments in the lead up to the death.

If the person’s death could have been avoided, this will be highlighted, along with what steps should have been taken instead. Many families and friends will receive answers to many questions that they may have around their loved one’s death.

At an inquest, there is no prosecution or defence. Although, witnesses may be represented by lawyers or solicitors if they wish. The Coroner will decide on who they need to call upon as a witness as part of the investigation. If you are chosen as a witness, you will be asked to provide a statement as evidence.

Inquest Outcomes

When the inquest has reached its end, the Coroner will determine the cause of death. This will be one of the following:

• Natural Causes
• Suicide
• Accident
• Unlawful or Lawful Killing
• Road Traffic Accident
• Industrial Disease
• Alcohol or Drugs
• Neglect, such as medical negligence
• Open, i.e., there is not enough evidence to determine how the death occurred

The Inquest Process

Unless you have been through an inquest before, you are unlikely to know what to expect. Here is a quick guide on the process, so you know exactly what it will be like.

• In the first instance, the death will be referred to the Coroner.
• The Coroner determines whether an inquest will be required.
• If required, there will be a post-mortem examination to establish the medical cause of death.
• The Coroner will decide whether a referral to the Police or CPS is needed for a criminal prosecution.
• In the event of a criminal prosecution, a pre-inquest review will be done to review the evidence and identify the key witnesses.
• An inquest date is set once all investigations have been completed.
• Witnesses will be notified of the date so they can attend to provide evidence and answer questions where necessary.
• The inquest hearing takes place, and the Coroner makes their decision.
• The final paperwork will be completed, and the death can be registered.

Tips on the Inquest Process

If you have lost a loved one and their death will be investigated during an inquest, there are some things that you and your family can do to process go as smoothly as possible.

Firstly, you should try and discuss between yourselves who should be the spokesperson for the family. Try to come to an amiable decision, so that there are no rifts in the family unit during this difficult time.

You can choose to write to the Coroner ahead of the inquest, outlining your main concerns with your loved ones passing. This will make sure that the Coroner addresses the key issues in the investigation.

You have the right to ask the Coroner to disclose any documents to you. If you have instructed us to represent you, we will do this on your behalf.

While the inquest can be very upsetting, it is also a time to get the answers to your questions. This will be a crucial part of your grieving process, as you come to terms with losing your loved one. You have the right to bring a friend along to the inquest for support, if you feel you may need it.

It’s important to be aware that the press and media can sometimes be present at the inquest, as this will be held in a public place. You don’t have to speak with the media afterwards, but you may decide that you would like to address the situation to the press. Alternatively, we can speak to the press on your behalf if you would rather not do this directly.

How Simpson Millar Can Help You

If you are facing an inquest due to a loss that is under investigation, we can help support you throughout the process.

We understand that you will be going through a difficult time, and we want to help ease as much of the stress from the inquest as possible. We can help handle the Coroner’s Court and represent you at the inquest.

During the inquest, we will seek to ensure that the relevant people are held accountable for their actions and that procedures are implemented to prevent this from happening again in the future.

Whether you have just a few questions about inquests or you would like our full support, our compassionate Solicitors are waiting to hear from you.