Neil Kenneth PARKES · Prevention of Future Deaths report

I opened an investigation on 25 June 2020 into the death of Neil Kenneth PARKES, late of Oak House, 357 Gwendolen Road, Evington, Leicester LE5 5FP. I concluded the inquest on 24 November 2021 and returned a conclusion that his death was accidental.

On 29th April 2020, the Deceased was found unconscious in a stairwell in Royale Court, Queens Road Nuneaton. There were no marks of assault on his body and on the balance of probabilities he had an unwitnessed fall. He was taken to UHCW by ambulance where he remained and subsequently died on 14th May 2020. Throughout his time in hospital he remained unidentified despite the hospital calling Warwickshire police on 2 occasions regarding him and despite his parents reporting him as a missing person to another force. Warwickshire police attended the scene and were aware of the Deceased had not been identified. He was only identified after he died by means of fingerprints. Prior to the fall, the Deceased was a resident of Oak House, Gwendolen Road, Leicester which is a unit specialising in individuals with complex needs including drug and alcohol issues. He had resided there since 2017. On 27th April 2020, the Deceased left the unit voluntarily albeit his eviction was very likely due to his alleged behaviour over a period of time and in particular his alleged behaviour on the 26th April 2020 consisting of damaging to property, throwing plant pots at staff and directing a fire extinguisher at staff. On 27th April 2020, the country was in lockdown due to the covid 19 pandemic. He was assisted to pack his bag and had clothing for about 3 days and some of his medication - some of his medication was withheld on the basis of safety to avoid an overdose. He was informed to attend the Homeless unit at Leicester City Council or the Dawn Centre (a centre for homeless people). He was familiar with both locations. He left at about 1.00pm. The Dawn Centre was an approximately 10 minutes from Oak House, although it was noted that the Deceased was a slow walker. He appears not to have attended either location although he was seen by a police officer in Leicester on the evening of 27th April 2020.

Throughout the time that Mr Parkes lay unconscious in UHCW his identity was unknown. He had been reported as a missing person by his parents to another police force during the time he was in hospital. Additionally, on 2 separate occasions, UHCW staff directly contacted Warwickshire police to seek assistance to identify him. No clear explanation has been provided to explain why Warwickshire failed to act on those requests. The effects of the failure to identify Mr Parkes meant the hospital had no access to his previous medical history which my have been of assistance in his treatment.