CQC prosecutes Richmond Psychosocial Foundation International after the death of a patient

Page last updated: 9 March 2021

Richmond Psychosocial Foundation International has been ordered to pay £60,170 by Uxbridge Magistrates’ Court after admitting it had failed to provide safe care and treatment to a person in its care.

Marilene Peggy Jhugroo, the manager of Lancaster Lodge, a service for people with eating disorders and mental health conditions in Richmond, South-West London, was also fined for specific failings during a period of sole management of this service.

The Care Quality Commission (CQC) brought the prosecution following the death of Sophie Bennett.

Sophie died, aged 19, whilst receiving care at Lancaster Lodge, in circumstances which CQC believes were avoidable.

In January 2016, Richmond Psychosocial Foundation International decided to change the care and support offered at Lancaster Lodge. This included removing the external therapies that were being provided to the young women with very complex mental health needs who lived there.

The removal of the therapies offered destabilised the household and the young women who lived there, who until then had been making progress in the previously stable environment of the service.

These changes in therapy appear to have contributed significantly to increased levels of anxiety for Sophie. Sophie was able to make a suicide attempt using a ligature on 2 May which resulted in her death in hospital on 4 May 2016.

Richmond Psychosocial Foundation International was fined £40,000 for failing to provide safe care and treatment and exposing a patient to significant risk of avoidable harm. It was also ordered to pay the prosecution costs of £20,000 and a £170 victim surcharge.

Marilene Peggy Jhugroo was fined £3,000 for failing to provide safe care and treatment and exposing a patient to a significant risk of avoidable harm. She was also ordered to pay the prosecution costs of £10,000 and a £170 victim surcharge.

Debbie Ivanova, CQC’s Deputy Chief Inspector for Adult Social Care in London and the South, said:

“This is an extremely tragic case and my thoughts are with Sophie’s family and friends.

“Services should build around people’s needs, with any changes made in consultation with the people using the services and their families. Richmond Psychosocial International clearly did not do this, and the consequences for Sophie were devastating.

“In these circumstances, we had no choice but to prosecute. I hope this case will serve to remind other providers to ensure they are taking all necessary steps to ensure that the care they provide is person-centred and appropriate for people’s needs, whatever these needs are.”


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About the Care Quality Commission

The Care Quality Commission (CQC) is the independent regulator of health and social care in England.

We make sure health and social care services provide people with safe, effective, compassionate, high-quality care and we encourage care services to improve.

We monitor, inspect and regulate services to make sure they meet fundamental standards of quality and safety and we publish what we find to help people choose care.