Improvements sought after death of Banbury paedo prisoner

Rodney Smallman died while an inmate at HM Prison Risley in Warrington on March 11 last year.

The paedophile was jailed for 12-and-and-half years at Oxford Crown Court in 2015, after being found guilty of molesting five former pupils of a home in Banbury.

The crimes were committed against children as young as 10 during the 1970s and 1980s, while Smallman was deputy head of a boys’ home which is now closed.

The predator subjected boys across the country to sadistic abuse when he was supposed to be looking after them.

Following his death, an independent investigation was undertaken by the Prisons and Probation Ombudsman, which aims to ‘contribute to safer, fairer custody and community supervision’, with a report now published.

Smallman, aged 81, collapsed at the Warrington Road prison and was taken to Warrington Hospital on March 11 last year, and he died at the Lovely Lane site that same day.

An inquest hearing heard how the prisoner suffered ‘sensation changes in his limbs and his condition deteriorated’.

He died chronic kidney disease, but he also had type two diabetes, heart failure, atrial fibrillation (an irregular and often fast heartbeat), peripheral vascular disease (a blood circulation disorder) and hypertension – which contributed to but did not cause his death.

At an inquest held on July 14 last year, the coroner concluded that Smallman died from natural causes.

The ombudsman’s family liaison officer wrote to Smallman’s next of kin to explain the investigation and to ask if she had any matters she wanted to raise for consideration, but she did not respond.

Rodney Smallman died while a prisoner at HMP Risley

The ombudsman investigated the non-clinical issues relating to Smallman’s care, but it found nothing of concern.

NHS England commissioned an independent clinical reviewer to review his clinical care at Risley.

It was concluded that the clinical care Smallman received at the prison was ‘variable’, and some areas of his care were ‘not equivalent to that which he could have expected to receive in the community’.

The report reads: “Annual reviews of his long-term conditions were not completed within the timescales outlined in guidelines, and care plans were not created in a timely fashion.

“He was not added to the complex care register when he should have been.

“Smallman developed venous leg ulcers at Risley. There is no evidence that healthcare staff carried out an initial assessment of his leg ulcers or created a management plan to treat them.”

The clinical reviewer made three recommendations related to Smallman’s death.

The head of healthcare should ensure that prisoners with long-term conditions are reviewed annually in line with guidelines and have appropriate care plans created in a timely manner.

Moreover, the head of healthcare should ensure that prisoners with complex care needs are added to the complex care register in a timely manner.

The head of healthcare should also ensure that prisoners who develop leg ulcers have an initial assessment and that a management care plan for their treatment is created.