THE leader of an underfire Hampshire health trust has again refused to resign in to the wake of a fresh report condemning the organisation for failings in the reporting hundreds of deaths of vulnerable patients with mental health problems and learning difficulties.

Southern Health NHS Foundation Trust chief executive Katrina Percy was today clinging to her job despite the release of another damning report revealing "serious concerns" over the organisation despite repeated warnings from regulators following a series of scandals hitting the trust.

Her refusal comes as trust chairman Mike Petter dramatically stepped down last night ahead of today's scathing report following inspectors launching a major probe into the organisation following demands from health secretary Jeremy Hunt.

Now leading politicians and grieving families demanded more leaders must be held to account as one mother revealed she is considering taking legal action against the trust.

It comes as bosses came under further fire earlier this week after an inquest heard how a vulnerable Hampshire man discharged by Southern Health without informing his family could have been dead in his home for six months before his body was discovered.

Today's report follows inspectors from the Care Quality Commission (CQC) visiting 10 of the trust's sites across the south.

Mr Hunt ordered the probe following the release of the Mazars inquiry, which revealed that of the 10,306 deaths between April 2011 and March, 2015, 722 were categorised as unexpected and only 272 had been investigated.

The watchdog was also checking whether the trust has made improvements following another previous comprehensive inspection in October 2014.

Today's report reveals there were "deficiencies" in the new system for reporting and investigating deaths which had been introduced after the Mazars report - relating to accuracy and timescales.

But it also highlighted further safety and security risks including a low roof at an acute ward in Melbury Lodge Winchester where in February one patient had used to escape to escape while another had been injured and required hospital treatment while trying to climb.

The trust, based at Tatchbury Mount in Calmore, had also failed to provide detailed information on how it was reducing the risk from potential ligature anchor points despite previous warnings in January 2014, October 2014 and August 2015.

The report also revealed:

  •  Failure to put in place robust governance to investigate incidents, including deaths -leading to missed opportunities in learning lessons.
  •  Failure to identify, record or respond to concerns about patient safety raised by patients their carers, the CQC and staff.
  •  Failures in effective, proactive, timely management of risk - where action was taken by the Trust to mitigate risk, this was delayed and mainly done in response to concerns raised by the CQC.
  • While all clinical staff had been informed of the new system for reporting incidents and patient deaths some staff were still unsure of when and how to involve families, and it was not always clear what discussions or communications had taken place to involve them.

But inspectors did find some improvements had been made to the environment in child and adolescent mental health inpatient and forensic services.

Improvements had also been made to support patients better who were acutely unwell in community services in Southampton, and to ensuring that patients did not experience multiple transfers between teams when they needed to be admitted or discharged from hospital, the report said.

CQC inspectors are expected to return for a further probe and are working with NHS Improvement and NHS England will be monitoring the trust's progress.

Dr Paul Lelliott, CQC's deputy chief inspector of hospitals and lead for mental health, said it was "too early" to gauge the effectiveness of the new reporting process but said: "We found that in spite of the best efforts of the staff, the key risks and actions to address them were not driving the senior leadership or board agenda.

"It is clear that the trust had still missed opportunities to learn from adverse incidents and to take action to reduce the chance of similar events happening in the future.

"I am concerned that the leadership of this trust shows little evidence of being proactive in identifying risk to the people it cares for or of taking action to address that risk before concerns are raised by external bodies."

Sarah Ryan, mother of Connor Sparrowhawke, who died in the trust's care, said: "It's scandalous that the board is still in position.

"They are a mix of incompetence and arrogance. They don't learn anything. It is shameful and we are considering taking legal action."

Southampton City Council independent councillor for Redbridge ward Cllr Andrew Pope called for a vote of no confidence in the trust's board.

He said: "It appals me that they claim to learn lessons when they haven't learned anything."

Ms Percy refused to resign saying the findings send a a "clear message" that improvements must be made and said: "I want to reassure our patients, their families and carers that I am absolutely focused on addressing the CQC's concerns and supporting our staff to provide the best care possible.

"We fully accept that until we address all these concerns and our new reporting and investigating procedures introduced in December 2015 are completely effective, we will remain, rightly, under intense scrutiny. We will continue to share regular updates on progress publicly to demonstrate improvement and help re-build trust in our services.”

"As well as rightly highlighting areas of concern, I am pleased that the CQC recognises our staff's caring attitude to patients and the progress made in a number of units.

"This progress reflects the unwavering dedication of our staff, and my job is to make sure these improvements are now carried through consistently across all our services."